What is Severe Asthma?

Severe asthma accounts for approximately 5 to 10% of those with asthma and refers to individuals who despite best efforts to manage, continue to have severe symptoms and asthma that remains uncontrolled.

Those with severe asthma need a greater number of medications and often higher doses of medication. There are many new therapies emerging, giving more hope to those living with severe asthma.

How is severe asthma diagnosed?

In addition to the steps taken to diagnose asthma, e.g., medical tests, physical examination, and breathing tests, additional tests like blood tests, may also be ordered. Those suspected of having severe asthma should be referred to a specialist to confirm their diagnosis and to assist in the right kind of management.

What is e-asthma?

e-asthma is a type of severe asthma associated with high levels of a white blood cell call eosinophils. These high levels of eosinophils can result in inflammation in the airways which in turn cause asthma symptoms.

How is Severe Asthma Treated and Managed?

In addition to the treatments used for those with mild-to-moderate asthma, people with severe asthma may be on additional controller therapies (medications), often called ‘add-on’ therapies. These add-on therapies include medications called leukotriene receptor agonists – LTRAs, and biologics, and might also include oral corticosteroids and macrolides.

Additional therapies for severe asthma

Leukotriene receptor agonists (LTRA)

• LTRAs are daily pills that help control inflammation in the airways.
• Examples include Singulair®
   

Biologics 

• Biologics are a type of asthma medication designed to prevent certain parts of the immune system from triggering inflammation and causing asthma symptoms.
• Examples include Xolair®, Cinquair™, Fasenra®, Nucala™, Dupixent®, Tezspire™

Oral corticosteroids (OCS)

• OCSs are the strongest anti-inflammatory asthma medication. They must be taken only as prescribed because of the many side effects they can cause when taken for prolonged periods.
• Examples include prednisone, methylprednisone, dexamethasone
   

Macrolides

• Macrolides are a type of antibiotic that have both an anti-microbial as well as an anti-inflammatory effect.
• Examples include azithromycin, clarithromycin

As with those with mild-to-moderate asthma, an asthma action plan should be given to those with severe asthma than can follow one.

What Resources are Available for Severe Asthma?

Give Your Lungs a Voice

Severe Asthma Charter

Asthma Action Plan