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Severe eosinophilic asthma — RCPSC IM MCQ

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HardRespirologySevere eosinophilic asthmaRCPSC IM

A 45-year-old woman has asthma with four prednisone-treated exacerbations in the last year despite high-dose inhaled corticosteroid-formoterol, tiotropium and adherence confirmed by pharmacy records. Spirometry shows reversible obstruction. Blood eosinophils are 0.72 x 10^9/L and FeNO is elevated. CT chest shows no bronchiectasis. What is the most appropriate next step?

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Correct answer: D — Add a biologic targeting type 2 inflammation after confirming phenotype and access criteria

Frequent exacerbations despite optimized high-dose inhaled therapy with eosinophilia support severe type 2 asthma; biologic therapy should be considered after confirming phenotype, adherence and comorbidities.

Reference: Canadian Thoracic Society severe asthma guidance