Adult Severe Asthma

Dixey, P; Abubakar-Waziri, H; Raby, K; Lakhdar, R; Kermani, N; Mumby, S; Owen, E; Adcock, I; Bhavsar, P; Chung, KF

doi:10.1016/B978-0-08-102723-3.00223-7

Adult Severe Asthma

Lookup NU author(s): Dr Ramzi Lakhdar ORCiD

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Abstract

© 2022 Elsevier Ltd. All rights reserved. Severe asthma is “asthma which requires treatment with high dose inhaled corticosteroids plus a second controller (and/or systemic corticosteroids) to prevent it from becoming ‘uncontrolled’ or which remains ‘uncontrolled’ despite this therapy.” Asthma diagnosis and its severity requires systematic assessment of the underlying causative factors including suboptimal adherence to treatments and inhaler technique, comorbidities, risk factors and triggers. This is followed by asthma phenotyping using blood eosinophil counts and the fractional level of nitric oxide (FeNO) in exhaled breath to enable treatment with targeted anti-Type 2 inflammation-directed antibodies. Deeper molecular phenotyping of type 2 and non-type 2 airway inflammatory processes and elucidation of better selective biomarkers will lead to further precision medicine approaches linking mechanisms to treatable traits and biomarkers.