Dr Michelle Cloutier Explains the Methodology Behind Updated NAEPP Asthma Guidelines

Michelle M Cloutier, MD, is professor emerita at UCONN Health in Farmington, Connecticut, and chair of the National Asthma Education and Prevention Program (NAEPP) Coordinating Committee Expert Panel Working Group.

These guidelines were developed using extremely high standards, said Michelle M. Cloutier, MD. Cloutier helped update the National Asthma Education and Prevention Program (NAEPP) asthma guidelines.


How has the reclassification of asthma as a syndrome with multiple phenotypes impacted diagnosis and treatment advancements?

We’re not quite there in meshing asthma treatment and asthma phenotypes. But the guidelines clearly state that we need to advance this area further. Because currently, we have a step diagram for therapy that's based upon age; it's a one-size-fits-all. But we now know that there isn't one size of asthma, there are these multiple phenotypes. As we move forward, I think we're going to see a separating out [of] the various phenotypes. That is currently being done, to some extent, in the area of the biologics, a whole treatment category for asthma that's not dealt with in the current guidelines, because at the time that the questions were being asked, that the topics were being determined, there was only one biologic on the market. It was felt to be an emerging area and not one that was ready for updating. Clearly, in hindsight, this was a mistake.

Why should providers take these new recommendations into account when treating patients with asthma?

These guidelines were developed using incredibly high standards, using state-of-the-art methodologies for developing guidelines, using strict conflict-of-interest policies. I feel very confident that clinicians should feel comfortable in incorporating these recommendations into their practice. These truly are guidelines that are trustworthy and that are also transparent. All of the recommendations, and all of the information, was developed in a very transparent way. Readers of the guidelines can see the rationale. They may not agree with the recommendation, but they can see how the recommendation was developed and the evidence that was used to support the recommendation.

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