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Patients with severe asthma risk premature mortality and corticosteroid-related comorbidities1–4

  • Severe asthma is a specific asthma that doesn’t respond to readily available treatments, rather than an extreme form of the condition1
  • Despite the use of high-dose treatments, underlying asthma is hard to control leading to a great burden of symptoms and asthma attacks1
  • Oral corticosteroids (OCS) are often used to mitigate symptoms, but these can often lead to severe side-effects, especially if taken long-term1

5.4 million people in the UK have asthma, with approximately 4% of those with severe asthma* (approximately 200,000–250,000).1,2,4,5

Approximately, 50,000 people with severe asthma are on the highest level of treatment.†1,6

*Severe asthma is associated with daily symptoms of: breathlessness, shortness of breath, disturbed sleep, cough and wheeze, compounded by frequent ‘attacks’ (sudden, unpredictable and often devastating worsening of symptoms).1

The highest level of treatment refers to step 5 of the British Thoracic Society (BTS) guidelines for asthma management which is regular OCS therapy.6

In the National Review of Asthma Deaths (NRAD) (2014) sufficient data was available on 195 people who died of asthma between 2012–2013. From 195 people, 155 had their asthma severity recorded prior to death.*4

Severity of asthma in the 12 months prior to death (n=155)†4

Severity of asthma n (%)
No history of asthma 4 (3)
Mild 14 (9)
Moderate 76 (49)
Severe 61 (39)

NRAD reported that many patients who were treated as having mild or moderate asthma were likely to have had poorly-controlled undertreated asthma, rather than truly mild or moderate disease.4

*The NRAD is the first UK-wide investigation into asthma deaths that took place between 1st February 2012 and 31st January 2013. Experts such as general practitioners (GPs), nurses and pharmacists looked at medical records and other information relating to these deaths from doctors’ surgeries, hospitals, emergency services and coroners’ offices.4

Severity was defined as follows: The BTS/Scottish Intercollegiate Guidelines Network (SIGN) treatment steps 1 and 2 were used as a surrogate for mild and moderate severity; those who were prescribed four asthma medications and those who had been admitted to hospital in the past year, needed OCS daily or had two or more prescriptions for systemic corticosteroids in the past year were classified as severe.4

Severe asthma* corticosteroid-dependent patients had the following comorbidities:3



Dyspeptic disorders






Psychiatric disorders







*Severe asthma was defined by the Global Initiative for Asthma (GINA) treatment step 5 with four or more prescriptions/year of OCS. 770 subjects with severe asthma from the BTS Difficult Asthma Registry (442 receiving daily OCS to maintain disease control).3 Psychiatric disorders included depression, anxiety and low mood.3

What is DUPIXENT? How can it help my severe asthma patients?


*A cross-sectional observational study to determine the prevalence of systemic corticosteroid-induced morbidity in severe asthma using the Optimum Patient Care Research Database (OPCRD), (7,195 subjects in three age- and gender-matched groups) – severe asthma (GINA treatment step 5 with four or more prescriptions/year of OCS, N=808), 770 subjects with severe asthma from the BTS Difficult Asthma Registry (442 receiving daily OCS to maintain disease control).3

BTS, British Thoracic Society; GINA, Global Initiative for Asthma; GP, general practitioner; NRAD, National Review of Asthma Deaths; OCS, oral corticosteroids; OPCRD, Optimum Patient Care Research Database; SIGN, Scottish Intercollegiate Guidelines Network.


  1. Asthma UK (2017). Severe asthma: the unmet need and the global challenge. Available at: Date accessed: April 2021.
  2. Asthma UK. What is severe asthma? Available at: Date accessed: April 2021.
  3. Sweeney J, et al. Thorax. 2016;71(4):339–346.
  4. Why asthma still kills. The National Review of Asthma Deaths (NRAD). May 2014. Available at: Date accessed: April 2021.
  5. Hekking PW, et al. J Allergy Clin Immunol. 2015;135(4):896–902.
  6. Walsh L, et al. Thorax. 1999;54(4):296–300.