Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jul-Aug;5(4):877-886.
doi: 10.1016/j.jaip.2017.04.027.

Management of Severe Asthma before Referral to the Severe Asthma Specialist

Tara F Carr  1 , Monica Kraft  2
Affiliations
Review

Management of Severe Asthma before Referral to the Severe Asthma Specialist

Tara F Carr et al. J Allergy Clin Immunol Pract. 2017 Jul-Aug.

Abstract

Severe asthma is associated with significant morbidity and can be challenging to assess and control, due to heterogeneity of disease, complexity of diagnosis, and impact of comorbidities. A structured approach to the assessment and management of severe asthma may be helpful to the practicing clinician. First, it is important to confirm a diagnosis of asthma. In patients who are either not responding to treatment, or who require high doses of medication to control symptoms, it is highly possible that disease mimickers or comorbidities are present and can inhibit therapeutic responsiveness. The assessment and management of common comorbidities of asthma may dramatically impact disease control and thus medication requirement. Determining medication adherence and optimizing drug dose and delivery may separate out truly severe asthmatics from those not using medications regularly or properly. Next, although true personalized medicine for severe asthma is not yet realized, for those individuals with severe asthma, phenotypic characteristics of each patient may guide which therapeutic options may be most effective for that patient. Finally, evaluation and management of severe asthma at a referral center can add additional phenotyping, therapeutic, and diagnostic strategies.

Keywords: Adherence; Biologic therapy; Comorbidities; Inhaled corticosteroid; Phenotype; Severe asthma.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: none

Figures

Figure 1
Figure 1
Approach to assessing and managing severe asthma in the clinical setting.
See this image and copyright information in PMC

References

    1. Carr TF, Bleecker E. Asthma heterogeneity and severity. World Allergy Organ J. 2016;9(1):41. - PMC - PubMed
    1. Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma. 2016.
    1. Akinbami LJ, Moorman JE, Bailey C, et al. Trends in asthma prevalence, health care use, and mortality in the United States, 2001–2010. NCHS Data Brief. 2012;94:1–8. - PubMed
    1. [Accessed February 19, 2016];Asthma’s Impact on the Nation Data from the CDC National Asthma Control Program. http://www.cdc.gov/asthma/impacts_nation/asthmafactsheet.pdf.
    1. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. Journal of Allergy and Clinical Immunology. 2007;120(5, Supplement 1):S94–S138. - PubMed

Substances