International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma
Identifieur interne : 004153 ( Main/Merge ); précédent : 004152; suivant : 004154International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma
Auteurs : KIAN FAN CHUNG [Royaume-Uni] ; Sally E. Wenzel [États-Unis] ; Jan L. Brozek [États-Unis] ; Andrew Bush [Royaume-Uni] ; Mario Castro [États-Unis] ; Peter J. Sterk [Pays-Bas] ; Ian M. Adcock [Royaume-Uni] ; Eric D. Bateman [Afrique du Sud] ; Elisabeth H. Bel [Pays-Bas] ; Eugene R. Bleecker [États-Unis] ; Louis-Philippe Boulet [Canada] ; Christopher Brightling [Royaume-Uni] ; Pascal Chanez [France] ; Sven-Erik Dahlen [Suède] ; Ratko Djukanovic [Royaume-Uni] ; Urs Frey [Suisse] ; Mina Gaga [Grèce] ; Peter Gibson [Australie] ; Qutayba Hamid [Canada] ; Nizar N. Jajour [États-Unis] ; Thais Mauad [Brésil] ; Ronald L. Sorkness [États-Unis] ; W. Gerald Teague [États-Unis]Source :
- The European respiratory journal [ 0903-1936 ] ; 2014.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Recommandation.
English descriptors
- KwdEn :
Abstract
Severe or therapy-resistant asthma is increasingly recognised as a major unmet need. A Task Force, supported by the European Respiratory Society and American Thoracic Society, reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults. A literature review was performed, followed by discussion by an expert committee according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for development of specific clinical recommendations. When the diagnosis of asthma is confirmed and comorbidities addressed, severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming "uncontrolled" or that remains "uncontrolled" despite this therapy. Severe asthma is a heterogeneous condition consisting of phenotypes such as eosinophilic asthma. Specific recommendations on the use of sputum eosinophil count and exhaled nitric oxide to guide therapy, as well as treatment with anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and bronchial thermoplasty are provided. Coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy.
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Pascal:14-0057428Le document en format XML
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<author><name sortKey="Frey, Urs" sort="Frey, Urs" uniqKey="Frey U" first="Urs" last="Frey">Urs Frey</name>
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Respiratory Dept and Asthma Centre, Athens Chest Hospital</s1>
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<author><name sortKey="Teague, W Gerald" sort="Teague, W Gerald" uniqKey="Teague W" first="W. Gerald" last="Teague">W. Gerald Teague</name>
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<author><name sortKey="Castro, Mario" sort="Castro, Mario" uniqKey="Castro M" first="Mario" last="Castro">Mario Castro</name>
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<s2>St Louis, MO</s2>
<s3>USA</s3>
<sZ>5 aut.</sZ>
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<country>États-Unis</country>
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<author><name sortKey="Sterk, Peter J" sort="Sterk, Peter J" uniqKey="Sterk P" first="Peter J." last="Sterk">Peter J. Sterk</name>
<affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Dept of Respiratory Medicine, Academic Medical Centre</s1>
<s2>Amsterdam</s2>
<s3>NLD</s3>
<sZ>6 aut.</sZ>
<sZ>9 aut.</sZ>
</inist:fA14>
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<placeName><settlement type="city">Amsterdam</settlement>
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<author><name sortKey="Adcock, Ian M" sort="Adcock, Ian M" uniqKey="Adcock I" first="Ian M." last="Adcock">Ian M. Adcock</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>National Heart and Lung Institute, Imperial College</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>7 aut.</sZ>
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</placeName>
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<author><name sortKey="Bateman, Eric D" sort="Bateman, Eric D" uniqKey="Bateman E" first="Eric D." last="Bateman">Eric D. Bateman</name>
<affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Lung Institute, University of Cape Town</s1>
<s2>Cape Town</s2>
<s3>ZAF</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Afrique du Sud</country>
