EAACI Biologicals Guidelines—Recommendations for severe asthma

Severe asthma imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, co‐morbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enab...

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Vydáno v:Allergy (Copenhagen) Ročník 76; číslo 1; s. 14 - 44
Hlavní autoři: Agache, Ioana, Akdis, Cezmi A., Akdis, Mubeccel, Canonica, Giorgio Walter, Casale, Thomas, Chivato, Tomas, Corren, Jonathan, Chu, Derek K., Del Giacco, Stefano, Eiwegger, Thomas, Flood, Breda, Firinu, Davide, Gern, James E., Hamelmann, Eckard, Hanania, Nicola, Hernández‐Martín, Irene, Knibb, Rebeca, Mäkelä, Mika, Nair, Parameswaran, O’Mahony, Liam, Papadopoulos, Nikolaos G., Papi, Alberto, Park, Hae‐Sim, Pérez de Llano, Luis, Pfaar, Oliver, Quirce, Santiago, Sastre, Joaquin, Shamji, Mohamed, Schwarze, Jurgen, Palomares, Oscar, Jutel, Marek
Médium: Journal Article
Jazyk:angličtina
Vydáno: Denmark Blackwell Publishing Ltd 01.01.2021
Témata:
Asthma
Asthma - diagnosis
Asthma - drug therapy
Asthma - epidemiology
Best practice
Biological products
biologicals
Cost-Benefit Analysis
cost‐effectiveness
Disease management
GRADE
Guidelines
Humans
Phenotype
Phenotypes
Precision medicine
severe asthma
severe asthma
biologicals
cost-effectiveness
GRADE
guidelines
ISSN:0105-4538, 1398-9995, 1398-9995
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Popis
Shrnutí:Severe asthma imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, co‐morbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enabled a stratified approach to the management of severe asthma, supporting the use of targeted treatments with biologicals. However, there are still many issues that require further clarification. These include selection of a certain biological (as they all target overlapping disease phenotypes), the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home‐based) and its cost‐effectiveness. The EAACI Guidelines on the use of biologicals in severe asthma follow the GRADE approach in formulating recommendations for each biological and each outcome. In addition, a management algorithm for the use of biologicals in the clinic is proposed, together with future approaches and research priorities.
Bibliografie:Stanley J. Szefler
Christer Jansen
Borja G. Cosio
Fundação ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Brazil
Departament de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Servei de Pneumologia, Corporació Sanitària Parc Taulí, Parc Taulí s/n, 08208, Sabadell (Barcelona), Spain
Sejal Saglani
Kian Fan Chung
Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University, St Louis, Mo
Section of Pulmonary and Sleep Medicine, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado.
Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; CIBER de Enfermedades Respiratorias, CIBERES, Spain; Department of Respiratory Medicine, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Clinica Rotger Quiron, Palma de Mallorca, Spain
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Department of Medicine, Division of Genetics, Genomics and Precision Medicine, University of Arizona Health Sciences, Tuscon, Arizona, USA
Leonard B. Bacharier
Experimental Studies Medicine at National Heart & Lung Institute, Imperial College London & Royal Brompton & Harefield NHS Trust, London, UK
Faculty of Medicine, University of Southampton, Southampton, UK
Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
EXTERNAL PEER REVIEW PANEL
Institute for Lung Health, Department of Respiratory Sciences, University of Leicester, Leicester, UK
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Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Eugene R. Bleeker
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Oscar Palomares and Marek Jutel are joint last authorship.
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Department of National Heart and Lung Institute, Imperial College London, UK; Department of Respiratory Paediatrics, Royal Brompton Hospital, London, UK
Alvaro Cruz
Stephen Holgate
Christian Domingo Ribas
Christopher Brightling
William W. Busse
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ISSN:0105-4538
1398-9995
1398-9995
DOI:10.1111/all.14425