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Evaluation and Management of Difficult-to-Treat and Severe Asthma: An Expert Opinion From the Korean Academy of Asthma, Allergy and Clinical Immunology, the Working Group on Severe Asthma

Allergy, Asthma & Immunology Research : AAIR 2020년 12권 6호 p.910 ~ 933
김병근, 박소영, 반가영, 김미애, 이지향, 안진, 심지수, 이영수, Won Ha-Kyeong, 이화영, 손경희, 강성윤, 박소영, 이현, 김민혜, 권재우, 윤선영, 이재현, 이진국, 문지용, 이태훈, 김소리, 박종숙, 김상헌, 박흥우, 정재원, 김상훈, 고영일, 오연목, 장안수, 김순종, 조유숙,
소속 상세정보
김병근 ( Kim Byung-Keun ) - Korea University College of Medicine Department of Internal Medicine
박소영 ( Park So-Young ) - Konkuk University School of Medicine Department of Internal Medicine
반가영 ( Ban Ga-Young ) - Hallym University College of Medicine Kangdong Sacred Heart Hospital Department of Pulmonary, Allergy and Critical Care Medicine
김미애 ( Kim Mi-Ae ) - CHA University CHA Bundang Medical Center Department of Pulmonology, Allergy and Critical Care Medicine
이지향 ( Lee Ji-Hyang ) - University of Ulsan College of Medicine Asan Medical Center Department of Allergy and Clinical Immunology
안진 ( An Jin ) - University of Ulsan College of Medicine Asan Medical Center Department of Allergy and Clinical Immunology
심지수 ( Shim Ji-Su ) - Ewha Womans University College of Medicine Department of Internal Medicine
이영수 ( Lee Young-Soo ) - Ajou University School of Medicine Department of Allergy and Clinical Immunology
 ( Won Ha-Kyeong ) - Veterans Health Service Medical Center Department of Internal Medicine
이화영 ( Lee Hwa-Young ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
손경희 ( Sohn Kyoung-Hee ) - Kyung Hee University Medical Center Department of Internal Medicine
강성윤 ( Kang Sung-Yoon ) - Gachon University Gil Medical Center Department of Internal Medicine
박소영 ( Park So-Young ) - Eulji University School of Medicine Eulji General Hospital Department of Internal Medicine
이현 ( Lee Hyun ) - Hanyang University College of Medicine Department of Internal Medicine
김민혜 ( Kim Min-Hye ) - Ewha Womans University College of Medicine Department of Internal Medicine
권재우 ( Kwon Jae-Woo ) - Kangwon National University School of Medicine Department of Allergy and Clinical Immunology
윤선영 ( Yoon Sun-Young ) - Chungnam National University Hospital Department of Internal Medicine
이재현 ( Lee Jae-Hyun ) - Yonsei University College of Medicine Department of Internal Medicine
이진국 ( Rhee Chin-Kook ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
문지용 ( Moon Ji-Yong ) - Hanyang University College of Medicine Department of Internal Medicine
이태훈 ( Lee Tae-Hoon ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Internal Medicine
김소리 ( Kim So-Ri ) - Chonbuk National University Medical School Department of Internal Medicine
박종숙 ( Park Jong-Sook ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
김상헌 ( Kim Sang-Heon ) - Hanyang University College of Medicine Department of Internal Medicine
박흥우 ( Park Heung-Woo ) - Seoul National University College of Medicine Department of Internal Medicine
정재원 ( Jeong Jae-Won ) - Inje University College of Medicine Department of Internal Medicine
김상훈 ( Kim Sang-Hoon ) - Eulji University School of Medicine Eulji General Hospital Department of Internal Medicine
고영일 ( Koh Young-Il ) - Chonnam National University Medical School Department of Internal Medicine
오연목 ( Oh Yeon-Mok ) - University of Ulsan College of Medicine Asan Medical Center Department of Pulmonary and Critical Care Medicine
장안수 ( Jang An-Soo ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
김순종 ( Yoo Kwang-Ha ) - Konkuk University School of Medicine Department of Internal Medicine
조유숙 ( Cho You-Sook ) - University of Ulsan College of Medicine Asan Medical Center Department of Allergy and Clinical Immunology

Abstract


Severe asthma (SA) presents in about 3%?5% of adult asthmatics and is responsible for over 60% of asthma-related medical expenses, posing a heavy socioeconomic burden. However, to date, a precise definition of or clear diagnostic criteria for SA have not been established, and therefore, it has been challenging for clinicians to diagnose and treat this disease. Currently, novel biologics targeting several molecules, such as immunoglobulin E, interleukin (IL)5, and IL4/IL13, have emerged, and many new drugs are under development. These have brought a paradigm shift in understanding the mechanism of SA and have also provided new treatment options. However, we need to agree on a precise definition of and its diagnostic criteria for SA. Additionally, it is necessary to explain the diagnostic criteria and to summarize current standard and additional treatment options. This review is an experts' opinion on SA from the Korean Academy of Asthma, Allergy, and Clinical Immunology, the Working Group on Severe Asthma, and aims to provide a definition of and diagnostic criteria for SA, and propose future direction for SA diagnosis and management in Korea.

키워드

Severe asthma; biologics; diagnosis; eosinophil; expert opinion; IgE; treatment, IL5; IL4

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