Table 3.

Summary of ERS/ATS severe asthma task force recommendations

Question	Recommendation	Strength	Quality of evidence
1	Suggest an anti-IL-5 strategy as add-on therapy for adult patients with severe uncontrolled asthma with an eosinophilic phenotype and for those with severe corticosteroid-dependent asthma	Conditional	Low
2	Suggest that a blood eosinophil cut-point ≥150 per µL can be used to guide anti-IL-5 initiation in adult patients with severe asthma and a history of prior asthma exacerbations	Conditional	Low
3	Suggest using a blood eosinophil cut-off ≥260 per µL to identify adolescents (>12 years) and adults with severe allergic asthma more likely to benefit from anti-IgE treatment	Conditional	Low
	Suggest using a FENO cut-off ≥19.5 ppb to identify adolescents (>12 years) and adults with severe allergic asthma more likely to benefit from anti-IgE treatment	Conditional	Low
4	For children, adolescents and adults with severe asthma uncontrolled despite GINA step 4–5 or NAEPP step 5 therapies, recommend the addition of tiotropium	Strong	Moderate
5	Suggest a trial of macrolide treatment to reduce asthma exacerbations in adult asthma subjects on GINA/NAEPP step 5 therapy that remain persistently symptomatic or uncontrolled	Conditional	Low
	Suggest against the use of chronic macrolide treatment in children and adolescents with severe uncontrolled asthma	Conditional	Low
6	Suggest dupilumab as add-on therapy for adult patients with severe eosinophilic asthma and for those with severe corticosteroid-dependent asthma regardless of eosinophil levels	Conditional	Low

Reproduced and modified from [6].