Targeted management of severe asthma: Developing a Canadian approach

Although only 5-10% of patients with asthma have severe disease, they account for a disproportionate share of the overall disease burden. Severe asthma is responsible for approximately 50% of all direct asthma-related costs as well as a significant decline in patient quality of life. For such patients, biologic or targeted therapies may be highly effective. However, their role is not widely understood and their use is currently minimal. Both Canadian and international research suggests that the adverse effects of oral corticosteroids in severe asthma are significant and costly but under-recognized. Our review of management of severe asthma in Canada highlights the need for increased recognition of the adverse effects of oral corticosteroids and more awareness of the newer alternative therapies on the part of physicians, as well as access to specialized care for the population with severe asthma including patient education resources, and ongoing monitoring with a severe asthma registry.