Wang Eileen, Hoyte Flavia C L
Division of Allergy and Clinical Immunology, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Colorado Hospital, 1635 Aurora Court, Aurora, CO 80045, USA.
Division of Allergy and Clinical Immunology, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Colorado Hospital, 1635 Aurora Court, Aurora, CO 80045, USA.
Immunol Allergy Clin North Am. 2016 Aug;36(3):581-608. doi: 10.1016/j.iac.2016.03.013.
Severe asthma is a complex and heterogeneous disease. The European Respiratory Society and American Thoracic Society guidelines define severe asthma for patients 6 years or older as "asthma which requires treatment with high-dose inhaled corticosteroids…plus a second controller or systemic corticosteroids to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy." This article reviews available traditional therapies, data behind their uses in severe asthma, and varying recommendations. As various asthma endotypes and phenotypes are better understood and characterized, targeted therapies should help improve disease outcomes, efficacy, and cost-effectiveness.
重度哮喘是一种复杂的异质性疾病。欧洲呼吸学会和美国胸科学会的指南将6岁及以上患者的重度哮喘定义为“需要使用高剂量吸入性糖皮质激素……加用第二种控制药物或全身性糖皮质激素进行治疗以防止病情‘失控’，或尽管进行了这种治疗仍处于‘失控’状态的哮喘”。本文综述了现有的传统疗法、其在重度哮喘中应用的依据以及不同的推荐意见。随着对各种哮喘内型和表型的更好理解和特征描述，靶向治疗应有助于改善疾病结局、疗效和成本效益。
