Back to the roots of medicine: It's severe asthma patient-reported symptoms that matter!

Louis G, Schleich F, Guillaume M, Sousa-Pinto B, Bousquet J, Ganse ÉV, Louis R, Pétré B.  Pulmonology. 2023 Nov 10:S2531-0437(23)00194-0. doi: 10.1016/j.pulmoe.2023.10.005.

To the Editor,

Severe asthma can be defined as an “asthma which requires treatment with high-dose inhaled corticosteroids (ICS) + LABA to prevent it from becoming ‘uncontrolled’ or which remains ‘uncontrolled’ despite this therapy”.1 It is an important public health problem strongly associated with a significant health-related quality of life (HRQL) burden 2 and with considerable healthcare costs, almost twice those of non-severe asthmatics.3

Several studies have assessed the factors associated with HRQL in severe asthmatics, demonstrating the key role played by asthma control and comorbidities.2 However, very few studies have assessed the impact of detailed respiratory symptoms on HRQL. A recent study conducted by Louis et al.4 has demonstrated that dyspnoea was the most impactful symptom on the lives of mild asthmatics. However, to the best of our knowledge, no study has ever assessed the impact of specific respiratory symptoms on HRQL in a population of severe asthmatics. Knowing which symptoms are the most impactful on the lives of severe asthmatics is useful for adopting personalised care strategies.

A cross-sectional study was conducted between 2018 and 2022 on a population of T2 high severe adult asthmatics recruited from the Liege University Hospital Asthma Clinic (Belgium) prior to initiation of biologics (n = 143)...

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