Klinisches Register Schweres Asthma

⁃ a. Positive bronchodilator reversibility testing (≥ 12% increase in FEV1 after SABA) or b. Significant bronchial hyperreactivity (BHR) after unspecific provocation test (e.g. methacholine challenge or treadmill) according to ATS criteria (Am J Respir Crit Care Med 2000) (vi) High level of treatment:

• Maintenance treatment with high doses of ICS (\>400 μg budesonide or equivalent / ≥ 200 μg of fluticasone as monotherapy) or

• Maintenance treatment with medium to high doses of ICS (≥400 μg budesonide or equivalent / ≥ 200 μg fluticasone) combined with LABA and/or LTRA and/or theophylline or

• Treatment with oral steroids for ≥ 3 months (vii) Poor asthma control:

⁃ Definition: Severe asthma in adults

⁃ High level of treatment (A), i.e. step 5 of GINA guideline or (B) medium level of treatment and poor symptom control:

⁃ (A) High level of treatment:

• Maintenance treatment with high-dose inhaled corticosteroids (≥ 1000 μg beclomethasone (BDP, powder) or equivalent) in combination with LABA or LTRA or theophylline or

• Maintenance treatment with oral corticosteroids (OCS) for ≥3 months independent of other asthma treatments or

• Treatment with monoclonal antibodies independent of other asthma treatments

⁃ B) Medium level of treatment and poor symptom control:

• Maintenance treatment with medium to high doses of ICS (≥ 500 μg BDP (powder) or equivalent) in combination with LABA or LTRA or theophylline and

• Poor symptom control:

⁃ (i) asthma symptoms ≥ 3 x / week or use of rescue medication ≥ 3 x / week; or (ii) activities limited due to asthma; or (iii) any nighttime asthma symptoms; or (iv) ≥ 1 exacerbation in the last year with ≥ 3 days of OCS treatment or (v) FEV1\<80% of predicted