International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

NEW GUIDELINES FROM EUROPEAN RESPIRATORY SOCIETY  AND AMERICAN THORACIC SOCIETY ON SEVERE ASTHMA

Very useful guidelines for all

please follow the link to get the full guidelines

http://erj.ersjournals.com/content/43/2/343.abstract

Definition of severe asthma for patients aged >=6 years
Asthma which requires treatment with guidelines suggested medications for GINA steps 4–5 asthma (high dose ICS# and LABA or leukotriene modifier/theophylline) for the previous year or systemic CS for >50% of the previous year to prevent it from becoming ‘‘uncontrolled’’ or which remains ‘‘uncontrolled‘‘ despite this therapy
Uncontrolled asthma defined as at least one of the following:
1) Poor symptom control: ACQ consistently .1.5, ACT ,20 (or ‘‘not well controlled’’ by NAEPP/GINA guidelines)
2) Frequent severe exacerbations: two or more bursts of systemic CS (.3 days each) in the previous year
3) Serious exacerbations: at least one hospitalisation, ICU stay or mechanical ventilation in the previous year
4) Airflow limitation: after appropriate bronchodilator withhold FEV1 ,80% predicted (in the face of reduced FEV1/FVC defined as less than
the lower limit of normal)
Controlled asthma that worsens on tapering of these high doses of ICS or systemic CS (or additional biologics)