What is severe asthma?

Most people with asthma will have their symptoms under control using medication, but for some people the medication available is not effective. Despite taking very high doses of medication people with severe asthma will still have daily symptoms. Often these symptoms get worse and need treatment with oral corticosteroids such as prednisolone.

We do not know why some people develop severe asthma and why some people do not. Thanks to research we now know that there are different subtypes (also called phenotypes) of severe asthma. This has led to the development of new treatments for some types of severe asthma which are very effective.

Who is affected?

Approximately 5-8% of all people with asthma have severe asthma. It can affect people of all ages and develop at anytime as a child, youth, adult or elderly adults. Often people with mild to moderate asthma will go on to develop severe asthma but sometimes it can be severe from the start. This is seen more often in patients who develop asthma after the age of 40 and who have not had any previous problems with their breathing.

You can access the latest data on asthma from the International Respiratory Coalition (IRC)’s Lung Facts website. It provides the latest epidemiological (who, when and where) and economic data for asthma in Europe.

What are the consequences for patients and their relatives?

People with severe asthma tend to have more frequent and more severe symptoms that can be very unpredictable. This can affect the person both physically and mentally, limiting their ability to lead a “normal” life despite taking a wide range of asthma medication. Asthma symptoms can get worse without warning which can be stressful as it prevents the person carrying out their normal daily routine and plans having to change at short notice.

Some people may have had a very severe or life threatening asthma attacks and the fear of if or when they have another attack can negatively effect their quality of life. Many struggle to manage their work or education because of the physical effects and unpredictability of their asthma attacks. Severe asthma can cause general symptoms such as fatigue and reduced ability to function intellectually.

What impact does severe asthma have on society?

Most people with severe asthma are adults and they may have a range of responsibilities such as work or have a family where people are dependent on them. Severe asthma can therefore have a negative impact not only for the person affected but for society too, as they might not be able to manage their responsibilities when their asthma is worse.

The healthcare cost of managing severe asthma is disproportionately high. The majority of the total spend on asthma is used to treat people with severe asthma.

Why does SHARP exist?

SHARP is a community of people with asthma and asthma experts (clinicians, scientists, academics, people in health services and pharma) from across Europe, working together to improve the lives of people living with severe asthma. The community collaborates to identify the unmet needs for people with severe asthma and then conduct research studies to enhance knowledge, and develop solutions to improve the management of severe asthma. The SHARP community has agreed on ambitious aims:

  • Prevent the worsening of asthma that needs treatment with oral corticosteroids and /or admission to hospital
  • Everyone with severe asthma in Europe will have access to the best care available.
  • Understand the mechanisms that cause people to develop severe asthma
  • Stop milder asthma becoming severe asthma.

In essence, SHARP connects people with severe asthma with key experts in severe asthma, including those,  working on the development of effective treatment, jointly aiming to pave the way towards improved management options.

The SHARP community is improving the management of severe asthma through research and sharing of knowledge by:

  • Building a European research platform  with data from more than 15000 people who have severe asthma across 28 countries. This data will give us new insights into what severe asthma is, the challenges of people with severe asthma and how we can improve management and prevention.
  • experience, and bringing insights from this research forward into studies testing better management models.
  • knowledge sharing through various activities for example the SHARP Rare Case Series


What do we need to do to improve outcomes for people with severe asthma?

Severe asthma is a debilitating condition with patients experiencing severe asthma attacks, admission to hospital and a reduced quality of life. For many years patients have been treated with oral corticosteroids such as prednisilone. Oral corticosteroids were the only option available to patients which helped them get control of their asthma but these drugs have devastating side effects when used over a long period of time. Antibody treatments such as omalizumab have been developed to treat certain types of severe asthma. Some patients who have used this treatment have benefitted hugely, with a reduction in daily symptoms and use of oral corticosteroids. These life changing treatments however are not available to all patient yet.

To improve severe asthma and treatment with these life changing drugs access to specialised care is required which is not currently available to all. Observational real world data is needed to go along side the results of randomised, placebo- controlled trials which can help influence countries to change the way they manage severe asthma.