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0:00
Hello. I am Professor
Fun Chung from
the National Heart
and Lung Institute
at Imperial College.
I also work as a clinician at
The Royal Brompton
Hospital in London.
One of my major interests
is about severe asthma.
One of the major problems
we have these days with asthma,
is about this group of patients
that we label at severe asthma.
In my talk, I'm
going to talk about
how we characterize these
patients with severe asthma.
I talk a bit about
the mechanisms
underlying this condition
that we call severe asthma.
Of course, end up with some
treatment aspects of this,
what we consider to be quite
difficult to treat the asthma.
0:49
In my talk, I'm going to talk
about the definition
of severe asthma.
The current treatments that
we have for severe asthma.
Then I will move on
to the question of
phenotyping and characterization
of severe asthma.
Then following that,
I will talk about
three important characteristics
of severe asthma.
Namely chronic
airflow obstruction,
chronic inflammation, and
corticosteroid insensitivity.
Then I will end up my talk
by talking about some of
the future approaches
that we have to trying
to get better treatments
for severe asthma.
1:27
I think one of the
first definitions
that came about was in 1999,
when the task force of
the European
Respiratory Society was
set up to look at the question
of definition of this condition.
You will see that these
conditions, severe asthma,
also goes often by
other names like
difficult-to-treat asthma,
or therapy-resistant asthma.
Indeed, those two terms
summarizes the problem
with severe asthma.
That they are
difficult to treat and
some of the treatments
that we have for asthma,
do not work very well for
this special category
of severe asthma.
The definition that came
about in 1999 was that,
severe asthma is a poorly
controlled asthma,
in terms of chronic symptoms,
episodic exacerbations,
persistent and variable
airflow, obstruction,
and a continued requirement for
short acting
Beta2-agonists despite
the use of a maximal dose
of inhaled corticosteroids.
Some of those patients
may require courses or
a regular dose of
oral corticosteroids
to maintain reasonable control.
I think 12 years down the line,
we would probably add
that those patients
would be on a combination
therapy of long acting,
Beta2-agonist and
inhaled corticosteroids,
because in the intervening
period of the last 11 years,
this combination
therapy has become
the mainstay of both
treatment of asthma.
