Co‐morbidities in severe asthma: C linical impact and management
Abstract
Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD), bronchiectasis, allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatous with polyangiitis (EGPA). Furthermore, the review offers a summary of recommended diagnostic and management approaches for each co-morbidity. Finally, the review links co-morbid conditions to specific phenotypes of severe asthma, in order to guide the clinician on which co-morbidities to look for in specific patients.
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Treatment of comorbid disorders co-occurring with asthma may improve asthma control, although there is a paucity of evidence to support this from well-designed randomized intervention trials.
“Treatment of these disorders co-occurring with asthma may improve asthma control (65), although there is a paucity of evidence to support this from well-designed randomized intervention trials (67).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [67]
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- Authors
- Porsbjerg, C., & Menzies‐Gow, A.
- Affiliations
- Bispebjerg Hospital (DK)
- Royal Brompton and Harefield NHS Foundation Trust London UK
- Corresponding author
- Porsbjerg, Celeste
- ORCID
- Porsbjerg, Celeste
- Venue
- Respirology
- Publisher
- Wiley
- Published
- 2017-03-22
- Volume
- 22
- Issue
- 4
- Pages
- 651-661
- ISSN
- 1323-7799 (ISSN-L)
- 1440-1843
- OpenAlex
- W2601652410
- Cited by
- 233
- References
- 125
- Citations by year
- 2026: 14 · 2025: 19 · 2024: 27 · 2023: 32 · 2022: 24 · 2021: 25 · 2020: 32 · 2019: 25 · 2018: 23 · 2017: 12
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Respirology (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- severe asthma, comorbidities, asthma phenotypes, chronic rhinosinusitis, nasal polyps, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnea, gastroesophageal reflux disease, bronchiectasis, allergic bronchopulmonary aspergillosis, eosinophilic granulomatosis with polyangiitis, asthma control, health care costs
- MeSH terms
- Aspergillosis, Allergic Bronchopulmonary, Asthma, Bronchiectasis, Chronic Disease, Gastroesophageal Reflux, Humans, Global Health, Comorbidity, Disease Management, Sleep Apnea, Obstructive, Rhinitis, Allergic
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