<wicri:noRegion>Cape Town</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bel, Elisabeth H" sort="Bel, Elisabeth H" uniqKey="Bel E" first="Elisabeth H." last="Bel">Elisabeth H. Bel</name>
<affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Dept of Respiratory Medicine, Academic Medical Centre</s1>
<s2>Amsterdam</s2>
<s3>NLD</s3>
<sZ>6 aut.</sZ>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bleecker, Eugene R" sort="Bleecker, Eugene R" uniqKey="Bleecker E" first="Eugene R." last="Bleecker">Eugene R. Bleecker</name>
<affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Dept of Medicine, Wake Forest University</s1>
<s2>Winston Salem, NC</s2>
<s3>USA</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Winston Salem, NC</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Boulet, Louis Philippe" sort="Boulet, Louis Philippe" uniqKey="Boulet L" first="Louis-Philippe" last="Boulet">Louis-Philippe Boulet</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec</s1>
<s2>Quebec, Quebec</s2>
<s3>CAN</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Canada</country>
<wicri:noRegion>Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Brightling, Christopher" sort="Brightling, Christopher" uniqKey="Brightling C" first="Christopher" last="Brightling">Christopher Brightling</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Institute for Lung Health, Leicester University</s1>
<s2>Leicester</s2>
<s3>GBR</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Leicester</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Chanez, Pascal" sort="Chanez, Pascal" uniqKey="Chanez P" first="Pascal" last="Chanez">Pascal Chanez</name>
<affiliation wicri:level="3"><inist:fA14 i1="15"><s1>Departement des Maladies Respiratoires, Marseille Universite</s1>
<s2>Marseille</s2>
<s3>FRA</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Provence-Alpes-Côte d'Azur</region>
<region type="old region">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Marseille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Dahlen, Sven Erik" sort="Dahlen, Sven Erik" uniqKey="Dahlen S" first="Sven-Erik" last="Dahlen">Sven-Erik Dahlen</name>
<affiliation wicri:level="3"><inist:fA14 i1="16"><s1>Institute of Environmental Medicine, Karolinska Institutet</s1>
<s2>Stockholm</s2>
<s3>SWE</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Suède</country>
<placeName><settlement type="city">Stockholm</settlement>
<region nuts="2">Svealand</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Djukanovic, Ratko" sort="Djukanovic, Ratko" uniqKey="Djukanovic R" first="Ratko" last="Djukanovic">Ratko Djukanovic</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Southampton NIHR Respiratory Biomedical Research Unit, University of Southampton School of Medicine and Southampton General Hospital</s1>
<s2>Southampton</s2>
<s3>GBR</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<wicri:noRegion>Southampton</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Frey, Urs" sort="Frey, Urs" uniqKey="Frey U" first="Urs" last="Frey">Urs Frey</name>
<affiliation wicri:level="1"><inist:fA14 i1="17"><s1>University Children's Hospital (UKBB), University of Basel</s1>
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<s3>CHE</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
<wicri:noRegion>Basel</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Gaga, Mina" sort="Gaga, Mina" uniqKey="Gaga M" first="Mina" last="Gaga">Mina Gaga</name>
<affiliation wicri:level="3"><inist:fA14 i1="18"><s1>7 <sup>th</sup>
Respiratory Dept and Asthma Centre, Athens Chest Hospital</s1>
<s2>Athens</s2>
<s3>GRC</s3>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Grèce</country>
<placeName><settlement type="city">Athènes</settlement>
<region nuts="2" type="region">Attique (région)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gibson, Peter" sort="Gibson, Peter" uniqKey="Gibson P" first="Peter" last="Gibson">Peter Gibson</name>
<affiliation wicri:level="1"><inist:fA14 i1="19"><s1>Hunter Medical Research Institute, John Hunter Hospital</s1>
<s2>Newcastle</s2>
<s3>AUS</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<wicri:noRegion>Newcastle</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hamid, Qutayba" sort="Hamid, Qutayba" uniqKey="Hamid Q" first="Qutayba" last="Hamid">Qutayba Hamid</name>
<affiliation wicri:level="4"><inist:fA14 i1="12"><s1>Meakins-Christie Laboratories, McGill University</s1>
<s2>Montreal, Quebec</s2>
