New therapies are exciting for the treatment of asthma, but it’s important to confirm the correct diagnosis of asthma, particularly severe asthma, since many of the newer therapies and treatments are involved and expensive, according to Diego Maselli, MD, FCCP.
During the Sunday session Beyond Spirometry: New Developments in the Diagnosis and Assessment of Severe Asthma, Dr. Maselli, associate professor of medicine in the division of pulmonary diseases and critical care at the University of Texas Health at San Antonio, and his co-presenters will review the current tools for a practical assessment and diagnosis of asthma and how that translates to clinical practice. The interactive session starts at 10:45 am in room 265 of the convention center.
“Once you confirm the diagnosis, there are many options out there for the treatment of severe asthma, particularly with biologicals,” Dr. Maselli said. “You want to understand the type of asthmatic you’re treating. Nowadays we’re using biomarkers, and there’s newer tools out there like imaging that may provide additional insights.”
One talk will address serum and sputum biomarkers. New recommendations from the Global Initiative for Asthma guidelines suggest these tests should be repeated up to three times, but not all experts agree.
Beyond the biomarkers of the sputum and imaging, there’s now more information about the use of eosinophils, IgE, and fractional exhaled nitric oxide (FeNO) to phenotype patients. The session will start a discussion about what might indicate their utility in managing and monitoring patients with severe asthma and discuss the controversies that exist regarding how to best select these therapies.
Physicians also are starting to use more CT scans to evaluate patients with pulmonary conditions, Dr. Maselli noted. This session will cover when to consider a CT scan for an asthma evaluation, including the indications for ordering a scan and what those scans show.
“The CT scans can help you classify patients into different subgroups,” Dr. Maselli explained. “We’re always trying to phenotype patients to figure out what is the best way to treat them. The other objective is to understand a little bit better the pathophysiology of these patients. The scan provides additional information that may guide you.”
Dr. Maselli further shared that a CT scan is a very effective diagnostic tool because it helps ensure patients don’t have other additional lung diseases or infections.
The session also will address newer information on patients with asthma, including patterns and specific abnormalities that may be associated with different outcomes in asthma—airway thickening, for example.
The last part of the session will review bronchoprovocation testing or the “methacholine challenge test” performed to evaluate how patients’ lungs respond or react to things in the environment as a reminder to clinicians about when to order it and of the contraindications.