Doporučený postup diagnostiky a léčby těžkého astmatu – group of authors (2023)

The recommended procedure for the diagnosis and treatment of severe asthma in adults and adolescents aged 12 and older is a joint document of the Czech Society of Allergology and Clinical Immunology and the Czech Pneumological and Phthisiological Society. It is a fundamental professional publication summarizing current information on the diagnosis and therapy of severe asthma. The first part is intended for allergists and pulmonologists (and possibly other physicians) in regular outpatient practice. Its mission is to provide these doctors with guidance on identifying adult asthmatics who should be referred to specialized facilities of the national centers for severe asthma (NCTA) and also on what examinations should be performed before referral to the center and what patient documentation should accompany them. The second part of the document is particularly aimed at physicians working in severe asthma centers and experts with a deeper interest in asthma. It focuses on the identification and phenotyping of severe asthma (asthmatics), emphasizing the distinction between true severe asthma, eosinophilic asthma (T2-high), and if it is eosinophilic, whether allergy is the dominant cause. The chapters logically follow on from the selection of initial targeted treatment, assessment of its effectiveness, and options for de-escalating systemic corticosteroid therapy.