Severe asthma: characterisation, mechanisms & treatment

Published on December 27, 2012 Updated on May 25, 2022   51 min

A selection of talks on Respiratory Diseases

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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.

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Severe asthma: characterisation, mechanisms & treatment

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