Abstract
This document constitutes a summary of the Clinical Practice Guidelines (CPGs) prepared at the initiative of the Latin American Thoracic Society (ALAT). Due to new evidence in the treatment of severe asthma, it was agreed to select 6 clinical questions, and the corresponding recommendations are provided herein. After considering the quality of the evidence, the balance between desirable and undesirable impacts and the feasibility and acceptance of procedures, the following recommendations were established: 1) We do not recommend the use of an ICS plus formoterol as rescue medication in the treatment of severe asthma. 2) We suggest performing many more high-quality randomised studies to evaluate the efficacy and safety of tiotropium in patients with severe asthma. 3) Omalizumab is recommended in patients with severe uncontrolled allergic asthma with serum IgE levels above 30 IU. 4) Anti-IL-5 drugs are recommended in patients with severe uncontrolled eosinophilic asthma (cut-off values above 150 cells·µL−1 for mepolizumab and above 400 cells·µL−1 for reslizumab). 5) Benralizumab is recommended in adult patients with severe uncontrolled eosinophilic asthma (cut-off values above 300 cells·µL−1). 6) Dupilumab is recommended in adult patients with severe uncontrolled allergic and eosinophilic asthma and in adult patients with severe corticosteroid-dependent asthma.
Footnotes
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Conflict of interest: Dr. García reports and GRANTS RESEARCH : Novartis, GSK, Boehringer Ingelheim, Astra Zeneca, Sanofi.CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis;Sanofi
Conflict of interest: Dr. Bergna reports and GRANTS RESEARCH : Novartis, GSK, Boehringer Ingelheim, Roche, Astra Zeneca, Sanofi. CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis.
Conflict of interest: Dr. Vazquez reports CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis, Boehringer Ingelheim,
Conflict of interest: Dr. Cano reports CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis, Boehringer Ingelheim,
Conflict of interest: Dr. Acuña reports CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis, Boehringer Ingelheim,
Conflict of interest: Dr. Cellis reports and GRANTS RESEARCH : Novartis, Astra Zeneca, Sanofi.CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis. Sanofi
Conflict of interest: Dr. Acuña reports CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis, Boehringer Ingelheim,
Conflict of interest: Dr. Barros reports and GRANTS RESEARCH : Novartis, GSK, Boehringer Ingelheim, Astra Zeneca.CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis.
Conflict of interest: Dra Garcia reports CONSULTANT / ADVISOR / SPEAKER: Astra Zeneca, Novartis
Conflict of interest: Dr. MAYORGA-BUTRON has nothing to disclose.
Conflict of interest: Dr Casanova has nothing to disclose.
Conflict of interest: Dra Gutierrez has nothing to disclose.
Conflict of interest: Dra Montero reports GRANTS RESEARCH : Novartis
Conflict of interest: Dra Utrecho Perez has nothing to disclose.
Conflict of interest: Dr. Antunez reports CONSULTANT / ADVISOR / SPEAKER: GSK, Astra Zeneca, Novartis, Boehringer Ingelheim,
Conflict of interest: Dra Williams has nothing to disclose.
Conflict of interest: Dr. Villatoro has nothing to disclose.
Conflict of interest: Dr. Motiño has nothing to disclose.Motiño
Conflict of interest: Dra. De Oliveira has nothing to disclose.
Conflict of interest: Dra Rey Sanchez has nothing to disclose.
Conflict of interest: Dra Arroyo has nothing to disclose.
Conflict of interest: Sr Rodriguez has nothing to disclose.
- Received June 12, 2020.
- Accepted September 21, 2020.
- Copyright ©ERS 2020
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