Doporučený postup diagnostiky a léčby těžkého astmatu (2026)

This recommended guideline for diagnosing and treating severe asthma in adults and adolescents aged 12 and over is a joint document of the Czech Society of Allergology and Clinical Immunology and the Czech Society for Pneumology and Phthisiology. The publication summarizes current information on the diagnosis and treatment of severe asthma, and its contents are in Czech. The first part is intended for allergists, pulmonologists and other physicians in routine outpatient practice. It provides guidance on identifying adult asthma patients who should be referred to specialized facilities within the national severe asthma centres, the examinations to perform before referral and the documentation to accompany the patient. The second part is aimed particularly at physicians working in severe asthma centres and specialists with a deeper interest in asthma. It addresses the identification and phenotyping of severe asthma, including whether the condition is truly severe, whether it is eosinophilic (T2-high) asthma and, when it is eosinophilic, whether allergy is the dominant cause. Further chapters cover the selection of initial targeted treatment, assessment of its effectiveness and the possible reduction of systemic corticosteroid therapy. A substantial section focuses on biological asthma treatment, while the final chapters discuss specific situations including allergic fungal airway disease, asthma-COPD overlap, bronchiectasis, hypereosinophilic syndromes, eosinophilic granulomatosis with polyangiitis, the effect of obesity on asthma and asthma during pregnancy.