Management of Severe Refractory Asthma / 대한내과학회지

ABSTRACT

Most patients with asthma have mild to moderate disease and are well controlled by regular use of inhaled corticosteroids with or without long-acting beta2-agonists. However, about 5-10% patients with severe asthma remain poorly controlled despite optimal treatment, and these patients have greater morbidity and mortality than mild to moderate asthmatics. Patients with severe refractory asthma (SRA) often require regular systemic corticosteroid use, which increase risk of steroid-related adverse events and require more health care support. A systematic approach is necessary to establish a correct diagnosis, identify coexisting disorders, and evaluate aggravating factors. The management of SRA remains extremely challenging, and many clinical studies are currently in progress. Anti-IgE antibody (omalizumab) and bronchial thermoplasty may be alternative treatment for SRA approved by US Food and Drug Administration. SRA is a heterogeneous disease, which is classified in to distinct clinical phenotypes. A better understanding of these subtypes may lead to improved treatment of SRA.