
Clinical Issues in Severe Asthma
Consensus and Controversies on the Road to Precision Medicine
Meeting Slides

Clinical Practice Guidelines
Global Strategy for Asthma Management and Prevention
Global Initiative for Asthma (GINA) 2017.
International ERS/ATS Guidelines on Definition, Evaluation and Treatment of Severe Asthma
Chung KF, et al. Eur Respir J. 2014;43(2):343-373.
An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications.
Dweik RA, et al. Am J Respir Crit Care Med. 2011;184(5):602-615.
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 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.
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.
Suggested Readings
Efficacy and safety of tralokinumab in patients with severe uncontrolled asthma: a randomised,double-blind, placebo-controlled, phase 2b trial.
Brightling CE, et al. Lancet Respir Med. 2015;3(9):692-701.
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.
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.
Biologics in asthma—the next step towards personalized treatment.
Darveaux J, Busse WW. J Allergy Clin Immunol Pract. 2015;3(2):152-161.
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.
Cluster analysis and clinical asthma phenotypes
Haldar P, et al. Am J Respir Crit Care Med. 2008;178(3):218-224.
Targeting key proximal drivers of type 2 inflammation in disease.
Gandhi NA, et al. Nat Rev Drug Discov. 2016;15(1):35-50
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.
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.
Severe eosinophilic asthma treated with mepolizumab stratified by baseline eosinophil thresholds: a secondary analysis of the DREAM and MENSA studies.
Ortega HG, et al. Lancet Respir Med. 2016;4(7):549-556
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.
Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial.
Wenzel S, et al. Lancet. 2016;388(10039):31-44
Identifying Patients and Coordinating Multidisciplinary Care
Consensus and Controversies on the Road to Precision Medicine
Relevant Resources
Differential Diagnosis and Comprehensive Management Strategies
Optimizing Maintenance Therapy Across Healthcare Settings
Improving Outcomes for Patients with COPD
Collaborative Approaches to Guideline-Concordant Patient Care
New Strategies for Individualizing Long-term Care
A New Era in Precision Medicine
Evolving Best Practices to Optimize Outcomes
Ongoing Monitoring, Pulmonary Rehabilitation, and Individualized Care
Debates and Discussions About Personalizing Patient Management
Differential Diagnosis, Multidisciplinary Management, and Patient Engagement
From Guideline Recommendations to Daily Clinical Decision-Making
Improving Patient Outcomes Through Shared Clinical Decision Making
Improving Patient Outcomes Through Shared Clinical Decision Making
Digging Deep on Shared Decision-Making
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 Focus on Exacerbation Prevention
Best Practices for Primary Care
Evolving Best Practices for Patient Management
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
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
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
New Avenues to Pre-Exposure Prophylaxis
New Pathways to Optimize Patient Outcomes
Debates and Discussions About New Upstream Treatment Avenues
A Case-Based Update on Pediatric Patients