Biologics in severe asthma: a state-of-the-art review.

Asthma is considered severe if it remains uncontrolled despite optimal conventional therapy, characterised by poor symptom control, frequent exacerbations and increased exposure to systemic corticosteroids. This has a significant impact on morbidity, mortality and healthcare resource utilisation. Recent advances in the understanding of asthma heterogeneity and immunopathogenesis have helped delineate precise disease pathways.

Peripheral airways dysfunction measured by oscillometry differentiates asthma from inducible laryngeal obstruction.

Background: Inducible laryngeal obstruction (ILO, also called vocal cord dysfunction) can be difficult to distinguish clinically from asthma. Limited studies have explored the use of respiratory oscillometry to detect changes unique to ILO, but more study is needed to determine if routine oscillometry can differentiate these two clinical entities.

Objective: Determine if impedance variables measured on routine oscillometry over tidal breathing vary between individuals with asthma and ILO.

Oral corticosteroid-sparing effects of mepolizumab in severe eosinophilic asthma: evidence from randomized controlled trials and real-world studies.

Oral corticosteroids (OCS) have long been a mainstay of treatment for asthma exacerbations and chronic severe asthma. However, it is increasingly recognized that both long-term and short-term OCS use are directly associated with a wide range of serious adverse effects, and as such OCS-sparing treatment alternatives are now widely recommended for patients with severe asthma. While several international guidelines recommend these treatments, guidance on OCS tapering, and which patients are most likely to tolerate OCS reduction and/or discontinuation, is still lacking.

Asthma biologics: Real-world effectiveness, impact of switching biologics, and predictors of response.

Background: Confirmation of effectiveness of asthma biologics in the real world is desirable because patient characteristics and experiences may differ from those included in randomized controlled trials.

Objective: To evaluate real-world effectiveness of asthma biologics and identify predictors of response.

Methods: We performed a retrospective study in patients with severe asthma receiving biologics.

Managing Corticosteroid-Related Comorbidities in Severe Asthma.

Oral corticosteroid (OCS) use in severe asthma remains all too common despite advances in asthma treatment. Use of OCS is associated with significant toxicity that can have a lasting adverse impact on a patient's overall health. Monoclonal antibodies have been developed that reduce both the rate of occurrence of OCS-treated exacerbations and the OCS requirements in patients with oral corticosteroid-dependent asthma.

Pulmonary Function Testing and Cardiopulmonary Exercise Testing: An Overview.

Respiratory symptoms are common reasons for patients to seek care and contribute significantly to use of health care resources. Identifying the underlying etiology of a respiratory symptom is key to management; yet, pinpointing the cause can be a challenge. Familiarity with the tools available to help discern between the various contributing etiologies is crucial in guiding management.

Systematic Approach to Asthma of Varying Severity.

Asthma is a serious global health issue and asthma guidelines recommend a stepwise approach to management with goals to achieve control and minimize future risk. Prior to escalation of pharmacotherapy, steps to confirm accurate diagnosis as well as address comorbidities and triggers are critical to effective asthma management. This article provides readers with a structured approach to evaluation and management of asthma of varying severity.

Subcutaneous treprostinil is well tolerated with infrequent site changes and analgesics.

Abstract Continuous prostanoid infusions are recommended for patients with advanced pulmonary arterial hypertension. Infusion site pain has discouraged some physicians from considering subcutaneous (SQ) treprostinil therapy even though it has safety and convenience advantages over intravenous epoprostenol. We conducted a 1-year prospective study of patients utilizing SQ treprostinil.