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Chest and Lung Research

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In India, stratified approaches for employing biomarkers in phenotyping for severe asthma management

Author(s): Alisiya Siyra*

Severe asthma is defined by various respiratory societies, such as the Global Initiative for Asthma (GINA), The European Respiratory Society (ERS), and the American Thoracic Society (ATS), as asthma that requires or remains uncontrolled despite treatment with systemic corticosteroids or high-dose inhaled corticosteroids plus another controller, such as a long-acting beta agonist. Due to inter-individual variability in evaluation factors, managing asthma as a separate entity is difficult. Targeted medicines for the treatment of severe asthma are becoming more common as science advances. A biomarker can be used as a substitute for phenotyping a patient or measuring the response to any medication therapy.In severe asthma, biomarkers have proved crucial in investigations of disease pathophysiology and the development of novel therapeutics. In nations with limited resources, such as India, it is critical to use biomarkers that are readily available and inexpensive. Choosing the right biomarkers is also vital when it comes to deciding on a treatment.

The cost of biologicals is significant, thus it's critical to assess the therapy's success as soon as possible, taking into account the patients' out-ofpocket expenses.

Severe asthma is a disease that is both complex and heterogeneous. Severe asthma is defined by the Global Initiative for Asthma (GINA), the European Respiratory Society, and the American Thoracic Society as asthma that requires or remains uncontrolled despite treatment with systemic corticosteroids or high-dose inhaled corticosteroids combined with another controller such as a long-acting beta-agonist. To assess disease control, guidelines recommend looking at things like lung function, exacerbations, and hospitalization rates. However, due to inter-individual heterogeneity in evaluation factors, managing asthma as a separate entity is difficult.

The variability of presenting symptoms and underlying causes or triggers has been acknowledged as a factor that led to the conclusion that "one size does not fit all" with the increase in asthma research. In the assess-treat-reassess paradigm contained in the treatment protocol, GINA 2021's latest guidance recognizes the necessity of customized asthma care.


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