Acute asthma attack outcomes will only improve if they are recognised as a heterogeneous condition that needs to be managed with a phenotype-directed personalised treatment approach, respiratory researchers say.

Writing in a Thorax state of the art review Dr Matthew Martin and Professor Tim Harrison from Nottingham Respiratory Research Unit and Professor Richard Beasley from the Medical Research Institute of New Zealand, said the recognition of asthma as a heterogeneous condition had revolutionised its long-term management, with greater emphasis placed on personalised treatment and the introduction of the treatable traits concept.

“In contrast, asthma attacks are poorly defined and understood and our treatment approach consists of bronchodilators and systemic corticosteroids,” they wrote.

According to the authors, improving the outcomes for people with asthma attacks involved overcoming challenges such as the current “limited and subjective definition” of an asthma attack and the lack of understanding about their underlying complexity.

Yet, asthma attacks were currently managed in the same way despite the questionable efficacy of current interventions in some patient groups, they said.

“We believe that there is convincing evidence of heterogeneity in acute asthma attacks as there is in stable asthma and that over the next decade we will see improved treatment of asthma attacks, moving away from high-dose corticosteroids for all towards a phenotype-directed personalised treatment approach which has transformed the management of severe stable asthma in recent years,” they concluded.