Difficult-to-treat asthma and severe asthma

Abstract:

The distinction between difficult-to-treat asthma and severe asthma is particularly significant because they represent different groups of patients. It is estimated that there are 17% of patients with difficult-to-treat asthma and 3.7% of patients with severe asthma. For people with difficult-to-treat asthma, attempts can be made to improve asthma control by optimizing asthma treatment according to patient preferences, raising adherence, assessing the patient’s ability to inhale the drug, and issuing an Asthma Action Plan. Patients lack education and should be referred for pulmonary rehabilitation. People with severe asthma should be referred to centres for severe asthma, where phenotyping will be performed. Patients with severe asthma and type 2 inflammation have an indication for the addition of biologic therapy (anti IgE, anti IL-5 or anti IL-4/IL-13). The selection of biological drugs is based on a careful history, including comorbidities, and detailed examinations, followed by a multidisciplinary decision based on the individual patient level analysis. The goal of treating patients with severe asthma is to alleviate symptoms as much as possible, and thus the social and financial consequences for the person and society.

Key words:
anti-asthmatic drugs; asthma; biological therapies; differencial diagnosis