Understanding disease burden, challenges in current treatment strategies and call for action for management of severe asthma in Asia: a position statement from Asian respiratory experts

In the Asia-Pacific region, there is limited data on the full extent of the burden of severe asthma, as well as a lack of clear guidance on improving care standards. Genetic, environmental, behavioural, policy and funding factors in -Asia-Pacific region differ from other parts of the world. To address these gaps, a panel of Asian experts conducted a comprehensive review of the existing literature in the region, aiming to understand the burden of severe asthma and provide key recommendations and actionable steps to improve its management across Asia. Experts identified several key challenges in managing SA, which include inadequate expertise, delayed patient identification or referral, limited access to advanced diagnostics and treatments, suboptimal adherence, and insufficient government support and funding, underlining the need for a more comprehensive approach to SA management. Experts also proposed that the Asia-Pacific region definition of clinical remission in SA should include elimination of exacerbation and use of oral corticosteroids, good symptom control, and inclusion of lung function criteria, particularly in light of the evolving treatment landscape. The experts concluded that while restoring normal lung function may be unrealistic for most patients with severe asthma and remodelled airways, striving for optimal individual lung function or maintaining stability may be a more attainable goal. Several key points and actionable recommendations were proposed to help reduce the overall burden of severe asthma in Asia.