Polish Society of Allergology statement on the diagnosis and treatment of severe, difficult-to-control bronchial asthma
Ładowanie...
Data
2019
Inny tytuł
Typ
Artykuł recenzyjny
Redaktor
dc.contributor.advisor
Dyscyplina PBN
Psychologia
Czasopismo lub seria
Advances in Dermatology and Allergology
ISSN
1642-395X
ISBN
DOI
10.5114/ada.2019.84591
Strona internetowa
Wydawca
Wydawca
Wydanie
Numer
Strony od-do
Tytuł monografii
item.page.defence
Tytuł tomu
Opis
Rodzaj licencji
Abstrakt (en)
Severe asthma requires at least high doses of inhaled corticosteroids (ICS) in combination with a long-acting β-agonist (LABA) or systemic corticosteroids (SCS) for more than 50% of days/year to avoid loss of control, or re mains uncontrolled despite the treatment described above. The diagnosis of severe asthma should be confirmed in a reference centre as it requires careful differential diagnosis and the exclusion of factors hindering the achievement of optimal control. Severe asthma represents a significant burden for the patient, their family and the healthcare system. This is due to the severity of the symptoms, drug costs, significant impairment of everyday functioning and life quality, and limitation in the professional work. In the case of ineffectiveness of the step 4 GINA treatment, the patient should be referred to a specialist centre to consider additional treatment, including anti-IgE receptor (omalizumab), anti-IL-5 receptor (mepolizumab), or an antibody directed against the α-subunit of receptor for IL-5 (benralizumab). In the case of severe asthma, intensification of therapy should first of all include biological therapy and not the use of SCS. Biological drugs are available in Poland as a part of the therapeutic programme for the treatment of severe asthma. In practice, the therapeutic programme may change with subsequent notices of the Ministry of Health and does not have to be consistent with the Summary of Product Characteristics for individual preparations. The current review presents the basic principles of differential diagnosis of severe asthma and the selection of the optimal biological therapy in Polish conditions.