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General practice Terapia 2023, 11 ( 430 ) :  38  -  46

GP's place in the management of severe astma

Summary: Difficult-to-treat and severe asthma represent a significant burden on patients, their families and healthcare systems. The path of a patient with more severe forms of asthma is defined by episodes of frequent exacerbations, unscheduled doctor visits or hospitalizations, sick leaves and a significant deterioration in the quality of life, which translates into stress, frustration, fear and loss of hope. Biological therapies used in well-defined phenotypes of severe asthma undoubtedly lead to a significant improvement in asthma control, quality of life, a decrease in the number of exacerbations and the need for systemic corticosteroids. GP specialist tasks include early identification of difficult forms of the disease, optimization of current inhalation therapy, education, and extensive differential diagnosis. Frequent exacerbations, lack of control of the disease, persistence of symptoms despite the use of high doses of ICS, or significant side effects of current therapy are alarm signs that should arouse special vigilance. Qualification for biological therapy in severe asthma is the task of the reference center (allergist/pulmonologist). Preparing the patient, documenting the current course of the disease, including the need for high doses of ICS, the number of exacerbations in the last year, the level of eosinophils in the peripheral blood and the exclusion of parasitic infection will facilitate the assessment of the phenotype and endotype of the disease and the implementation of optimal biological therapy for a patient.
Keywords: asthma, severe asthma, difficult-to-treat asthma, biological treatment

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