Evaluation and Management of Difficult-to-Treat and Severe Asthma: An Expert Opinion From the Korean Academy of Asthma, Allergy and Clinical Immunology, the Working Group on Severe Asthma
Byung‐Keun Kim, So‐Young Park, Ga‐Young Ban, Mi‐Ae Kim, Ji‐Hyang Lee, Jin An, Ji‐Su Shim, Young‐Soo Lee, Ha‐Kyeong Won, Hwa Young Lee, Kyoung‐Hee Sohn, Sung‐Yoon Kang, So Young Park, Hyun Lee, Min‐Hye Kim, Jae‐Woo Kwon, Sun‐Young Yoon, Jae‐Hyun Lee, Chin Kook Rhee, Ji‐Yong Moon, Taehoon Lee, So Ri Kim, Jong‐Sook Park, Sang‐Heon Kim, Heung‐Woo Park, Jae Won Jeong, Sang‐Hoon Kim, Young‐Il Koh, Yeon‐Mok Oh, An‐Soo Jang, Kwang Ha Yoo, You Sook Cho
Abstract
Severe asthma (SA) presents in about 3%-5% of adult asthmatics and is responsible for over 60% of asthma-related medical expenses, posing a heavy socioeconomic burden. However, to date, a precise definition of or clear diagnostic criteria for SA have not been established, and therefore, it has been challenging for clinicians to diagnose and treat this disease. Currently, novel biologics targeting several molecules, such as immunoglobulin E, interleukin (IL)5, and IL4/IL13, have emerged, and many new drugs are under development. These have brought a paradigm shift in understanding the mechanism of SA and have also provided new treatment options. However, we need to agree on a precise definition of and its diagnostic criteria for SA. Additionally, it is necessary to explain the diagnostic criteria and to summarize current standard and additional treatment options. This review is an experts' opinion on SA from the Korean Academy of Asthma, Allergy, and Clinical Immunology, the Working Group on Severe Asthma, and aims to provide a definition of and diagnostic criteria for SA, and propose future direction for SA diagnosis and management in Korea.