Severe Asthma Update: Clinical Management and Key Considerations to Target Optimal Patient Care – Tweetorial #3 Activity

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Patients like Maria with type 2 severe asthma should be considered for add-on biologic therapy. There are currently several approved options with good efficacy and safety.

The decision to initiate Maria on a biologic will depend on multiple factors. The GINA 2020 recommendations provide the following guidance:

If add-on T2-targeted biologic therapy is available and affordable, the next step is to evaluate which biologic(s) the patient is eligible for and likely to respond to. The GINA 2020 recommendations outline a systematic approach to help guide biologic selection:

Based on Maria’s nonallergic T2 phenotype, she and her doctor agree on an initial trial of add-on anti-IL-4R. GINA recommends an initial biologic trial for at least four months, with a six to twelve month extension for patients with severe asthma if treatment response remains unclear.

An important part of severe asthma management is regular reevaluation of the need for oral corticosteroids, and tapering/termination if appropriate. Biologics can play a significant role; randomized clinical trials indicate that their use significantly decrease steroid use in patients with severe asthma.

Patients with T2 severe asthma should be considered for biologic therapy, and those with access may be initiated on a biologic based on eligibility and probability of good response. In absence of a good response, a switch to an alternative targeted therapy should be considered.

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