Diagnosis and Treatment of Severe Asthma

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 15 February 2025 | Viewed by 1739

Special Issue Editor


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Guest Editor
Department of Pediatric Pulmonology, New York University School of Medicine, New York, NY, USA
Interests: respiratory; asthma; cough; pediatric pulmonology

Special Issue Information

Dear Colleagues,

It is a pleasure to invite you to contribute to this Special Issue. 

The ERS/ATS taskforce defines severe uncontrolled asthma (SUA) as, “asthma which requires treatment with high dose inhaled corticosteroids (ICS) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming ‘uncontrolled’ or which remains uncontrolled despite this therapy”. 

It is important to state that severe uncontrolled asthma shall be diagnosed only after considerable effort is made to address potential complicating factors, primarily medication adherence, as well as medication administration techniques, allergen exposure, smoking, and others.  When this diagnostic criteria is applied, approximately 5% of patients with asthma fit the diagnosis of SUA.  Considering the fact that asthma affects millions of patients in different countries, it is apparent that the burden of SUA is high. The obvious link between SUA in children and the development of COPD later in life makes it imperative that the SUA is managed appropriately and full controlled is achieved.

Given the extremely high interest in this topic from both researchers and medical practitioners, Medicina is launching a Special Issue entitled "Diagnosis and Treatment of Severe Asthma".  The aim of this Special Issue is to explore the issues related to the pathogenesis of SUA, with special attention paid to its phenotypes and the role of complicating factors which affect its management.

We are pleased to invite submissions of original articles concerning basic and clinical research in severe asthma in children and adults, as well as interesting case reports, perspectives, reviews, systematic reviews, and meta-analyses focusing on topics including, but not limited to, the following:

  • Phenotypes and endotypes of SUA, with special attention paid to airway sampling;
  • Airway remodeling and its potential management;
  • Eosinophilic and reflux esophagitis as an important example of comorbidity for SUA;
  • Role of obesity in SUA;
  • Strategies for choosing biological medications for SUA.

Prof. Dr. Mikhail Kazachkov
Guest Editor

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Keywords

  • severe asthma
  • severe pediatric asthma
  • asthma phenotypes
  • asthma comorbidities
  • esophagitis and asthma
  • biological medications for asthma

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Published Papers (1 paper)

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Review

20 pages, 385 KiB  
Review
Evaluating Severe Therapy-Resistant Asthma in Children: Diagnostic and Therapeutic Strategies
by Andrew Bush
Medicina 2024, 60(11), 1799; https://doi.org/10.3390/medicina60111799 - 2 Nov 2024
Cited by 1 | Viewed by 1432
Abstract
Introduction: Worldwide, asthma is the most common non-communicable respiratory disease and causes considerable morbidity and mortality. Most people with asthma can be treated effectively with low-dose medications if these are taken correctly and regularly. Around 10% of people with asthma have an [...] Read more.
Introduction: Worldwide, asthma is the most common non-communicable respiratory disease and causes considerable morbidity and mortality. Most people with asthma can be treated effectively with low-dose medications if these are taken correctly and regularly. Around 10% of people with asthma have an uncontrolled form of the disease or can only achieve control with high-dose medications, incurring disproportionately high health care costs. Areas Covered: PubMed and personal archives were searched for relevant articles on the definition, management and pharmacotherapy of severe asthma. The WHO classification of severe asthma and the treatment levels encompassed in the definition are discussed. Most children and young people referred for consideration of ‘beyond-guidelines therapy’ can in fact be managed on standard treatment after a multi-disciplinary team assessment focusing on ensuring correct basic management, and these steps are described in detail. Options for those with true therapy-resistant asthma are described. These include monoclonal antibodies, most of which target type 2 inflammation. Expert Opinion: Getting the basics right is still the most important aspect of asthma care. For those with severe, therapy-resistant asthma, an increasing number of life-transforming monoclonals have been developed, but there is still little understanding of, and a paucity of treatment options for, non-eosinophilic asthma. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Severe Asthma)
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