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Point-of-Careā„¢ 201

Finding the Right Path in Severe Asthma

Mechanistic Insights and Emerging Treatment Options

Clinical Practice Guidelines

Difficult-to-treat & severe asthma in adolescent and adult patients.

Global Initiative for Asthma, 2019.

Management of severe asthma: a European Respiratory Society/American Thoracic Society guideline.

Holguin F, et al. Eur Respir J. 2020;55(1). pii: 1900588.

Clinical Practice Tools

Centers for Disease Control and Prevention (CDC) Asthma Action Plans

These tools for asthma control were created following the evidence-based guidance published by the National Institutes of Health.

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.

Shared Decision-Making Tool

The CHEST Foundation, Allergy and Asthma Network, and ACAAI have developed a shared-decision making tool for adults with severe asthma so that they may work collaboratively with clinicians to improve self-management skills, choose the best treatment plan, and increase adherence.

Suggested Readings

Understanding asthma phenotypes, endotypes, and mechanisms of disease.

Kuruvilla ME, et al. Clin Rev Allergy Immunol. 2019;56(2): 219-233.

Predictive biomarkers for asthma therapy.

Medrek SK, et al. Curr Allergy Asthma Rep. 2017;17(10):69.

Tezepelumab: a novel biological therapy for the treatment of severe uncontrolled asthma.

Marone G, et al. Expert Opin Investig Drugs. 2019;28(11):931-940.

Tezepelumab in adults with uncontrolled asthma.

Corren J, et al. N Engl J Med. 2017;377(10):936-946. (Erratum: N Engl J Med. 2019;380(21):2082.)

Mepolizumab treatment in patients with severe eosinophilic asthma.

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

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.

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.

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.

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

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

The effect of treatment with omalizumab, an anti-IgE antibody, on asthma exacerbations and emergency medical visits in patients with severe persistent asthma.

Bousquet J, et al. Allergy. 2005;60(3):302-308.

Biologic therapies for treatment of asthma associated with type 2 inflammation: effectiveness, value, and value-based price: final evidence report.

Institute for Clinical and Economic Review, 2018.

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

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

Oral corticosteroid exposure and adverse effects in asthmatic patients.

Sullivan PW, et al. J Allergy Clin Immunol. 2018;141(1):110-116.e7.

Doctor-patient communication: a review.

Ha JF, Longnecker N. Ochsner J. 2010; 10(1): 38-43.

Patient Advocacy Organizations and 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 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.

American Thoracic Society (ATS)

The mission of the ATS is to improve health worldwide by advancing research, clinical care, and public health in respiratory disease, critical illness, and sleep disorders.

Chest Foundation

The CHEST Foundation creates trusted patient education resources and disease awareness campaigns that empower patients to engage in better managing their health.

Interactive Presentation

Management of severe asthma in the pediatric patient.

Presented by Drs. Linda Rogers and Jonathan Corren.


Management of severe asthma in the gravid patient.

Presented by Drs. Linda Rogers and Jonathan Corren.


Severe asthma and comorbid disease: the role of biologic therapies.

Presented by Drs. Linda Rogers and Jonathan Corren.


Activity
Finding the Right Path in Severe Asthma

Mechanistic Insights and Emerging Treatment Options

Relevant Resources

Chronic Obstructive Pulmonary Disease, Asthma, or Both

Differential Diagnosis and Comprehensive Management Strategies

Improving Outcomes in Chronic Obstructive Pulmonary Disease

Optimizing Maintenance Therapy Across Healthcare Settings

Clearing the Air

Improving Outcomes for Patients with COPD

Comprehensive Management of Chronic Obstructive Pulmonary Disease

Collaborative Approaches to Guideline-Concordant Patient Care

Clinical Updates in the Management of Severe Asthma

New Strategies for Individualizing Long-term Care

Improving Outcomes in Severe Asthma

A New Era in Precision Medicine

Caring for Patients with Severe Asthma

Evolving Best Practices to Optimize Outcomes

Clinical Issues in Severe Asthma

Consensus and Controversies on the Road to Precision Medicine

Breathing Life Into COPD Management

Ongoing Monitoring, Pulmonary Rehabilitation, and Individualized Care

Clinical Issues in Severe Asthma

Debates and Discussions About Personalizing Patient Management

Advancing the Care of Severe Asthma

Differential Diagnosis, Multidisciplinary Management, and Patient Engagement

Focusing on Patients With Severe Asthma

From Guideline Recommendations to Daily Clinical Decision-Making

Clearing the Air in Severe Asthma Management

Improving Patient Outcomes Through Shared Clinical Decision Making

Clearing the Air in Severe Asthma Management

Improving Patient Outcomes Through Shared Clinical Decision Making

Marching Forward in Atopic Dermatitis

Digging Deep on Shared Decision-Making

Airing It Out

A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis

COPD in Managed Care

The Clinical and Utilization Benefits of Exacerbation Prevention

COPD Cases and Conversations

A Focus on Exacerbation Prevention