5 | CONCLUSIONS
Exacerbations account for much of the morbidity and cost associated with chronic asthma, and new preventive and treatment approaches are needed. Insights into the immunopathogenesis of asthma have proven efficacy in reducing the risk of exacerbations in patients with mild or moderate to severe asthma. While these developments represent progress in preventing exacerbations, remaining knowledge gaps include developing an evidence base to determine which medication will work best for any given patient.
New initiatives toward understanding different phenotypes of asthma, including those associated with repeated exacerbations, may lead to greater precision in treatment. There are also important obstacles related to cost, obesity, the use of biologics in children, and prevention of exacerbations in patients with type-2-low asthma phenotypes. In addition, better understanding of the contributions of airway viruses and bacteria to exacerbations will lead to new strategies for prevention. Unfortunately, there has been less progress in developing new treatments for exacerbations during acute illness. Evidence implicating mucin hypersecretion and airway inflammatory responses from both infectious and noninfectious sources could lead to new approaches toward achieving this goal.