Traditional Therapies for Severe Asthma

Eileen Wang; Flavia C L Hoyte

doi:10.1016/j.iac.2016.03.013

Traditional Therapies for Severe Asthma

Immunol Allergy Clin North Am. 2016 Aug;36(3):581-608. doi: 10.1016/j.iac.2016.03.013.

Authors

Eileen Wang¹, Flavia C L Hoyte²

Affiliations

¹ Division of Allergy and Clinical Immunology, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Colorado Hospital, 1635 Aurora Court, Aurora, CO 80045, USA.
² Division of Allergy and Clinical Immunology, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Colorado Hospital, 1635 Aurora Court, Aurora, CO 80045, USA. Electronic address: hoytef@njhealth.org.

PMID: 27401628
DOI: 10.1016/j.iac.2016.03.013

Abstract

Severe asthma is a complex and heterogeneous disease. The European Respiratory Society and American Thoracic Society guidelines define severe asthma for patients 6 years or older as "asthma which requires treatment with high-dose inhaled corticosteroids…plus a second controller or systemic corticosteroids to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy." This article reviews available traditional therapies, data behind their uses in severe asthma, and varying recommendations. As various asthma endotypes and phenotypes are better understood and characterized, targeted therapies should help improve disease outcomes, efficacy, and cost-effectiveness.

Keywords: Add-on therapies; Controller therapies; European Respiratory Society and American Thoracic Society (ERS/ATS); Expert Panel Report 3 (EPR-3); Global Initiative for Asthma (GINA); Guidelines; Nonbiologic therapies; Severe asthma.

Publication types

Review

MeSH terms

Adrenal Cortex Hormones / administration & dosage
Adrenal Cortex Hormones / adverse effects
Adrenal Cortex Hormones / therapeutic use
Adrenergic beta-Agonists / administration & dosage
Adrenergic beta-Agonists / adverse effects
Adrenergic beta-Agonists / therapeutic use
Age Factors
Anti-Asthmatic Agents / administration & dosage
Anti-Asthmatic Agents / adverse effects
Anti-Asthmatic Agents / therapeutic use
Asthma / diagnosis
Asthma / immunology
Asthma / therapy*
Combined Modality Therapy
Desensitization, Immunologic
Disease Management
Drug Therapy, Combination
Female
Humans
Male
Muscarinic Antagonists / administration & dosage
Muscarinic Antagonists / adverse effects
Muscarinic Antagonists / therapeutic use
Omalizumab / administration & dosage
Omalizumab / adverse effects
Omalizumab / therapeutic use
Practice Guidelines as Topic
Pregnancy
Severity of Illness Index

Substances

Adrenal Cortex Hormones
Adrenergic beta-Agonists
Anti-Asthmatic Agents
Muscarinic Antagonists
Omalizumab