Richard Barbers, MD, FCCP; Monica Kraft, MD, FCCP; Louis J. Papa, MD

Distinguishing severe asthma from asthma that is difficult to control can present a clinical challenge, especially in primary care settings. Patients with severe asthma often benefit from multidisciplinary assessment and management. 

In this panel ReCAP, experts in allergy, pulmonary disease, and primary care discuss the difference between severe and difficult-to-control asthma and the clinical importance of this distinction. They then outline optimal management of severe asthma using conventional therapies and the six biologics that are now available. 

According to the panelists, patients with asthma that is difficult to control may have comorbidities that have not been addressed and may contribute to their respiratory symptoms. In patients with severe asthma, comorbidities have typically been addressed and patients are adherent to prescribed therapies; their disease worsens if therapy is stepped down. This definition follows the 2022 Global Initiative for Asthma guidelines. 

The experts discuss how tests administered in primary care and specialty settings can distinguish between eosinophilic and non-eosinophilic phenotypes. In patients who continue to have symptoms despite maximized conventional therapies, biologics targeting specific inflammatory pathways may come into play.  

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Richard Barbers, MD, Professor of Medicine, KECK Medical Center of the University of Southern California, Los Angeles, California 

Richard Barbers, MD, has disclosed no relevant financial relationships. 

Monica Kraft, MD, Murray M. Rosenberg Professor of Medicine, System Chair, Department of Medicine, Icahn School of Medicine at Mount Sinai; System Chair, Department of Medicine, Respiratory Institute at Mount Sinai Hospital, New York, NY 

Monica Kraft, MD, has disclosed the following relevant financial relationships: Serve(d) as a consultant for: Sanofi; Regeneron; AstraZeneca; Chiesi  

Serve(d) as Co-founder for: CMO; RaeSedo, Inc  
Received research grant from: National Institutes of Health; American Lung Association  

Have a 5% or greater equity interest in: RaeSedo, Inc (start-up in preclinical development of therapeutics) 

Received income in an amount equal to or greater than $250 from: UptoDate, section editor; received > $250 and < $5k from consultant activities above 

Louis J. Papa, MD, Professor of Clinical Medicine, Department of Medicine, Primary Care, University of Rochester Medical Center; Director of Professional Licensing and Credentialing Navigation, Olsan Medical Group, Rochester, New York 

Louis J. Papa, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Lifetime Healthcare Cos 

Received income in an amount equal to or greater than $250 from: Lifetime Healthcare Cos 

Distinguishing severe asthma from asthma that is difficult to control can present a clinical challenge, especially in primary care settings. Patients with severe asthma often benefit from multidisciplinary assessment and management. 

In this panel ReCAP, experts in allergy, pulmonary disease, and primary care discuss the difference between severe and difficult-to-control asthma and the clinical importance of this distinction. They then outline optimal management of severe asthma using conventional therapies and the six biologics that are now available. 

According to the panelists, patients with asthma that is difficult to control may have comorbidities that have not been addressed and may contribute to their respiratory symptoms. In patients with severe asthma, comorbidities have typically been addressed and patients are adherent to prescribed therapies; their disease worsens if therapy is stepped down. This definition follows the 2022 Global Initiative for Asthma guidelines. 

The experts discuss how tests administered in primary care and specialty settings can distinguish between eosinophilic and non-eosinophilic phenotypes. In patients who continue to have symptoms despite maximized conventional therapies, biologics targeting specific inflammatory pathways may come into play.  

--

Richard Barbers, MD, Professor of Medicine, KECK Medical Center of the University of Southern California, Los Angeles, California 

Richard Barbers, MD, has disclosed no relevant financial relationships. 

Monica Kraft, MD, Murray M. Rosenberg Professor of Medicine, System Chair, Department of Medicine, Icahn School of Medicine at Mount Sinai; System Chair, Department of Medicine, Respiratory Institute at Mount Sinai Hospital, New York, NY 

Monica Kraft, MD, has disclosed the following relevant financial relationships: Serve(d) as a consultant for: Sanofi; Regeneron; AstraZeneca; Chiesi  

Serve(d) as Co-founder for: CMO; RaeSedo, Inc  
Received research grant from: National Institutes of Health; American Lung Association  

Have a 5% or greater equity interest in: RaeSedo, Inc (start-up in preclinical development of therapeutics) 

Received income in an amount equal to or greater than $250 from: UptoDate, section editor; received > $250 and < $5k from consultant activities above 

Louis J. Papa, MD, Professor of Clinical Medicine, Department of Medicine, Primary Care, University of Rochester Medical Center; Director of Professional Licensing and Credentialing Navigation, Olsan Medical Group, Rochester, New York 

Louis J. Papa, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Lifetime Healthcare Cos 

Received income in an amount equal to or greater than $250 from: Lifetime Healthcare Cos 

Distinguishing severe asthma from asthma that is difficult to control can present a clinical challenge, especially in primary care settings. Patients with severe asthma often benefit from multidisciplinary assessment and management. 

In this panel ReCAP, experts in allergy, pulmonary disease, and primary care discuss the difference between severe and difficult-to-control asthma and the clinical importance of this distinction. They then outline optimal management of severe asthma using conventional therapies and the six biologics that are now available. 

According to the panelists, patients with asthma that is difficult to control may have comorbidities that have not been addressed and may contribute to their respiratory symptoms. In patients with severe asthma, comorbidities have typically been addressed and patients are adherent to prescribed therapies; their disease worsens if therapy is stepped down. This definition follows the 2022 Global Initiative for Asthma guidelines. 

The experts discuss how tests administered in primary care and specialty settings can distinguish between eosinophilic and non-eosinophilic phenotypes. In patients who continue to have symptoms despite maximized conventional therapies, biologics targeting specific inflammatory pathways may come into play.  

--

Richard Barbers, MD, Professor of Medicine, KECK Medical Center of the University of Southern California, Los Angeles, California 

Richard Barbers, MD, has disclosed no relevant financial relationships. 

Monica Kraft, MD, Murray M. Rosenberg Professor of Medicine, System Chair, Department of Medicine, Icahn School of Medicine at Mount Sinai; System Chair, Department of Medicine, Respiratory Institute at Mount Sinai Hospital, New York, NY 

Monica Kraft, MD, has disclosed the following relevant financial relationships: Serve(d) as a consultant for: Sanofi; Regeneron; AstraZeneca; Chiesi  

Serve(d) as Co-founder for: CMO; RaeSedo, Inc  
Received research grant from: National Institutes of Health; American Lung Association  

Have a 5% or greater equity interest in: RaeSedo, Inc (start-up in preclinical development of therapeutics) 

Received income in an amount equal to or greater than $250 from: UptoDate, section editor; received > $250 and < $5k from consultant activities above 

Louis J. Papa, MD, Professor of Clinical Medicine, Department of Medicine, Primary Care, University of Rochester Medical Center; Director of Professional Licensing and Credentialing Navigation, Olsan Medical Group, Rochester, New York 

Louis J. Papa, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Lifetime Healthcare Cos 

Received income in an amount equal to or greater than $250 from: Lifetime Healthcare Cos