Severe Asthma

Around 5% of people with asthma have what is called severe asthma.¹ A person with this type of asthma has trouble breathing almost all of the time, as well as having more frequent asthma attacks. It is also called “severe persistent asthma.”

It is also important to understand what severe asthma is not¹:

• Having occasional asthma symptoms that are severe does not always mean that you have this form of asthma
• Finding it hard to manage your asthma symptoms effectively does not always mean that you have this type of asthma

People with this asthma have severe symptoms all or most of the time, and even when they take their medications exactly the right way, it may not reduce their symptoms. Life with this asthma can be very challenging. The person may be unable to take full part in day-to-day activities, school, and/or work. People with severe asthma are also more likely to end up in the hospital for treatment than people with less severe and other types of asthma.

How is severe asthma diagnosed?

It is one of the four categories, or levels, of asthma^1-4:

• Mild intermittent asthma
• Mild persistent asthma
• Moderate persistent asthma
• Severe persistent asthma

These categories are based on how severe a person’s asthma is, and a person’s asthma severity will often change over time. To find out what category of asthma a patient has, healthcare providers will look at the asthma signs and symptoms the patient has without taking any medications, and the results of the patient’s lung function tests.

People with this asthma generally have symptoms throughout the day on most (or all) days and they wake up frequently due to their symptoms at night (sometimes every night). These symptoms can make daily physical activities very difficult. People with severe asthma also have poor lung functioning that can change a lot from the morning to the afternoon. They often need to use their rescue inhalers several times each day, and they tend to have more frequent asthma attacks that require steroids to treat.

What causes severe asthma?

It can have a range of different causes. Patients who are more likely to have this type of asthma include¹:

• People who have other chronic medical conditions, like diabetes
• People who are current smokers
• People who have trouble taking their long-term asthma medications regularly and on time

How can severe asthma be treated?

It can cause symptoms that are hard to manage, because they may not respond very well to typical asthma medicines. To treat and manage this asthma subtype, patients will often need more complex treatments that involve higher doses of several different medicines every day.^1,4 For example, patients might take a combination of:

• Long-term maintenance medicines to reduce inflammation in the airways (such as inhaled corticosteroids)
• Long-acting and short-acting bronchodilators to relieve symptoms that suddenly get worse
• Anti-inflammatory medicines called “leukotriene modifiers”

Sometimes, patients may need to take their medications using a special device called a nebulizer.
Physiotherapy can be very helpful for patients living with severe asthma. Specialists called physiotherapists can perform special types of therapies to clear the patient’s airways and coach patients about how to develop good breathing patterns. They can also provide guidance about ways patients can carry out regular exercise routines, even when their physical abilities are limited by their asthma.