Caminati Marco, Vaia Rachele, Furci Fabiana, Guarnieri Gabriella, Senna Gianenrico
Department of Medicine, University of Verona, Verona, Italy.
Allergy Unit and Asthma Center, University of Verona and Verona University Hospital, Verona, Italy.
J Asthma Allergy. 2021 May 3;14:457-466. doi: 10.2147/JAA.S260604. eCollection 2021.
The recent scientific research has provided clinicians with the tools for substantially upgrading the standard of care in the field of bronchial asthma. Nevertheless, satisfactory asthma control still remains an unmet need worldwide. Identifying the major determinants of poor control in different asthma severity levels represents the first step towards the improvement of the overall patients' management. The present review aims to provide an overview of the main unmet needs in asthma control and of the potential tools for overcoming the issue. Implementing a personalized medicine approach is essential, not only in terms of pharmacological treatments, biologic drugs or sophisticated biomarkers. In fact, exploring the complex profile of each patient, from his inflammation phenotype to his preferences and expectations, may help in filling the gap between the big potential of currently available treatments and the overall unsatisfactory asthma control. Telemedicine and e-health technologies may provide a strategy to both optimize disease assessment on a regular basis and enhance patients' empowerment in managing their asthma. Increasing patients' awareness as well as the physicians' knowledge about asthma phenotypes and treatment options besides corticosteroid probably represent the key and more difficult goals of all the players involved in asthma management at every level.
最近的科学研究为临床医生提供了大幅提升支气管哮喘领域护理标准的工具。然而，在全球范围内，令人满意的哮喘控制仍然是未被满足的需求。确定不同哮喘严重程度水平下控制不佳的主要决定因素是改善整体患者管理的第一步。本综述旨在概述哮喘控制方面主要未被满足的需求以及克服该问题的潜在工具。实施个性化医疗方法至关重要，不仅在药物治疗、生物药物或复杂生物标志物方面。事实上，探究每个患者的复杂特征，从其炎症表型到其偏好和期望，可能有助于填补当前可用治疗的巨大潜力与整体不尽人意的哮喘控制之间的差距。远程医疗和电子健康技术可能提供一种策略，既能定期优化疾病评估，又能增强患者管理哮喘的能力。除了皮质类固醇之外，提高患者对哮喘表型和治疗选择的认识以及医生的相关知识，可能是各级参与哮喘管理的所有人员的关键且更具挑战性的目标。
