Clinical features and associated factors with severe asthma in Salvador, Brazil

Obesity, Inflammation, and Severe Asthma: an Update

“…The links between obesity and asthma are complex and perhaps best considered to be bi-directional [24]. Poorer asthma control and quality of life, increased corticosteroid use, and emergency service attendance in this patient cohort have been demonstrated in numerous studies worldwide [7,19,20,26,27,31].…”

“…The association between obesity and asthma has historically been considered uni-directional; people with severe asthma become less active and deconditioned, weight increases, and increased usage of oral corticosteroids (OCS) further aggravates the weight gain cycle. Whilst this cohort of patients undeniably exists, increasing evidence supports the causal link between raised BMI, asthma, and poor asthma control (Table 1 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]). Cluster cohort studies show a now widely recognised female-predominant obese severe asthma phenotype [38][39][40], particularly affecting peri-and post-menopausal women [37].…”

Severe asthma in Brazil: from diagnosis to treatment

“…(9) Os corticoides inalatórios associados aos broncodilatadores β 2 -agonistas de longa duração habitualmente compõe o esquema terapêutico principal para asmáticos graves, enquanto a adição de outros fármacos ou terapias não farmacológicas deve ser guiada pelas características fenotípicas de cada indivíduo. (10) Para exemplificar, alguns fármacos imunobiológicos são indicados para asma grave eosinofílica, enquanto o anticorpo anti-IgE está indicado para os indivíduos atópicos com IgE elevada; a azitromicina, apesar da menor robustez das evidências, tem sido indicada para prevenir exacerbações da asma; e a termoplastia brônquica é o último recurso para os pacientes que não respondem ou não preenchem critérios para medicamentos imunobiológicos.…”

“… 9 Inhaled corticosteroids associated with long-acting β 2 agonist bronchodilators are usually the main therapeutic regimen for patients with severe asthma, whereas the addition of other drugs or non-pharmacological therapies should be guided by the phenotypic characteristics of each patient. 10 As an example, some biologic drugs are indicated for severe eosinophilic asthma, whereas the anti-IgE antibody is indicated for atopic individuals with high IgE; azithromycin, despite less robust evidence, has been indicated to prevent asthma exacerbations; and bronchial thermoplasty is the last resort for patients who do not respond to or do not meet criteria for biologic drugs.…”