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CME Snapshot™

Advancing the Care of Severe Asthma

Differential Diagnosis, Multidisciplinary Management, and Patient Engagement

Clinical Practice Guidelines

Global Strategy for Asthma Management and Prevention

Global Initiative for Asthma (GINA) 2018.

International ERS/ATS Guidelines on Definition, Evaluation and Treatment of Severe Asthma

Chung KF, et al. Eur Respir J. 2014;43(2):343-373.

National Asthma Education and Prevention Program

Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma – Full Report 2007.

Patient Resources

Asthma and Allergy Foundation of America (AAFA)

AAFA is dedicated to improving the quality of life for people with asthma and allergic diseases through education, advocacy, and research.

American Academy of Allergy, Asthma, and Immunology (AAAAI)

The AAAAI is dedicated to the advancement of the knowledge and practice of allergy, asthma, and immunology for optimal patient care.

American College of Allergy, Asthma Immunology (ACAAI)

The ACAAI fosters a culture of collaboration and congeniality in which members work toward the common goals of patient care, education, advocacy, and research.

American Lung Association

The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through education, advocacy, and research.

Asthma Action Plan

This printable reference tool is designed to help patients know when to use their different asthma medications and when to call their health care providers.

Clinical Assessment Tools

Asthma Control Test (ACT)

This 5-question test evaluates asthma control over the past 4 weeks on a 5-point Likert scale. A score of <20 on the ACT suggests asthma that is uncontrolled. Nathan RA, et al. J Allergy Clin Immunol. 2004;113(1):59-65.

Asthma Control Questionnaire (ACQ)

This 7-question assessment tool measures asthma control over the past 7 days. Six questions are self-administered by the patient, and 1 question requires a clinician’s input. Scores range from 1 (totally controlled) to 6 (severely uncontrolled). Juniper EF, et al. Eur Respir J. 1999;14(4):902-907.

Asthma Therapy Assessment Questionnaire (ATAQ)

This 4-question test assesses asthma control over the past 4 weeks. Each question has a possible score of 0 or 1; if the sum of the 4 question scores is >1, the patient’s asthma may be uncontrolled. Vollmer WM, et al. Am J Respir Crit Care Med. 1999;160(5 Pt 1):1647-1652.

Asthma APGAR Tool

This 6-question assessment tool evaluates asthma control over the past 2 weeks. Any combination with a total score >2 is considered not well controlled. Yawn BP, et al. J Asthma Allergy. 2008;1:1-10.

Suggested Readings

Efficacy and safety of benralizumab for patients with severe asthma uncontrolled with high-dosage inhaled corticosteroids and long-acting β2-agonists (SIROCCO): a randomised, multicentre, placebo-controlled phase 3 trial.

Bleecker ER, et al. Lancet. 2016;388(10056):2115-2127.

Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials.

Castro M, et al. Lancet Respir Med. 2015;3(5):355-366.

Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma.

Castro M, et al. N Engl J Med. 2018;378(26):2486-2496.

Tezepelumab in adults with uncontrolled asthma.

Corren J, et al. N Engl J Med. 2017;377(10):936-946.

A review of anti-IgE monoclonal antibody (omalizumab) as add on therapy for severe allergic (IgE-mediated) asthma.

D’Amato G, et al. Ther Clin Risk Manag. 2007;3(4):613-619.

Inflammatory and comorbid features of patients with severe asthma and frequent exacerbations.

Denlinger LC, et al. Am J Respir Crit Care Med. 2017;195(3):302-313.

Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial.

FitzGerald JM, et al. Lancet. 2016;388(10056):2128-2141.

Severe and difficult-to-treat asthma in adults.

Israel E, Reddel HK. N Engl J Med. 2017;377(10):965-976.

Adult asthma biomarkers.

Kim MA, et al. Curr Opin Allergy Clin Immunol. 2014;14(1):49-54.

Mepolizumab treatment in patients with severe eosinophilic asthma.

Ortega HG, et al. N Engl J Med. 2014;371(13):1198-1207.

Allergen immunotherapy in asthma; what is new?

Passalacqua G, et al. Asthma Res Pract. 2015;1:6.

Co-morbidities in severe asthma: clinical impact and management.

Porsbjerg C, Menzies-Gow A. Respirology. 2017;22(4):651-661.

Use of asthma APGAR tools in primary care practices: a cluster-randomized controlled trial.

Yawn BP, et al. Ann Fam Med. 2018;16(2):100-110.

Activity
Ask the Experts: Identifying the Needs of Patients with Severe Asthma

Module 1

Activity
Identifying Cases of Severe Asthma

Module 2

Activity
Patient Engagement Via Open Communication

Module 3

Activity
Differential Diagnosis Multidisciplinary Management, and Patient Engagement

Module 4

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