Q1

Q2

Q3

Q4

Q5

Q6

Q7

Q8

Q9

1 OF 9

Have you been diagnosed with Severe Asthma by a doctor?

3 OF 9

How would you describe your asthma condition?

4 OF 9

In the past 2 to 4 weeks, how often have you used your rescue or “quick-relief” inhaler?

5 OF 9

In the past 12 months, how many times has a doctor prescribed you oral steroids, like prednisone, for your asthma?

6 OF 9

In the past 12 months, how many times have you been to the hospital for your asthma condition, or received emergency medical care?

7 OF 9

In the past month, how many times have you gotten up in the middle of the night due to your asthma symptoms (such as coughing, difficulty breathing, or shortness of breath)?

8 OF 9

Have you felt lonely or isolated because of your asthma condition?

9 OF 9

In the past 2 to 4 weeks, how much has your asthma condition caused you to limit daily activities or tasks?

Read About Severe Asthma

Result

Below results will be determined by the choice of answers given in the Q&A above.

The indicators below will be pointed to the level of severity.

The indicators will be pointed to the level of your asthma control.

The indicators below will be pointed to the level of the emotional impact due to asthma.

The indicators below will be pointed to the level of daily life impact due to asthma.

Result

Below results will be determined by the choice of answers given in the Q&A above.

The indicators below will be pointed to the level of severity.

The indicators will be pointed to the level of your asthma control.

The indicators below will be pointed to the level of the emotional impact due to asthma.

The indicators below will be pointed to the level of daily life impact due to asthma.

Result 1

Result 2

Result 3

Result 4

Asthma Severity

Severe

Difficult to treat

Uncontrolled

Mild

Asthma Control

Poorly Controlled

Not well controlled

Well Controlled

You reported that your asthma is well controlled. If you notice you’re starting to increase your rescue inhaler use, oral steroid use, hospital visits, and/or experiencing symptoms of asthma more frequently, we encourage you to share this information with your doctor.

You reported that your asthma is not well controlled. Using a rescue inhaler more than twice a week, taking oral steroids 2 times in the past 12 months or waking up 1-3 times per week because of your asthma symptoms are signs your asthma is not well controlled.

Proper inhaler use and taking your medication regularly are the key to helping control your asthma. HOWEVER, some asthma patients may have an underlying factor that’s impacting their ability to control their asthma. It could be a type of asthma called severe asthma. Speak to the Breathe EaSY nurse to learn more.

You reported that your asthma is poorly controlled. Using a rescue inhaler several times per day, taking oral steroids everyday or every other day, having been to the hospital or receiving emergency care at least 1 time in the past 12 months, or waking up at least 4 times per week because of your asthma symptoms are signs of asthma that is very poorly controlled.

Proper inhaler use and taking your medication regularly are the key to helping control your asthma. HOWEVER, some asthma patients may have an underlying factor that’s impacting their ability to control their asthma. It could be a type of asthma called severe asthma. Speak to the Breathe EaSY nurse to learn more.

You reported that your asthma is poorly controlled. Using a rescue inhaler several times per day, taking oral steroids everyday or every other day, having been to the hospital or receiving emergency care at least 1 time in the past 12 months, or waking up at least 4 times per week because of your asthma symptoms are signs of asthma that is very poorly controlled.

Proper inhaler use and taking your medication regularly are the key to helping control your asthma. HOWEVER, some asthma patients may have an underlying factor that’s impacting their ability to control their asthma. It could be a type of asthma called severe asthma. Speak to the Breathe EaSY nurse to learn more.

Emotional Impact

High impact

Medium impact

Low impact

Your asthma seems to have had a low impact on your emotional well-being.

You have occasionally felt lonely or isolated because of your asthma.

Your asthma seems to have had a high impact on your emotional well-being.

Your asthma seems to have had a high impact on your emotional well-being.

Daily Life Impact

High

Medium

Low

Read About Severe Asthma

Result

The test results are a representation of the level of your asthma based on the answers provided.

Save your test results Share on social media

Click here to learn more about severe asthma.

Click here to speak to the Breathe EaSY nurse on your asthma condition and treatment options.

What is Severe Asthma?