<s3>CAN</s3>
<sZ>19 aut.</sZ>
</inist:fA14>
<country>Canada</country>
<placeName><settlement type="city">Montréal</settlement>
<region type="state">Québec</region>
</placeName>
<orgName type="university">Université McGill</orgName>
</affiliation>
</author>
<author><name sortKey="Jajour, Nizar N" sort="Jajour, Nizar N" uniqKey="Jajour N" first="Nizar N." last="Jajour">Nizar N. Jajour</name>
<affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Dept of Medicine, University of Wisconsin</s1>
<s2>Madison, WI</s2>
<s3>USA</s3>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Madison, WI</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mauad, Thais" sort="Mauad, Thais" uniqKey="Mauad T" first="Thais" last="Mauad">Thais Mauad</name>
<affiliation wicri:level="3"><inist:fA14 i1="20"><s1>Dept of Pathology, University Medical School</s1>
<s2>Sao Paulo</s2>
<s3>BRA</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
<country>Brésil</country>
<placeName><settlement type="city">São Paulo</settlement>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Sorkness, Ronald L" sort="Sorkness, Ronald L" uniqKey="Sorkness R" first="Ronald L." last="Sorkness">Ronald L. Sorkness</name>
<affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Dept of Medicine, University of Wisconsin</s1>
<s2>Madison, WI</s2>
<s3>USA</s3>
<sZ>20 aut.</sZ>
<sZ>22 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Madison, WI</wicri:noRegion>
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<author><name sortKey="Teague, W Gerald" sort="Teague, W Gerald" uniqKey="Teague W" first="W. Gerald" last="Teague">W. Gerald Teague</name>
<affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Division of Respiratory Medicine, Allergy, and Immunology, Dept of Paediatrics, University of Virginia School of Medicine</s1>
<s2>VA</s2>
<s3>USA</s3>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>VA</wicri:noRegion>
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</analytic>
<series><title level="j" type="main">The European respiratory journal</title>
<title level="j" type="abbreviated">Eur. respir. j.</title>
<idno type="ISSN">0903-1936</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">The European respiratory journal</title>
<title level="j" type="abbreviated">Eur. respir. j.</title>
<idno type="ISSN">0903-1936</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Asthma</term>
<term>Definition</term>
<term>Evaluation</term>
<term>International</term>
<term>Recommendation</term>
<term>Respiratory disease</term>
<term>Severe</term>
<term>Treatment</term>
<term>World</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Pathologie de l'appareil respiratoire</term>
<term>International</term>
<term>Monde</term>
<term>Recommandation</term>
<term>Définition</term>
<term>Evaluation</term>
<term>Traitement</term>
<term>Grave</term>
<term>Asthme</term>
<term>Forme grave</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Recommandation</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Severe or therapy-resistant asthma is increasingly recognised as a major unmet need. A Task Force, supported by the European Respiratory Society and American Thoracic Society, reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults. A literature review was performed, followed by discussion by an expert committee according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for development of specific clinical recommendations. When the diagnosis of asthma is confirmed and comorbidities addressed, severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming "uncontrolled" or that remains "uncontrolled" despite this therapy. Severe asthma is a heterogeneous condition consisting of phenotypes such as eosinophilic asthma. Specific recommendations on the use of sputum eosinophil count and exhaled nitric oxide to guide therapy, as well as treatment with anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and bronchial thermoplasty are provided. Coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy.</div>
</front>
</TEI>
<affiliations><list><country><li>Afrique du Sud</li>
<li>Australie</li>
<li>Brésil</li>
<li>Canada</li>
<li>France</li>
<li>Grèce</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>Suède</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Attique (région)</li>
<li>Grand Londres</li>
<li>Hollande-Septentrionale</li>
<li>Ontario</li>
