Severe asthma patients’ and physicians’ perspectives of disease burden: do they match?

Abstract

Significant changes have occurred in the management and treatment of asthma over recent decades. From using anticholinergic alkaloids as first-line treatment to developing adrenergic-based bronchodilators and emerging targeted biologics, advancements in asthma treatment have significantly improved asthma morbidity and mortality [1, 2]. However, the burden of severe asthma ( i.e. that requires treatment with high-dose inhaled corticosteroids and additional controller medication) remains significant [3]. Severe asthma disease is complex, and impacts patients physically and emotionally [4]. Therefore, in addition to targeted pharmacological treatments, behavioural and lifestyle modifications ( i.e. regular exercise and stress management techniques) are considered to positively impact outcomes [4].

Asthma Phenotypes in the Era of Personalized Medicine

“…Patients with similar clinical and inflammatory features can be categorized as belonging to a specific "phenotype" of asthma [4,7,61,62]. Comorbidities directly impacting asthma severity [63][64][65][66] and nutritional factors such as iron or vitamin D deficiency [67] further complicate and augment the heterogeneity of asthma's clinical presentation.…”

Asthma Phenotypes in the Era of Personalized Medicine

“…However, the heterogeneity of asthma is not limited to endotypes; clinical and inflammatory features (phenotypes) may also be variable; patients with similar clinical and inflammatory features can be classified as belonging to a specific ʺphenotypeʺ of asthma [4,7,61,62]. Comorbidities directly impacting asthma severity [63][64][65][66] or nutritional factors (e.g., iron or vitamin D deficiency) [67] further complicate and increase the heterogeneity of asthma clinical presentation. Studies refer to a "endotypic range", classified as complex type 2 high or low, with one end of the spectrum being eosinophilic and the other end being neutrophilic [68].…”