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

Abstract

As seen in this CME online activity (available at http://courses.elseviercme.com/708e), the various forms of asthma affect > 300 million people globally and > 25 million people in the United States. Asthma-related symptoms and exacerbations result in nearly 2 million ED visits annually, and many of these visits lead to inpatient hospital stays. There is an urgent need to improve the care of the estimated 5%to 15%of patients who have severe asthma. Importantly, studies have shown that severe asthma accounts for an outsized proportion of the disease-related morbidity, mortality, and health-care costs. Examining cohorts from several large patient networks that were created to better understand clinical presentations, biopsychosocial consequences, and long-term outcomes of severe asthma revealed substantial disease burden, significant gaps in longitudinal care, and a clear need for additional treatment options. This CME-accredited Clinical Issues program is intended for allergists/clinical immunologists, pulmonologists, and other health-care providers involved in the management of patients with severe asthma. During the activity, a panel of expert faculty will discuss and debate a series of topics related to the evaluation and long-term treatment of various severe asthma phenotypes. Activity topics include education regarding (1) The classification of severe asthma to differentially diagnose patients with disease that is uncontrolled despite relatively intensive therapy; (2) potential phenotypes and available biomarkers, including strengths, limitations, and how to translate results into the selection of therapies; and (3) the different mechanisms of action, efficacy, and safety of biologic therapies that target the pathophysiology of severe asthma. The goal is to provide clinician learners with the latest evidence and a fresh perspective on evolving management paradigms for severe asthma.