SR电子T1重症哮喘的管理:欧洲188bet官网地址呼吸学会/美国胸科学会指南摩根富林明欧洲呼吸杂志乔和J FD欧元欧洲呼吸学会SP 1900588 10.1183/13993003.00588 -2019签证官55 1 A1奥尔金市中心,费尔南多A1 Cardet,胡安·卡洛斯A1涌,Kian风扇A1潜水员,莎拉A1费雷拉,第欧根尼美国A1 Fitzpatrick安妮A1嘎嘎,米娜A1 Kellermeyer,利兹A1 Khurana认为,Sandhya A1骑士Shandra A1麦当劳,凡妮莎·m·A1摩根,丽贝卡·l·A1奥尔特加,Victor e . A1 Rigau Padmaja A1妮娅,大卫•A1 Subbarao Thomy A1爱德考克,伊恩·m·A1布,尤金·r·A1 Brightling克里斯•A1 Boulet A1小屋,仅凭记性迈克尔A1卡斯特罗,马里奥A1 Chanez,帕斯卡A1 Custovic,Adnan A1元首,弗雷姆A1,一致的A1 Frankemolle,贝蒂A1吉布森,彼得•A1 Hamerlijnck Nizar A1 Konno,多米尼克•A1 Jarjour Satoshi A1沈,Huahao A1 Vitary,凯茜A1布什,安迪年2020 UL //www.qdcxjkg.com/content/55/1/1900588.abstract AB本文档提供了严重哮喘的临床管理的建议。综合证据综合，包括荟萃分析，总结了与欧洲呼吸学会/美国胸科学会工作组的问题相关的所有可用证据。188bet官网地址使用GRADE(建议、评估、发展和评价的分级)方法对证据进行评价，并在证据概要中总结了结果。由哮喘专家组成的多学科工作队讨论了证据综合并提出了建议，并就六个具体问题提出了具体建议。在权衡各种干预措施的可取和不可取的结果、证据质量、可行性和可接受性后，工作组提出了以下建议:1)建议使用抗白细胞介素(IL)-5和抗IL-5受体α治疗严重不受控制的成人嗜酸性粒细胞哮喘表型;2)建议使用≥150 μL−1的血嗜酸性粒细胞切点指导成人重度哮喘患者抗il -5启动;3)建议考虑特异性嗜酸性粒细胞(≥260 μL−1)和呼出性一氧化氮(≥19.5 ppb)的临界值，以确定对抗ige治疗反应可能性最大的青少年或成人; 4) suggest using inhaled tiotropium for adolescents and adults with severe uncontrolled asthma despite Global Initiative for Asthma (GINA) step 4–5 or National Asthma Education and Prevention Program (NAEPP) step 5 therapies; 5) suggest a trial of chronic macrolide therapy to reduce asthma exacerbations in persistently symptomatic or uncontrolled patients on GINA step 5 or NAEPP step 5 therapies, irrespective of asthma phenotype; and 6) suggest using anti-IL-4/13 for adult patients with severe eosinophilic asthma and for those with severe corticosteroid-dependent asthma regardless of blood eosinophil levels. These recommendations should be reconsidered as new evidence becomes available.The ERS/ATS Task Force makes recommendations on the use of novel therapies for severe asthma, specifically biologicals for type 2 high asthma, and antimuscarinic agents and macrolides, as well as on biomarkers for predicting treatment response http://bit.ly/2kZLRaD