ABSTRACT

Severe asthma is a complex pathology with heterogeneous clinical features and underlying mechanisms (endotypes), being represented by a small group of patients, who present frequent exacerbations and obstruction of the airways, being refractory to standard treatment, requiring high doses of inhaled corticosteroids in combination with a second controller. Some even without presenting improvement despite this therapy. These are the severe uncontrolled asthmatics. New strategies have been achieved to control severe asthma, considering the components of the disease and the specific mechanisms of each phenotype; an important part has been the use of non-invasive biomarkers such as total serum IgE, the eosinophil count in peripheral blood and in sputum, and the determination of fractional exhaled nitric oxide (FeNO) for both, diagnosis, and follow-up. The development of biological therapies targeting specific inflammatory pathways in asthma have been a breakthrough in recent years, which are administered in selected patients to reduce exacerbations and improve disease control. In this manuscript we describe the perspectives of a group of experts in pulmonology and allergology on severe asthma.

KEYWORDS

Severe asthma, respiratory function tests, biomarkers, biological treatment.

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