journal contribution posted on 17.04.2019, 14:43 by S Saglani, A Bush, W Carroll, S Cunningham, L Fleming, E Gaillard, A Gupta, C Murray, P Nagakumar, J Paton, G Roberts, P Seddon, I Sinha
While most asthma in UK children can be controlled with low-moderate dose inhaled corticosteroids
(ICS), there remains a small group with severe disease and poor control despite maximal treatment
whose needs are unmet because of discrimination compared to adults. Severe asthma is a
commissioned service for adults with only named specialist centres able to assess patients and
prescribe biologics. A systematic assessment at a dedicated severe asthma centre is associated with
improved quality of life and asthma control and a reduction in health-care utilisation(1). This
multidisciplinary assessment helps to identify remediable factors such as poor adherence and ensures
that appropriate patients are started on costly biologics. In contrast, although international guidelines
exist(2), there is no such service provision or specification for children, despite clear evidence of their
long-term morbidity, including development of chronic obstructive pulmonary disease in
adulthood(3), and the potential risks associated with the prescription of biologics.
WC reports grants from Trudell Medical International; personal fees from
Novartis, Trudell Medical International, Circassia, Orion, and GSK; and nonfinancial support from Novartis and Trudell Medical International. LF reports
grants from Asthma UK; and support to her institution from Boehringer
Ingelheim, AstraZeneca, GSK, Sanofi, Respiri, and Novartis. EG reports grants
from Chiesi, Gilead Sciences, and Circassia; non-financial support and
collaboration from MedImmune; a travel grant from Vertex; and support to his
institution from Boehringer Ingelheim and Anaxsys. AG reports support to his
institution from GSK and Novartis; personal fees from GSK and Novartis; and
non-financial support from Novartis. CM reports grants from the National
Institute for Health Research; personal fees from Novartis, GSK, and
AstraZeneca; and educational grants from Novartis, GSK, and AstraZeneca.
CitationLancet Respiratory Medicine, 2019, 7(4), pp. 294-296.
Author affiliation/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and Inflammation
VersionAM (Accepted Manuscript)
Published inLancet Respiratory Medicine
NotesThe file associated with this record is under embargo until 6 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.