Unconventional treatment options in severe asthma: An overview

Abstract

In Canada, asthma is the leading cause of admission in hospital. About of 80% of the death from asthma is preventable. Severe asthma is defined as a patient with persistent symptoms despite the use of adequate controller therapy, including multiple courses of oral glucocorticosteroids. However, about 10% of patients with severe asthma remain poorly controlled despite optimal treatment and these patients have the greatest morbidity and mortality. The management of refractory severe asthma remains extremely challenging. For patients with refractory severe asthma, the adjunct therapies recommended by national guidelines only included oral glucocorticosteroid and anti-IgE antibody (omalizumab) therapy. Currently, there is limited published literature on the unconventional treatments such as methotrexate, cyclosporine, gold and antimicrobials treatments, for refractory severe asthma. The objective of this review article is to provide an updated therapeutic overview of unconventional treatment options for refractory severe asthma.