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.