Fast Five Quiz: Severe Asthma Phenotypes

Zab Mosenifar, MD


April 05, 2021

Figure 1. Development of bronchiole constriction associated with asthma.

Adult-onset eosinophilic asthma is one of the most severe and difficult-to-treat asthma subtypes. This asthma phenotype is associated with the development of persistent airflow limitation and risk for severe exacerbations despite the fact that its symptoms are relatively mild and are atypical.

Men more often than women fit the typical clinical profile of adult-onset eosinophilic asthma, but this phenotype is seen in both men and women with severe asthma.

Patients with severe asthma commonly express a type 2–high phenotype characterized by eosinophilic inflammation. Anti-interleukin-5 (IL-5) agents may be beneficial as add-on therapy in patients with severe eosinophilic asthma that is refractory to conventional anti-inflammatory drugs (eg, inhaled and systemic corticosteroids). On the basis of available evidence, a Task Force Report from the European Respiratory Society/American Thoracic Society recommends using a blood eosinophil count cut-off point of ≥ 150/μL to guide anti-IL-5 therapy initiation in adult patients with severe asthma and a history of prior asthma exacerbations.

Learn more about severe asthma.


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