Medicus, Vol. 20 No. 2_Alergije, 2011.
Review article
Severe Asthma
Sanja Popović-Grle
; Klinika za plućne bolesti “Jordanovac”
Abstract
Severe a sthma i s p resent in 5 -10% o f asthma patients. Its exact pathophysiological mechanisms are not known. However, neutrophilic airway inflammation or absence of inflammatory changes with accelerated bronchial remodelling have been often recorded. Clinically, non-allergic asthma in women, mostly late-onset and aspirin asthma phenotype, is the most common type of severe asthma. Allergic asthma may be classified as severe in a significantly lower number of cases. In every patient with severe asthma, its diagnosis and compliance should be evaluated on several occasions and triggers explored. The administration of oral corticosteroids should be preceded by the administration of the highest doses of inhaled corticosteroids, i.e. up to 2,000 μg of beclomethasone, with the addition of long-acting beta2-agonists, leukotriene receptor antagonists, theophyllin preparations and long-acting anticholinergics. In the event of treatment failure, omalizumab or several months of antifungal therapy, or a patient-tailored approach should be applied. Bronchial thermoplasty has been also developed. The treatment of patients with severe asthma requires 30- 50% of funds earmarked for asthma treatment.
Keywords
severe asthma; definition; phenotype; treatment
Hrčak ID:
81078
URI
Publication date:
19.12.2011.
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