Overview
Neutrophilic asthma is a subtype characterized by an increased presence of neutrophils in airway inflammation, distinct from typical eosinophilic asthma 1. This condition often presents with refractory symptoms and may require tailored management strategies.Diagnosis
Elevated sputum neutrophils (>60%) 1
Persistent airflow limitation despite standard asthma therapy
Exclusion of other neutrophilic respiratory conditions through clinical evaluationManagement
First-line treatments: High-dose inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) 1
Adjunctive therapies: Addition of oral corticosteroids for acute exacerbations 1
Consideration of biologic therapies: Anti-IL-17 or anti-IL-8 pathways may be explored in refractory cases, though specific dosing details are not provided 1Special Populations
Comorbidities: No specific guidance provided for special populations such as pregnancy, pediatrics, or elderly patients 1Key Recommendations
Initiate treatment with high-dose inhaled corticosteroids combined with long-acting beta-agonists for managing neutrophilic asthma (Evidence: Moderate) 1
Incorporate oral corticosteroids for acute exacerbations to control inflammation (Evidence: Moderate) 1
Consider advanced biologic therapies targeting neutrophil pathways in patients with refractory symptoms, though evidence is limited (Evidence: Weak) 1References
1 Sequeira W, Polisky RB, Alrenga DP. Neutrophilic dermatosis (Sweet's syndrome). Association with a hydralazine-induced lupus syndrome. The American journal of medicine 1986. link90316-5)