Coming up for Air to Manage Patients With Severe Asthma
Clinical Practice Guidelines
Efficacy and safety of treatment with biologicals (benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab) for severe eosinophilic asthma. A systematic review for the EAACI Guidelines – recommendations on the use of biologicals in severe asthma.
Agache I, et al. Allergy. 2020;75(5):1023-1042.
Healthcare Improvement Scotland.
Scottish Intercollegiate Guidelines Network. Evidence-based clinical guidelines, 2019.
Difficult-to-treat & severe asthma in adolescent and adult patients.
Global Initiative for Asthma, 2019.
Global Strategy for Asthma Management and Prevention.
Global Initiative for Asthma, 2020.
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
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.
Royal College of Physicians, 3 Questions for Asthma (RCP-3Qs)
A 3-question health outcome indicator developed to assess asthma morbidity. A score of 0 indicates no symptoms, while a score of 3 is indicative of daily symptoms.
Hoskins G, et al. BMC Fam Pract. 2011;12:105.
Suggested Readings
Understanding asthma phenotypes, endotypes, and mechanisms of disease.
Kuruvilla ME, et al. Clin Rev Allergy Immunol. 2019;56(2): 219-233.
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.
Co-morbidities in severe asthma: clinical impact and management.
Porsbjerg C, Menzies-Gow A. Respirology. 2017;22(4):651-661.
Revisiting type 2-high and type 2-low airway inflammation in asthma: current knowledge and therapeutic implications.
Robinson D, et al. Clin Exp Allergy. 2017;47(2):161-175.
Oral corticosteroid exposure and adverse effects in asthmatic patients.
Sullivan PW, et al. J Allergy Clin Immunol. 2018;141(1):110-116.e7.
Patient Resources
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.
European Lung Foundation
Founded by the European Respiratory Society in 2000, the European Lung Foundation (ELF) aims to bring patients and the public together with respiratory health professionals to positively impact lung health.
Global Initiative for Asthma (GINA)
Launched in 1993 as a collaborative effort from the National Heart, Lung, and Blood Institute, National Institutes of Health, USA, and the World Health Organization, GINA provides programs and strategies for asthma care that are shaped by leading asthma experts around the world.
National Asthma Council Australia
The National Asthma Council Australia aims to build the capabilities for people to breathe well and facilitates best-practice health care for people with asthma and allergies.
Relevant Resources
Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes
Evidence-Based Strategies for Improved Patient Outcomes
Proactive Diagnosis and Targeted Management
Differential Diagnosis and Comprehensive Management Strategies
Optimizing Maintenance Therapy Across Healthcare Settings
Evolving Strategies for Diagnosis and Long-Term Management
Consensus and Controversies for Responsible Opioid Prescribing
Best Practices in Combination Therapy
Evolving Approaches to Insulin Based Therapy
Improving Outcomes for Patients with COPD
New Strategies for Insulin Replacement Therapy
Clinical Updates in LDL-C Management
Improving Comprehensive Patient Care
Identifying Patients and Tailoring Therapy
Collaborative Approaches to Guideline-Concordant Patient Care
New Strategies for Individualizing Long-term Care
A Focus on Patients With Opioid-Induced Constipation
Consensus and Controversies Across the Spectrum of Patient Presentations
A New Era in Precision Medicine
Evolving Treatment Algorithms and Expert Perspectives on Biosimilars
Evolving Best Practices to Optimize Outcomes
Consensus and Controversies on the Road to Precision Medicine
Ongoing Monitoring, Pulmonary Rehabilitation, and Individualized Care
The PCP’s Role in Timely Recognition and Referral
Debates and Discussions About Personalizing Patient Management
Differential Diagnosis, Multidisciplinary Management, and Patient Engagement
Key Issues Impacting OB/GYN Practice
From Guideline Recommendations to Daily Clinical Decision-Making
Improving Patient Outcomes Through Shared Clinical Decision Making
Volume II: Expanding Evidence for the Role of Rapid ART Initiation in HIV Practice
Improving Patient Outcomes Through Shared Clinical Decision Making
Digging Deep on Shared Decision-Making
Mechanistic Insights and Evolving Treatment Options
Clinical Resource Center
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis
The Clinical and Utilization Benefits of Exacerbation Prevention
Mechanistic Insights and Emerging Treatment Options
A PrEP Primer
A Foundation for Managed Care
A Focus on Exacerbation Prevention
Cardiovascular and Renal Outcomes With SGLT2 Inhibitors
Best Practices for Primary Care
New Paths to Chronic Pain Management
What the Pharmacist Needs to Know about PrEP
Unlocking Novel Paths to Patient Care
Evolving Best Practices for Patient Management
The Increasing Role of JAK Inhibitors
Shared Decision-making in the Era of Biologics
New Pathways to Patient Management
From Comprehensive Patient Evaluations to Individualized Evidence-based Care
Preventing COPD Exacerbations to Improve Outcomes
A Whole Patient Case Series
Debates and Discussions about Monoclonal Antibody Therapies
An Update on Monoclonal Antibody Therapies
New Avenues to the Management of Severe Asthma
Getting on the Fast Track to Identify AxSpA
Establishing Clinical Readiness Through Mentored Learning
Evolving Best Practices for Pediatric Patients
Interdisciplinary Strategies for Adult and Pediatric Patients
Interdisciplinary Management of Eosinophilic Esophagitis and Hereditary Angioedema
Reducing LDL-C and a Lifetime of Cardiovascular Risk
Updates, Clinical Scenarios, and Future Directions
A Multidisciplinary Look at Early Diagnosis and Management
Finding the Path in Chronic Rhinosinusitis with Nasal Polyps
Recent Developments in Anti-SARS-CoV-2 Monoclonal Antibodies for Treatment
Best Practices for Diagnosis and Management
An Update on Best Practices
New Avenues to Pre-Exposure Prophylaxis
New Pathways to Optimize Patient Outcomes
Are You Aware of New Blood-Based Multi-Cancer Screening Tools
Debates and Discussions About New Upstream Treatment Avenues
A Case-Based Update on Pediatric Patients
A Look at the Changing HIV Playing Field
A “How To” Series Spanning Policy to Practice
Test Your Mastery!
Building Bridges to Reach People who Inject Drugs with the Goal of Employing PrEP for HIV Prevention
Strengthening Your Knowledge of Blood-Based Screening Tools
Bringing HIV Prevention to a New Level
Optimizing HIV Prevention in Primary Care
What You Need to Know About New Blood-Based Screening Tools
Monoclonal Antibodies for the Prevention and Treatment of COVID-19
Exploring New Treatment Avenues in Nonadvanced Systemic Mastocytosis
Practical Updates on the 2023 GOLD Guidelines
A Phone-a-Friend CME Series – Volume 2
Incorporating New Data and Updated Guidelines Into Daily Practice
Focus on Psoriasis
Capitalizing on BCMA-Directed Therapies
