Is it severe asthma or asthma with severe comorbidities?
Open Access
- 1 November 2017
- journal article
- editorial
- Published by Informa UK Limited in Journal of Asthma and Allergy
- Vol. ume 10, 303-305
- https://doi.org/10.2147/jaa.s150462
Abstract
Severe asthma is defined as asthma that requires treatment with high-dose inhaled corticosteroids (ICSs) plus a second controller and/or systemic corticosteroids to prevent it from becoming uncontrolled or that remains uncontrolled despite this therapy. This definition has limitations: 1) it does not define any biological characteristic that distinguishes severe asthma from asthma in general and 2) it relies on the clinical interpretation of asthma symptoms that are not specific. Actually, wheezing, dyspnea, cough and chest tightness may be caused by the comorbidities (such as rhinosinusitis, obesity and vocal cord dysfunction [VCD]) which are associated with asthma. In clinical practice, clinicians are often prone to diagnose uncontrolled asthma and increase doses of ICSs without considering the comorbidities, resulting in poor control of symptoms. This commentary wishes the clinicians to focus on the comorbidities of asthma, particularly in patients with severe asthma, because the correct diagnosis of these comorbidities implies specific treatments that lead to a better asthma control.Keywords
This publication has 20 references indexed in Scilit:
- Innovative treatments for severe refractory asthma: how to choose the right option for the right patient?Journal of Asthma and Allergy, 2017
- Effect of Subcutaneous Dupilumab on Nasal Polyp Burden in Patients With Chronic Sinusitis and Nasal PolyposisJAMA, 2016
- Effect of bariatric surgery on asthma control, lung function and bronchial and systemic inflammation in morbidly obese subjects with asthmaThorax, 2015
- International ERS/ATS guidelines on definition, evaluation and treatment of severe asthmaEuropean Respiratory Journal, 2013
- Underdiagnosis and overdiagnosis of asthma in the morbidly obeseRespiratory Medicine, 2013
- Asthma: Vocal Cord Dysfunction (VCD) and other Dysfunctional Breathing DisordersSeminars in Respiratory and Critical Care Medicine, 2012
- Clinical and lung-function variables associated with vocal cord dysfunction.2009
- Treatment of chronic rhinosinusitis and its effects on asthmaEuropean Respiratory Journal, 2006
- Breathing retraining for dysfunctional breathing in asthma: a randomised controlled trialThorax, 2003
- "CF asthma": what is it and what do we do about it?Thorax, 2002