Severe Asthma is a respiratory disease that affects the airways and does not respond to commonly prescribed medication for regular asthma. Severe asthma includes the use of oral corticosteroids and an over-reliance on reliever medication to get severe asthma under control. Each individual has different causes and triggers for the symptoms which react differently to their airways.1

Severe Asthma, by the numbers.

1,642

Malaysians (1.29%)

passed from asthma-related complications.

2 million sufferers,

7% to 11%

prevalence

of Severe Asthma in adults among Asian countries.13

Better understand your asthma, so you have better control of your symptoms 6

DescriptionAsthmaUncontrolled AsthmaDifficult-to-treat AsthmaSevere Asthma
Daily asthma symptoms and activity limitations
Waking up at night due to asthma
Daily use of quick-relief medicine
Asthma episode requiring oral corticosteroid (OCS)
Use of multiple medium to high dose long term controller medicines
Biomarkers are positive for type 2 or non-type 2 inflammation
DescriptionDaily asthma symptoms and activity limitations
Asthma
Uncontrolled Asthma
Difficult-to-treat Asthma
Severe Asthma
DescriptionWaking up at night due to asthma
Asthma
Uncontrolled Asthma
Difficult-to-treat Asthma
Severe Asthma
DescriptionDaily use of quick-relief medicine
Asthma
Uncontrolled Asthma
Difficult-to-treat Asthma
Severe Asthma
DescriptionAsthma episode requiring oral corticosteroid (OCS)
Asthma
Uncontrolled Asthma
Difficult-to-treat Asthma
Severe Asthma
DescriptionUse of multiple medium to high dose long term controller medicines
Asthma
Uncontrolled Asthma
Difficult-to-treat Asthma
Severe Asthma
DescriptionBiomarkers are positive for type 2 or non-type 2 inflammation
Asthma
Uncontrolled Asthma
Difficult-to-treat Asthma
Severe Asthma

Who Gets Severe Asthma?

Severe asthma affects both adults and children. It can develop at any age. Most people who are diagnosed with severe asthma already have an asthma diagnosis: It could have been that their asthma had changed over time, or developed into severe asthma because of hormonal changes, or pneumonia for example. 1

What is it like to have Severe Asthma?

Severe asthma is an unpredictable condition and it is different for everyone. People with severe asthma have more asthma attacks than people with mild or moderate asthma. They are more likely to have to stay in hospital and they are also more likely to be on long term medication.

The symptoms, triggers, responses to medicines, energy levels and impact on daily life are unique to each individual, plus they can change over time.

Having severe asthma can be tough but with the right support and treatment, you can better manage your symptoms.

Detection:

Severe Asthma Signs and Symptoms6

Individuals who suffer from asthma have an underlying inflammation in the airway that can usually be treated with a combination of quick-relief and long-term controller medicine. However, some individuals do not respond well to inhaled corticosteroids and long-term controller medicine which is a sign of severe asthma.

This inflammation that causes severe asthma may be more difficult to treat, which also requires testing to find the root cause of the inflammation.

Individuals with severe asthma use the highest dose of inhaled corticosteroids with a second oral corticosteroids controller. However, despite using high doses of medication, reducing risks, and following their treatment plan, most of the time their severe asthma remains uncontrolled.

Other signs and symptoms of severe asthma may include:11'12

Shortness of breath that continues to worsen

Pain or tightness in your chest

Cough

Wheezing that persists after treatment

Pale skin, lips, or fingernails that may turn blue in colour

Little or no improvement after using your rescue inhaler

Types of Severe Asthma4

Generally, there are two main types of severe asthma which are categorised based on the individual’s response to treatment. Type 2 inflammation and Non-Type 2 inflammation. Type 2 inflammation includes allergic asthma and eosinophilic asthma that respond to treatment with inhaled corticosteroids and IgE (biomarker immunoglobulin E). Non-Type 2 inflammation includes non-eosinophilic asthma which does not respond well to inhaled corticosteroids.

Some specific type of severe asthma includes:

Allergic asthma

Eosinophilic asthma (E-asthma)

Non-eosinophilic asthma

Neutrophilic asthma

Diagnosing Severe Asthma in 3 steps4

Step 1

Consult a specialist.

The specialist would review your medical history and current Asthma treatment plan before doing a physical test to access your symptoms.

Step 2

Determining if it's Severe Asthma.

If it is, the specialist would do additional testing to determine your specific type via biomarkers.

