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Severe Asthma Attacks / Exacerbations / Flare-ups

Home Severe Asthma Severe Asthma Attacks / Exacerbations / Flare-ups

Severe Asthma Attacks / Exacerbations / Flare-ups

Asthma is characterised by day-to-day variation in symptoms. Sometimes a person’s symptoms progressively worsen over time, and lung function decreases, to the extent that a change in their treatment is needed to avoid serious outcomes. This worsening may occur over minutes or hours (Elliot et al. 2009), but more often over several days or sometimes even weeks. Significant worsenings are termed asthma attacks.

Attacks (also called flare-ups or exacerbations) are common in uncontrolled asthma, including in patients with severe asthma. They are commonly associated with eosinophilic inflammation in the airways (Jayaram et al. 2006). Virus infections are also a common cause of lung attacks and these are associated with neutrophilic inflammation in the airways (Wark et al. 2002).

signs and symptoms of an asthma attack, severe asthma attack, asthma exacerbation

Signs and Symptoms of an Asthma Attack

Prior to a severe asthma attack, a person with asthma may experience a period of gradual worsening, or attacks may follow exposure to specific triggers, which vary between different people. These triggers include viral or bacterial infection, exposure to an allergen to which the patient is sensitised, occupational sensitisers, stress, or poor adherence with inhaled preventer therapy. Viral exacerbations are associated with a temporary reduction in response to inhaled beta 2-agonists (Reddel et al. 1999). Epidemics of severe asthma attacks can occur amongst people with allergic rhinitis (with or without a history of asthma) who are sensitised to rye grass pollen, when a thunderstorm-associated with updraft and outflow occurs during high rye grass pollen levels (Girgis et al. 2000, Marks et al. 2001).

Asthma attacks should prompt a review of the patient’s asthma management, as they are burdensome and risky for patients and, in patients not taking inhaled preventers, can lead to greater decrease in lung function (Bai et al. 2007, O’Byrne et al. 2009). Medications should also be reviewed. For more information see Living with Severe asthma – Experience of Attacks

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Last Updated on February 11, 2019

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  • Overview
  • Definition
  • Prevalence & Burden
  • Pathophysiology
  • Symptoms
  • Severe Asthma Attacks / Exacerbations / Flare-ups
  • Asthma Phenotypes

What is Severe Asthma?

It is asthma that remains uncontrolled despite treatable factors having been addressed and maximal inhaled therapy being taken regularly.

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