Page 67 - Škrgat, Sabina, ed. 2023. Severe Asthma Forum - Monitoring and Treatable Traits in Severe Asthma. Koper: University of Primorska Press. Severe Asthma Forum, 2
P. 67
ls of asthma control11. All changes since guidelines corrected the recommendation to 67
the previous visit should be carefully analyzed re-evaluate the therapeutic response every
in terms of frequency and severity of exacer- 3-4 months. The EAACI 2021 guidelines rec- mon i tor i ng a n d eva luat ion of t h e r a peu t ic r e sponse i n pat i e n ts w i t h sev e r e a st h m a on biologic s
bations, all elements of asthma symptom con- ommend an e valuation every 4-6 months.
trol (frequency of symptoms, use of SABA,
nocturnal awakening due to asthma, activi- If therapeutic response to b iologics is
ty limitation), treatment intensity (including good and asthma is well controlled, it is rec-
OCS dose), quality of life, adherence and in- ommended to consider reducing and eventu-
halation technique, pulmonary function, pa- ally discontinuing oral corticosteroid treat-
tient satisfaction, side effects and possible con- ment, then other add-on therapies, and finally
cerns. inhaled corticosteroids. Oral corticosteroids
and all other asthma drugs should be reduced
GINA and EAACI Guidelines for the gradually. Inhaled corticosteroids should nev-
treatment of severe asthma with b iologics dif- er be completely ruled out, but at least a mod-
fer slightly about the time period for monitor- erate dose should be maintained. If after step-
ing the therapeutic response, but agrees that down during treatment with biologics there is
it should be done between 3 and 6 months1,11. a loss of symptom control and/or exacerba-
The GINA 2020 guidelines recommend that tions reoccur, the therapy should be intensi-
the first assessment of the therapeutic response fied to the previous dose to re-establish good
to b iologics in severe asthma be made after 4 asthma control1.
months. If the response is good, it is recom-
mended to continue treatment with a reas- Well-defined criteria for assessing the
sessment every 3-6 months. The GINA 2021 therapeutic response to biological therapy
in severe asthma do not currently exist, but
Figure 2. Response to treatment of s evere asthma with b iologics (all three anti-IL-5 drugs) after 2 years (26)
(Taken from Eger K et al. J Alerg Clin Imunol Pract 2021)
it is clear that not all outcomes are of equal acerbation of severe asthma, control of asth-
strength and importance. According to the ma symptoms assessed using the ACQ (Asth-
latest EAACI 2021 guidelines, expected out- ma Control Questionnaire) or ACT (Asthma
comes are classified into three groups. The Control Test), quality of life measured by the
most critical outcomes are considered to be ex- quality of life of the Asthma Questionnaire
the previous visit should be carefully analyzed re-evaluate the therapeutic response every
in terms of frequency and severity of exacer- 3-4 months. The EAACI 2021 guidelines rec- mon i tor i ng a n d eva luat ion of t h e r a peu t ic r e sponse i n pat i e n ts w i t h sev e r e a st h m a on biologic s
bations, all elements of asthma symptom con- ommend an e valuation every 4-6 months.
trol (frequency of symptoms, use of SABA,
nocturnal awakening due to asthma, activi- If therapeutic response to b iologics is
ty limitation), treatment intensity (including good and asthma is well controlled, it is rec-
OCS dose), quality of life, adherence and in- ommended to consider reducing and eventu-
halation technique, pulmonary function, pa- ally discontinuing oral corticosteroid treat-
tient satisfaction, side effects and possible con- ment, then other add-on therapies, and finally
cerns. inhaled corticosteroids. Oral corticosteroids
and all other asthma drugs should be reduced
GINA and EAACI Guidelines for the gradually. Inhaled corticosteroids should nev-
treatment of severe asthma with b iologics dif- er be completely ruled out, but at least a mod-
fer slightly about the time period for monitor- erate dose should be maintained. If after step-
ing the therapeutic response, but agrees that down during treatment with biologics there is
it should be done between 3 and 6 months1,11. a loss of symptom control and/or exacerba-
The GINA 2020 guidelines recommend that tions reoccur, the therapy should be intensi-
the first assessment of the therapeutic response fied to the previous dose to re-establish good
to b iologics in severe asthma be made after 4 asthma control1.
months. If the response is good, it is recom-
mended to continue treatment with a reas- Well-defined criteria for assessing the
sessment every 3-6 months. The GINA 2021 therapeutic response to biological therapy
in severe asthma do not currently exist, but
Figure 2. Response to treatment of s evere asthma with b iologics (all three anti-IL-5 drugs) after 2 years (26)
(Taken from Eger K et al. J Alerg Clin Imunol Pract 2021)
it is clear that not all outcomes are of equal acerbation of severe asthma, control of asth-
strength and importance. According to the ma symptoms assessed using the ACQ (Asth-
latest EAACI 2021 guidelines, expected out- ma Control Questionnaire) or ACT (Asthma
comes are classified into three groups. The Control Test), quality of life measured by the
most critical outcomes are considered to be ex- quality of life of the Asthma Questionnaire
