Severe Asthma: Multidisciplinary Assessment and Management Including Biologic Therapy

Richard Barbers, MD, FCCP; Monica Kraft, MD, FCCP; Louis J. Papa, MD


July 26, 2023

In Collaboration With

Distinguishing severe asthma from asthma that is difficult to control can present a clinical challenge, especially in primary care settings. Patients with severe asthma often benefit from multidisciplinary assessment and management.

In this panel ReCAP, experts in allergy, pulmonary disease, and primary care discuss the difference between severe and difficult-to-control asthma and the clinical importance of this distinction. They then outline optimal management of severe asthma using conventional therapies and the six biologics that are now available.

According to the panelists, patients with asthma that is difficult to control may have comorbidities that have not been addressed and may contribute to their respiratory symptoms. In patients with severe asthma, comorbidities have typically been addressed and patients are adherent to prescribed therapies; their disease worsens if therapy is stepped down. This definition follows the 2022 Global Initiative for Asthma guidelines.

The experts discuss how tests administered in primary care and specialty settings can distinguish between eosinophilic and non-eosinophilic phenotypes. In patients who continue to have symptoms despite maximized conventional therapies, biologics targeting specific inflammatory pathways may come into play.


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