<li>Pennsylvanie</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Québec</li>
<li>Svealand</li>
<li>État de São Paulo</li>
</region>
<settlement><li>Amsterdam</li>
<li>Athènes</li>
<li>Hamilton (Ontario)</li>
<li>Londres</li>
<li>Marseille</li>
<li>Montréal</li>
<li>Pittsburgh</li>
<li>Stockholm</li>
<li>São Paulo</li>
</settlement>
<orgName><li>Université McGill</li>
<li>Université McMaster</li>
<li>Université de Pittsburgh</li>
</orgName>
</list>
<tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Kian Fan Chung" sort="Kian Fan Chung" uniqKey="Kian Fan Chung" last="Kian Fan Chung">KIAN FAN CHUNG</name>
</region>
<name sortKey="Adcock, Ian M" sort="Adcock, Ian M" uniqKey="Adcock I" first="Ian M." last="Adcock">Ian M. Adcock</name>
<name sortKey="Brightling, Christopher" sort="Brightling, Christopher" uniqKey="Brightling C" first="Christopher" last="Brightling">Christopher Brightling</name>
<name sortKey="Bush, Andrew" sort="Bush, Andrew" uniqKey="Bush A" first="Andrew" last="Bush">Andrew Bush</name>
<name sortKey="Bush, Andrew" sort="Bush, Andrew" uniqKey="Bush A" first="Andrew" last="Bush">Andrew Bush</name>
<name sortKey="Djukanovic, Ratko" sort="Djukanovic, Ratko" uniqKey="Djukanovic R" first="Ratko" last="Djukanovic">Ratko Djukanovic</name>
<name sortKey="Kian Fan Chung" sort="Kian Fan Chung" uniqKey="Kian Fan Chung" last="Kian Fan Chung">KIAN FAN CHUNG</name>
</country>
<country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Wenzel, Sally E" sort="Wenzel, Sally E" uniqKey="Wenzel S" first="Sally E." last="Wenzel">Sally E. Wenzel</name>
</region>
<name sortKey="Bleecker, Eugene R" sort="Bleecker, Eugene R" uniqKey="Bleecker E" first="Eugene R." last="Bleecker">Eugene R. Bleecker</name>
<name sortKey="Brozek, Jan L" sort="Brozek, Jan L" uniqKey="Brozek J" first="Jan L." last="Brozek">Jan L. Brozek</name>
<name sortKey="Castro, Mario" sort="Castro, Mario" uniqKey="Castro M" first="Mario" last="Castro">Mario Castro</name>
<name sortKey="Jajour, Nizar N" sort="Jajour, Nizar N" uniqKey="Jajour N" first="Nizar N." last="Jajour">Nizar N. Jajour</name>
<name sortKey="Sorkness, Ronald L" sort="Sorkness, Ronald L" uniqKey="Sorkness R" first="Ronald L." last="Sorkness">Ronald L. Sorkness</name>
<name sortKey="Teague, W Gerald" sort="Teague, W Gerald" uniqKey="Teague W" first="W. Gerald" last="Teague">W. Gerald Teague</name>
</country>
<country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Sterk, Peter J" sort="Sterk, Peter J" uniqKey="Sterk P" first="Peter J." last="Sterk">Peter J. Sterk</name>
</region>
<name sortKey="Bel, Elisabeth H" sort="Bel, Elisabeth H" uniqKey="Bel E" first="Elisabeth H." last="Bel">Elisabeth H. Bel</name>
</country>
<country name="Afrique du Sud"><noRegion><name sortKey="Bateman, Eric D" sort="Bateman, Eric D" uniqKey="Bateman E" first="Eric D." last="Bateman">Eric D. Bateman</name>
</noRegion>
</country>
<country name="Canada"><noRegion><name sortKey="Boulet, Louis Philippe" sort="Boulet, Louis Philippe" uniqKey="Boulet L" first="Louis-Philippe" last="Boulet">Louis-Philippe Boulet</name>
</noRegion>
<name sortKey="Hamid, Qutayba" sort="Hamid, Qutayba" uniqKey="Hamid Q" first="Qutayba" last="Hamid">Qutayba Hamid</name>
</country>
<country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Chanez, Pascal" sort="Chanez, Pascal" uniqKey="Chanez P" first="Pascal" last="Chanez">Pascal Chanez</name>
</region>
</country>
<country name="Suède"><region name="Svealand"><name sortKey="Dahlen, Sven Erik" sort="Dahlen, Sven Erik" uniqKey="Dahlen S" first="Sven-Erik" last="Dahlen">Sven-Erik Dahlen</name>
</region>
</country>
<country name="Suisse"><noRegion><name sortKey="Frey, Urs" sort="Frey, Urs" uniqKey="Frey U" first="Urs" last="Frey">Urs Frey</name>
</noRegion>
</country>
<country name="Grèce"><region name="Attique (région)"><name sortKey="Gaga, Mina" sort="Gaga, Mina" uniqKey="Gaga M" first="Mina" last="Gaga">Mina Gaga</name>
</region>
</country>
<country name="Australie"><noRegion><name sortKey="Gibson, Peter" sort="Gibson, Peter" uniqKey="Gibson P" first="Peter" last="Gibson">Peter Gibson</name>
</noRegion>
</country>
<country name="Brésil"><region name="État de São Paulo"><name sortKey="Mauad, Thais" sort="Mauad, Thais" uniqKey="Mauad T" first="Thais" last="Mauad">Thais Mauad</name>
</region>
</country>
</tree>
</affiliations>
</record>
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