Severe Chronic Allergic (and related) diseases: A uniform approach - A MeDALL - GA(2)LEN - ARIA position paper

WHO Collaborating Ctr Asthma, J. Bousquet*, J. M. Anto, P. Demoly, H. J. Schuenemann, A. Togias, M. Akdis, C. Auffray, C. Bachert, T. Bieber, P. J. Bousquet, K. H. Carlsen, T. B. Casale, A. A. Cruz, T. Keil, K. C. Lodrup Carlsen, M. Maurer, K. Ohta, N. G. Papadopoulos, M. Roman RodriguezB. Samolinski, I. Agache, A. Andrianarisoa, C. S. Ang, I. Annesi-Maesano, F. Ballester, C. E. Baena-Cagnani, X. Basagana, E. D. Bateman, E. H. Bel, A. Bedbrook, B. Beghe, M. Beji, A. Ben Kheder, M. Benet, K. S. Bennoor, K. C. Bergmann, F. Berrissoul, C. Bindslev Jensen, E. R. Bleecker, S. Bonini, A. L. Boner, L. P. Boulet, C. E. Brightling, J. L. Brozek, A. Bush, W. W. Busse, P. A. M. Camargos, D. Ryan, A. Sheikh, D. Y. Wang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies. Copyright (C) 2012 S. Karger AG, Basel

Original languageEnglish
Pages (from-to)216-231
Number of pages16
JournalInternational archives of allergy and immunology
Issue number3
Publication statusPublished - 2012


  • randomized trial
  • quality of life
  • nonallergic rhinitis
  • chronic urticaria
  • asthma
  • rhinitis
  • rhinosinusitis
  • urticaria
  • chronic rhinosinusitis
  • nasal polyposis
  • atopic dermatitis
  • Immunoglobulin E
  • task force
  • World Health Organization
  • asthma control questionnaire


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