Page 16 - Demo

16Highlights of EAP 2023The understanding of the pathophysiology of asthma is expanding along with the understanding of the optimal use of therapies according to asthma phenotypes. There is a growing role of the internal and external environment in asthma, including microbiome and micronutrients, as well as the COVID-19-exaggerated disparities in asthma care. The most recent interdisciplinary advancements in asthma were summed up by Dr. Robert Ross Russell in this talk.Regarding the evolution in asthma therapies, Dr. Russell stated that the maintenance and reliever therapy (MART) that includes a combination of a steroid with a longacting beta-agonist (budesonide/formoterol) (Figure 1) had caught the widespread attention of practitioners and researchers for the treatment of mild asthma, and had been recommended in the Global Initiative for Asthma 2021 Strategy. Regarding the role of the environment in asthma,Dr. Russell highlighted that worldwide, the COVID-19 pandemic has disproportionately affected vulnerable populations, the aftereffects of which continue to be seen in terms of poor access to asthma care and poor asthma control. Vitamin D has been shown to be associated with severe asthma and increased risk of exacerbations in several studies. The gut (Clostridia) and lung microbiome (Proteobacteria and Firmicutes) were also associated with asthma.Dr. Russell concluded that the combination of a steroid with a long-acting beta-agonist is more effective in mild asthma than short-acting beta-agonists. New biological therapies are becoming available for difficult asthma. Vitamin D and lung and gut microbiome are likely to affect asthma risk. COVID has had a disproportionate effect on disadvantaged families and children with asthma. Asthma UpdateRobert Ross Russell Consultant, Pediatric Intensive Care and Respiratory PediatricsCambridge University HospitalUKDr. Russell stated that the development of biologics for difficult asthma had been another major recent therapeutic advancement in asthma. He discussed the various available biological agents for pediatric asthma and also shared an algorithm to aid the selection of appropriate biological therapy (Fig. 2). Figure 1: Clinical trial evidence for MART therapy in mild asthma.Figure 2: Algorithm forbiologic selection in difficult asthma.Presenter