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Examining the unmet need in adults with severe asthma

CORRESPONDENCE: M. R. Partridge, Dept of Respiratory Medicine, Faculty of Medicine, Imperial College London, Charing Cross Campus, St Dunstans Road, London W6 8RP, UK. Fax: 44 2088467999. E-mail: m.partridge{at}imperial.ac.uk

Asthma currently affects an estimated 300 million people worldwide and the number is expected to rise to 400 million by 2025. Asthma morbidity remains high and the economic burden is significant. Approximately 20% of patients have severe persistent asthma. As patients with severe asthma often have a variety of conditions that may coexist with or be mistaken for asthma, careful diagnosis and management are essential, and adhering to a protocol for investigations is helpful.

For patients with severe persistent asthma, the Global Initiative for Asthma 2005 guidelines recommend the use of high-dose inhaled corticosteroids in combination with a long-acting ß₂-agonist, with one or more additional controller medications if required (step 4 therapy). However, recent studies have shown that asthma remains inadequately controlled in many patients with severe asthma, despite treatment in accordance with guidelines.

Patients with severe asthma have the highest healthcare utilisation and mortality, and there is clearly an unmet need for the effective and safe treatment of patients with severe persistent allergic asthma who remain symptomatic despite optimised standard treatment. The latest guidelines suggest that omalizumab may address this unmet need.

KEYWORDS: Adults, difficult asthma, severe asthma, unmet needs