Thorax 2012;67:754-756 doi:10.1136/thoraxjnl-2012-201869

• Chest clinic

• Audit update

Clinical management and outcome of refractory asthma in the UK from the British Thoracic Society Difficult Asthma Registry

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1. Joan Sweeney1, 
2. Chris E Brightling2, 
3. Andrew Menzies-Gow3, 
4. Robert Niven4,
5. Chris C Patterson5, 
6. Liam G Heaney1, 
7. on behalf of the British Thoracic Society Difficult Asthma Network

+Author Affiliations

1. ¹Centre for Infection and Immunity, Queen's University of Belfast, Belfast, UK
2. ²Institute for Lung Health, Department of Infection, Inflammation and Immunity, University of Leicester, Leicester, UK
3. ³Royal Brompton and Harefield NHS Foundation Trust, London, UK
4. ⁴The University of Manchester (MAHSC) and University Hospital of South Manchester, UK
5. ⁵Centre for Public Health, Queen's University of Belfast, Belfast, UK

1. Correspondence toProfessor Liam G Heaney, Centre for Infection and Immunity, Queen's University of Belfast, Level 8, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, UK; l.heaney@qub.ac.uk

1. Contributors LGH is the coordinator of the British Thoracic Society Difficult Asthma Registry and with JS collated and managed the data for this manuscript. CEB and AM-G and RN co-lead the British Thoracic Society Difficult Asthma Network and all have contributed equally to this manuscript.

• Received 6 March 2012
• Accepted 30 March 2012
• Published Online First 11 May 2012

Abstract

Refractory asthma represents a significant unmet clinical need. Data from a national online registry audited clinical outcome in 349 adults with refractory asthma from four UK specialist centres in the British Thoracic Society Difficult Asthma Network. At follow-up, lung function improved, with a reduction in important healthcare outcomes, specifically hospital admission, unscheduled healthcare visits and rescue courses of oral steroids. The most frequent therapeutic intervention was maintenance oral corticosteroids and most steroid sparing agents (apart from omalizumab) demonstrated minimal steroid sparing benefit. A significant unmet clinical need remains in this group, specifically a requirement for therapies which reduce systemic steroid exposure.

Full Text

http://thorax.bmj.com/content/67/8/754.full