Personalised management of difficult asthma in women

The aim of our study was to demonstrate the value of personalized management of difficult asthma in women. Prospective study including 50 women. Therapeutic interventions were performed. The mean age was 55. At least three aggravating factors were identified in 64% of cases. The measures that targeted these factors were: therapeutic education(66%), hygienic-dietary rules and pump inhibitor(52%), nasal corticosteroid therapy and antihistamines (72%), psychological interview(68%) and continuous positive airway pressure(10%). Asthma control was achieved in 25 patients. Phenotyping of the remaining patients identified TH2 inflammation in 18 and non-TH2 in 7. Treatment according to phenotyping consisted in: increasing inhaled corticosteroid therapy in case of bronchial eosinophilia, adding an anticholinergic in case of severe obstruction, and an anti-leukotriene in case of aspirin intolerance. The ACT score improved from 15.7 to 20.2 (p=0.0001).Personalized management of difficult asthma seems to be effective in our context.