Clinical Focus Series Difficult Asthma

Most patients with asthma are easily diagnosed and treated with the use of an inhaler or medication. Approximately five per cent of people that suffer from asthma have ‘difficult’ or ‘refractory’ asthma, whereby they experience persistent problems that are not controlled by standard treatment methods. Part of the Clinical Focus Series, this book provides a complete overview of difficult asthma, discussing the clinical assessment and management of this complex condition. Beginning with the epidemiology and characteristics of severe asthma, the book defines current understanding of the immunological mechanisms and disease heterogeneity. It also offers insight into how the condition can affect the physical and psychological aspects of a person’s life. Separate chapters examine novel therapeutic strategies and the economic burden of refractory asthma. Key points Discusses clinical assessment and management of difficult asthma Includes epidemiology, immunology, physical and psychological effects, economic burden and novel therapeutics Internationally renowned author and editor team

This book provides a practical, stepwise, evidence-based approach to effective management of patients with difficult to treat asthma. The impact of asthma on morbidity and healthcare utilization increases exponentially with severity. Severe refractory asthma accounts for less than 5% of all asthma. Its prevalence, however, is often overestimated as there are several other confounding factors that make asthma ‘difficult to treat’. Many novel (albeit expensive) therapies are now available and providers caring for patients with severe asthma are charged with selecting the best evidence treatment. This calls for complex and nuanced decision-making. Whether people with asthma gain and maintain control over their condition depends not only on the availability of effective drugs, but also multiple patient and healthcare provider behaviors. Therefore, now more than ever, it has become increasingly important to differentiate “difficult” from “severe refractory” asthma to allow identification of patients most likely to benefit from these therapies. This volume delves into the current understanding of mechanisms and increasingly recognized heterogeneity of this complex disease. It discusses a structured approach to identification and optimization of factors contributing to poor asthma control, including nonadherence, comorbidities and occupational/environmental triggers. The book includes ‘state of the art’ reviews on recent advances in traditional and targeted asthma therapies, as well as a glimpse into what the future may hold. Highlights include a comprehensive guide to management of severe asthma in children and pregnancy, as well as practical considerations to management of asthma based on different clinical phenotypes. Each chapter is authored by leading experts in the field who share their own clinical approach. This is an ideal guide for clinical pulmonologists and allergist/immunologists, as well as primary care providers, physician extenders in specialty practice, physicians in pulmonary/allergy training, and even industry partners.

Severe asthma is a form of asthma that responds poorly to currently available medication, and its patients represent those with greatest unmet needs. In the last 10 years, substantial progress has been made in terms of understanding some of the mechanisms that drive severe asthma; there have also been concomitant advances in the recognition of specific molecular phenotypes. This ERS Monograph covers all aspects of severe asthma – epidemiology, diagnosis, mechanisms, treatment and management – but has a particular focus on recent understanding of mechanistic heterogeneity based on an analytic approach using various ‘omics platforms applied to clinically well-defined asthma cohorts. How these advances have led to improved management targets is also emphasised. This book brings together the clinical and scientific expertise of those from around the world who are collaborating to solve the problem of severe asthma.

Enormous progress in asthma research has been made in the past 50 years, including a greater understanding of its complex pathogenesis and new and more effective therapies. Consequently, the scientific literature has grown vast and can be difficult to integrate. With contributions from a distinguished panel of world-renowned authors, Clinical Asthma: Theory and Practice presents a comprehensive study of both the common and the more challenging problems faced by all health care personnel who treat patients with asthma. The book is divided into seven sections, starting with the basics of asthma and ending with a discussion on the approach to asthma worldwide and in the primary care setting. Reflecting a strong clinical emphasis, each chapter begins with a patient case study supported by essential background information on the basic science and clinical decision-making process. This is followed by a discussion of clinical evaluation and management. The multidisciplinary coverage explores a range of topics including genetics, inflammation, immunology, and the identification of different endotypes. Using a bench-to-bedside approach, the book links basic science to the clinical management of asthma and explores options for improvement. The carefully selected authorship from experts worldwide presents a truly global outlook.

Personalized medicine is a rapidly emerging area in health care, and asthma management lends itself particularly well to this new development. This practical resource by Dr. Stanley J. Szefler helps you navigate the many asthma medication options available to your patients, as well as providing insights into those which may be introduced within the next several years. Features a wealth of information on available asthma medications, including new immunomodulators, new responses to treatment, and new treatment strategies at all levels of asthma care. Prepares you to meet your patients’ needs regarding asthma exacerbation prevention and asthma prevention. Consolidates today’s available information and guidance in this timely area into one convenient resource.

The purpose of this book is to provide medical students, postgraduate fellows, general practitioners and specialists a succinct, easy to read, well-illustrated and comprehensive review of interstitial disorders encountered in clinical practice. Authored by a team of internationally recognized experts, the chapters cover different aspects of these complex maladies and suggest plans for effective management of patients with diffuse parenchymal disease. The book opens with a brief historical account followed by physiological and radiological features of interstitial lung diseases. Each concise ch.

A fully updated edition of a widely respected classic on the diagnosis and management of asthma in a variety of patient subpopulations. Though this fifth edition continues to emphasize the definition, medications, and use of asthma treatment plans, it also focuses on the special needs patient, including the pediatric patient, the pregnant patient, and the patient undergoing surgery, as well as on the perennial issues of exercise and asthma, pulmonary aspergillosis, occupation, recreational drug use, and psychological/social considerations. Highlights for the fifth edition include a liberal use of tables and charts to make the book more practical and user-friendly, updates on the many new pharmaceuticals used to treat asthma, and first-time sections on food sensitivity and the diagnosis of asthma.

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