David M Lang1. 1. Respiratory Institute, Department of Allergy and Clinical Immunology, Cleveland Clinic, Cleveland, Ohio, USA.
Abstract
BACKGROUND: Patients with severe persistent asthma comprise only 5-10 % of the total asthma population, but account for a large proportion of asthma morbidity and health care expenditures. Among patients with severe asthma, higher costs can be expected in association with not well or poorly controlled asthma. OBJECTIVE: To summarize the evidence concerning the epidemiology, burden, and heterogeneity of severe asthma. METHODS: A literature search was performed to identify citations using the terms "severe asthma" and "epidemiology", "asthma control", "asthma" and "heterogeneity". RESULTS: Successful management of patients with severe asthma continues to be a major unmet need. One of the barriers to successful management is the heterogeneity of asthma. Asthma is not one disease; it is a disorder that can be subdivided into a number of different phenotypes and endotypes. A revised paradigm for asthma management, that entails categorization of asthma patients via use of "biomarkers", and prescribing targeted therapy, will supplant what has been a "one size fits all" approach to asthma management. CONCLUSION: The novel approach to asthma management, in which therapy will be more mechanism-specific based on phenotype/endotype, offers the potential for improved asthma care outcomes - particularly for patients with severe persistent asthma who are not well or poorly controlled.
BACKGROUND:Patients with severe persistent asthma comprise only 5-10 % of the total asthma population, but account for a large proportion of asthma morbidity and health care expenditures. Among patients with severe asthma, higher costs can be expected in association with not well or poorly controlled asthma. OBJECTIVE: To summarize the evidence concerning the epidemiology, burden, and heterogeneity of severe asthma. METHODS: A literature search was performed to identify citations using the terms "severe asthma" and "epidemiology", "asthma control", "asthma" and "heterogeneity". RESULTS: Successful management of patients with severe asthma continues to be a major unmet need. One of the barriers to successful management is the heterogeneity of asthma. Asthma is not one disease; it is a disorder that can be subdivided into a number of different phenotypes and endotypes. A revised paradigm for asthma management, that entails categorization of asthmapatients via use of "biomarkers", and prescribing targeted therapy, will supplant what has been a "one size fits all" approach to asthma management. CONCLUSION: The novel approach to asthma management, in which therapy will be more mechanism-specific based on phenotype/endotype, offers the potential for improved asthma care outcomes - particularly for patients with severe persistent asthma who are not well or poorly controlled.
Authors: Min Hye Kim; Sang Heon Kim; So Young Park; Ga Young Ban; Joo Hee Kim; Jae Woo Jung; Ji Yong Moon; Woo Jung Song; Hyouk Soo Kwon; Jae Woo Kwon; Jae Hyun Lee; Hye Ryun Kang; Jong Sook Park; Tae Bum Kim; Heung Woo Park; Kwang Ha Yoo; Yeon Mok Oh; Young Il Koh; An Soo Jang; Byung Jae Lee; Young Joo Cho; Sang Heon Cho; Hae Sim Park; Choon Sik Park; Ho Joo Yoon; You Sook Cho Journal: Allergy Asthma Immunol Res Date: 2019-01 Impact factor: 5.764
Authors: Paula Ribó; Jesús Molina; Myriam Calle; Luis Maiz; Carlos Campo; Paula Rytilä; Vicente Plaza; Antonio Valero Journal: NPJ Prim Care Respir Med Date: 2020-07-31 Impact factor: 2.871