Biomarkers identify the causes of inflammation in your airways by:

Taking your blood sample.

Analysing your mucus sample.

Analysing substances in your breath droplets.

Step 3

Deciding on a treatment option.

Once your biomarkers have been identified, the specialist would know the type of your Severe Asthma and the different treatment options available.

Treating Severe Asthma

Deciding on a treatment option.5

Once your asthma specialist has determined the type of severe asthma you are suffering from, they can tailor treatment based on your specific type.

Below is the chart that describes the biomarkers for severe asthma, the testing method, the type (or phenotype) and the available possible treatment options for targeted therapy.

BiomarkerTesting methodPhenotypeAvailable treatments
IgE*Blood SkinAllergic (early onset)Omalizumab
EosinophilBlood Sputum Breath (FeNO)Eosinophilic (late-onset) - allergic and non-allergicMepolizumab
Reslizumab
Benralizumab
Dupilumab
NeutrophilSputumNeutrophilicAntibiotics Lifestyle Changes
BiomarkerIgE*EosinophilNeutrophil
Testing methodBlood SkinBlood Sputum Breath (FeNO)Sputum
PhenotypeAllergic (early onset)Eosinophilic (late-onset) - allergic and non-allergicNeutrophilic
Available treatmentsOmalizumabMepolizumab
Reslizumab
Benralizumab
Dupilumab		Antibiotics Lifestyle Changes

For individuals that require a more personalised treatment include:4'5

Macrolide Antibiotics

Macrolide Antibiotics are used by assisting the body in fighting infections.

Oral corticosteroids

Oral corticosteroid is mainly used to assist with inflammation. This medication is often combined with quick-relief medicine.

Biologics

Biologics assist by blocking the response to airway triggers that cause inflammation.

Outpatient Procedure

Bronchial Thermoplasty (BT) involves the use of radio frequency energy to apply mild heat to smooth muscle tissue in the airway.

Long term steroids treatment

A daily dose of steroid as an anti-inflammatory medicine to assist in reducing sensitivity in the airways.

Behaviour and Lifestyle Changes

A change to the lifestyle by getting rid of smoking, changing diet, and exercising to reduce obesity and gastroesophageal reflux disease (GERD).

What should I do if I think I have severe asthma

Seek help now

References:

  1. Asthma UK. What is severe asthma? Available at: https://www.asthma.org.uk/advice/severe-asthma/what-is-severe-asthma/
  2. Severe Asthma Statistics. LAUNCHING OF THE CLINICAL PRACTICE GUIDELINES ON THE MANAGEMENT OF ASTHMA IN ADULTS: https://www.moh.gov.my/index.php/database_stores/store_view_page/57/1000
  3. American Lung Association. Asthma Risk Factors: https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/asthma-symptoms-causes-risk-factors/asthma-risk-factors
  4. American Lung Association. Signs and Symptoms, Type of Severe Asthma, Asthma Screening / Diagnosis, Treatment for Severe Asthma: https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/severe-asthma
  5. Asthma UK. How is severe asthma treated?: https://www.asthma.org.uk/advice/severe-asthma/treating-severe-asthma/how-is-severe-asthma-treated/#treatments
  6. American Lung Association. Do I Have Severe Asthma?: https://www.lung.org/getmedia/1f571956-ee14-4ecc-b608-1f3ab9c15b89/ala-asthma-infographic-2020-v1april-2020.pdf
  7. Asthma and Allergy Foundation of America. What Causes or Triggers Asthma?: https://www.aafa.org/asthma-triggers-causes/
  8. Asthma Malaysia. Figures of asthma sufferers: https://www.asthmamalaysia.org/
  9. NSH UK. Montelukast: https://www.nhs.uk/medicines/montelukast/
  10. Asthma UK. Taking theophylline for asthma: https://www.asthma.org.uk/advice/inhalers-medicines-treatments/add-on-treatments/theophylline/
  11. Severe asthma symptoms: https://www.healthline.com/health/severe-asthma?c=1301326415610#symptoms
  12. Facts and Statistics About Severe Asthma: https://www.healthline.com/health/severe-asthma/facts-statistics-you#symptoms
  13. Challenges faced in managing adult asthma: A perspective from Asian countries https://onlinelibrary.wiley.com/doi/10.1111/resp.13935

MY-8501_04MAR2022