| Treatment strategy | Role |
| Monoclonal antibody therapies (‘biologic’ agents) | Targeted anti-inflammatory treatment according to allergic status and inflammatory phenotype, for patients under specialist care |
| Maintenance high-dose ICS-LABA plus as-needed SABA | Short-term (3–6 months) treatment trial while investigating causes of persistent symptoms/severe exacerbations, or pending eligibility for monoclonal antibody therapy Under specialist care when symptoms and exacerbations cannot be controlled with medium-dose ICS-LABA |
Maintenance ICS-LABA-LAMA plus as-needed SABA (ICS dose medium or high) | Treatment trial in patients with blood eosinophil count/FeNO within normal range, while investigating causes of persistent symptoms/severe exacerbations, or pending eligibility for monoclonal antibody therapy Long-term treatment for selected patients with demonstrated benefit, including those not eligible for monoclonal antibody therapy |
| Montelukast | May be considered as add-on treatment for patients with aspirin-exacerbated respiratory disease Limited use in severe asthma ⚠ Montelukast TGA-approved product information and consumer medicine information carry a warning about potential neuropsychiatric adverse effects. Counsel parents about risks (see TGA safety alert). |
| Azithromycin | An add-on treatment option used in specialist care for patients with persistent exacerbations despite maintenance treatment with medium-dose ICS-LABA. Screening is required and cautions apply (see Centre of Excellence in Severe Asthma guidance on azithromycin). |