Tables
- TABLE 1
Important concerns in the management of severe asthma identified at the European Respiratory Biologics Forum
How can biomarkers and phenotypes be best identified and utilised in daily clinical practice? Is the ACQ the right tool for monitoring the response to biologics? Is treatment response assessed using the ACQ related to the effect of treatment on exacerbations? How can awareness be raised among patients and non-specialists regarding the burden of oral corticosteroids and the potential of new treatments available? Are oral steroids effective in patients having exacerbations while on biological therapies? When should patients start and stop taking a biologic? When should patients be switched from one biologic to another? ACQ: Asthma Control Questionnaire.
- TABLE 2
Current status of biologics in severe asthma management
Further understanding is needed on how and when to switch from one biological therapy to another There is still no consensus on the appropriate length of waiting time before a patient is classified as a non-responder The efficacy of biologics in severe asthma has been demonstrated in a number of trials in recent years, but further research is needed to understand the long-term effects of biological therapy Several clinical studies have demonstrated the oral corticosteroid-sparing effect of biologics - TABLE 3
Core principles from the charter to improve patient care in severe asthma
1 I deserve a timely, straightforward referral when my uncontrolled asthma cannot be managed in primary care 2 I deserve a timely, formal diagnosis of my severe asthma by an expert team 3 I deserve support to understand my type of severe asthma 4 I deserve care that reduces the impact of severe asthma on my daily life and improves my overall quality of care 5 I deserve not to be reliant on oral corticosteroids 6 I deserve to access consistent quality care, regardless of where I live or where I choose to access it - TABLE 4
Key challenges in incorporating the use of treatable traits in the management of severe asthma
Education of non-specialists and patients Better identification of patients with severe asthma Regional standardisation of the referral pathway Real-life identification and application of phenotypes and biomarkers in clinical practice Further evidence on treatable traits Understanding the clinical relevance of biomarkers and phenotypes Understanding the value of combining different biomarkers and establishing criteria for their combination - TABLE 5
The future of asthma management: scientific questions that need to be addressed
How are acute and chronic oral corticosteroids managed once biologics are initiated in a real-life setting? How should a second-line biological treatment be chosen if a patient fails with first-line respiratory biological therapy? What are the different sub-phenotypes of non-eosinophilic asthma? Can the natural course of the disease be modified by early intervention with anti-interleukin-5? What is the effect of biological therapies on airway remodelling? Could there be a beneficial impact of biologics on the cost of treatment through home care delivery in the severe asthma population? What real-life factors could be used to distinguish between high and low responders to biologics? What is the effect of using biologics in an acute asthma setting?