Unmet needs in severe chronic upper airway disease (SCUAD)

Jean Bousquet, Claus Bachert, Giorgio W Canonica, Thomas B Casale, Alvaro A Cruz, Richard J Lockey, Torsten Zuberbier, David Price (Collaborator), Extended Global Allergy and Asthma European Network, World Allergy Organization and Allergic Rhinitis and its Impact on Asthma Study Group

Research output: Contribution to journalArticlepeer-review

201 Citations (Scopus)


Although the majority of patients with chronic upper airway diseases have controlled symptoms during treatment, many patients have severe chronic upper airway diseases (SCUADs). SCUAD defines those patients whose symptoms are inadequately controlled despite adequate (ie, effective, safe, and acceptable) pharmacologic treatment based on guidelines. These patients have impaired quality of life, social functioning, sleep, and school/work performance. Severe uncontrolled allergic rhinitis, nonallergic rhinitis, chronic rhinosinusitis, aspirin-exacerbated respiratory diseases, or occupational airway diseases are defined as SCUADs. Pediatric SCUADs are still unclear. In developing countries SCUADs exist, but risk factors can differ from those seen in developed countries. Comorbidities are common in patients with SCUADs and might increase their severity. The present document is the position of a group of experts considering that SCUADs should be considered differently from mild chronic upper airway diseases. It reviews the state of the art, highlighting gaps in our knowledge, and proposes several areas for a better understanding, prevention, and management of SCUADs. This document can also serve to optimize the pharmacoeconomic evaluation of SCUADs by means of comparison with mild chronic upper airway diseases.
Original languageEnglish
Pages (from-to)428-433
Number of pages6
JournalJournal of Allergy and Clinical Immunology
Issue number3
Early online date5 Aug 2009
Publication statusPublished - Sept 2009


  • allergens
  • aspirin
  • child
  • chronic disease
  • drug hypersensitivity
  • humans
  • nasal polyps
  • prevalence
  • quality of life
  • rhinitis, allergic, perennial
  • severity of illness index
  • sinusitis


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