Do no harm

Safer and better treatment options for people with asthma

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Many people with asthma live in constant fear of their next asthma attack. They can become caught in a vicious cycle of emergency trips to hospital, intensive care and regular doses of strong oral corticosteroids (OCS) tablets or injections. These tablets can stop the symptoms, but they have devastating side effects on physical and mental health, from kidney and bone damage to insomnia and suicidal thoughts.

There are now biologic therapies, a new type of medicine which work in a different way to traditional asthma treatments, available on the NHS.  They can improve symptoms, reduce asthma attacks and stop the need for steroid tablets.

Our new report, Do no harm: safer and better treatment options for people with asthma, shows how the combination of uncontrolled asthma and the side effects from steroid tablets ruins people’s daily lives, destroying their confidence, relationships and careers. They may even have severe asthma, the most debilitating and life-threatening form of the condition, and not know it. However, it also shows how a simple referral to a specialist severe asthma centre can transform someone’s life, helping to confirm their diagnosis and opening the possibility of being able to have new biologic treatments.

Our survey of over 200 people on one of the new biologic injections also revealed how for one in five the treatment has been completely life-changing and almost half have been able to reduce or stop their steroid tablets completely. Yet, our updated analysis showed that 46,000 people who are potentially eligible for these biologic treatments are still missing out.

In this report we recommend:

  • Repeated steroid tablet use must be seen as a failure of asthma management and prompt urgent action and appropriate referral to a specialist.
  • Clinicians treating people with asthma should be pro-active in recognising and referring those with suspected severe asthma.
  • NICE should develop a single comprehensive severe asthma guideline and ensure that all related asthma guidelines are consistent and explicit with their recommendations for people with persistent poor asthma control.
  • There needs to be a system-wide drive to increase and speed up access to biologic treatment for all those who are eligible to receive them.

Download our report [PDF] to read our full recommendations and analysis.

Download the report

Our previous difficult and severe asthma reports

Our 2020 report Falling into isolation: lived experience of people with severe asthma finds that living with severe asthma is so much more than asthma attacks and occasional hospital admissions.

Our 2019 report Living in limbo: the scale of unmet need in difficult and severe asthma outlines the size of the unmet need in difficult and severe asthma services.

Our 2018 report Slipping through the net: The reality facing patients with difficult and severe asthma used interviews with asthma clinicians and a clinician survey to find out about the care that people with difficult and severe asthma receive.

Our 2017 report Severe asthma: the unmet need and the global challenge focused on making new treatments for severe asthma available more quickly and the need to better identify the different types of severe asthma.