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Respiratory Health 2020 Q4

Do no harm – safer and better treatment options for severe asthma

Image provided by Asthma UK

Dr Samantha Walker

Director of Research & Innovation, Asthma UK and the British Lung Foundation

Four in five people in England who might have severe asthma1 are not being referred to specialists for the treatments that could transform – and even save – their life. 


Research by Asthma UK shows that 200,000 people have severe asthma2, a type of asthma that does not respond to conventional inhaled steroid treatments

People with severe asthma often get caught in a never-ending cycle of emergency trips to hospital, intensive care and regular doses of strong steroid tablets.

These tablets stop the symptoms but if taken repeatedly, can lead to diabetes, osteoporosis, and obesity. They also increase the risk of serious illness from respiratory infections such as flu and pneumonia. Evidence is still emerging, but this may also be true for coronavirus.

We estimate that tens of thousands of people with severe asthma are not being referred for alternative treatments when they should.

One of the key issues is that there is not a severe asthma guideline from the National Institute of Clinical Excellence (NICE) and therefore, there is no clear referral path for healthcare providers to follow. 

We estimate that tens of thousands of peoplewith severe asthma are not being referred for alternative treatments when they should. 

Ensuring patient access to new medicines 

New biologic treatments are available that can transform the lives of people with severe asthma, but too few patients are being referred to asthma specialists, which means they are not getting a diagnosis or an opportunity to try these new treatments.

We want to provide healthcare professionals with the information they need to identify and refer suspected severe asthma patients more quickly, as they are at the highest risk of dying from an asthma attack.

This is why we have launched a new campaign and interactive tool, designed to help people with asthma and healthcare professionals identify ‘suspected severe asthma’, so that they can be urgently assessed and considered for referral for life-changing new treatments. 

The tool can be found on the Asthma UK website: www.asthma.org.uk/advice/severe-asthma/could-you-have-severe-asthma


1 Living in limbo, the scale of unmet need in difficult and severe asthma. New analysis found that 18% of people prescribed high dose inhaled corticosteroids (ICS) were referred to secondary care. This data is via the Clinical Practice Research Datalink (CPRD) and looked at referral rates in England in 2016. Further detail on this data is available in the report.
2 Do no harm: safer and better treatment options for people with asthma, Asthma UK, November 2020. www.asthma.org.uk/support-us/campaigns/publications/do-no-harm/

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