ALAT-SEPAR Consensus on the Definition and Classification of Asthma Exacerbations by Severity: A Move Toward International Standardization

Asthma exacerbation is a significant clinical event that occurs with varying severity, yet a set of universally accepted standardized definitions is still needed. The aim of this consensus developed by ALAT and SEPAR was to fill this gap with a validated proposal for classifying asthma exacerbations into levels of severity: non-severe, severe, and very severe. The consensus was based on an in-depth review of the literature conducted by the scientific committee to identify key parameters for each level of severity, including worsening symptoms, respiratory function changes, and the need for specific medical interventions. A total of 67 publications were analyzed to generate a questionnaire on the defining elements of asthma exacerbations, and this was put to the vote. Twenty-eight international experts participated in the validation of characteristics and definitions of exacerbation severity following Delphi methodology. The resulting definitions clearly distinguish non-severe exacerbations (requiring minor adjustments in treatment) from severe exacerbations (requiring more intensive interventions, including longer systemic corticosteroid use or hospitalization) and very severe exacerbations (life-threatening events requiring intensive care). These definitions provide a standardized framework that facilitates comparison between clinical trials and optimizes patient care. This consensus lays the foundation for unifying management criteria in global clinical practice and fostering research on the efficacy of asthma treatments. It also underlines the importance of accurate classification in improving clinical outcomes and reducing the overall burden of disease.