Treating asthma in the time of COVID

Precision Interventions for Severe and/or Exacerbation-Prone Asthma Network Research Group

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The Precision Interventions for Severe and/or Exacerbation-Prone Asthma clinical trials network is actively assessing novel treatments for severe asthma during the coronavirus disease (COVID-19) pandemic and has needed to adapt to various clinical dilemmas posed by the COVID-19 pandemic. Pharmacologic interactions between established asthma therapies and novel drug interventions for COVID-19 infection, including antivirals, biologics, and vaccines, have emerged as a critical and unanticipated issue in the clinical care of asthma. In particular, impaired metabolism of some long-acting beta-2 agonists by the cytochrome P4503A4 enzyme in the setting of antiviral treatment using ritonavir-boosted nirmatrelvir (NVM/r, brand name Paxlovid) may increase risk for adverse cardiovascular events. Although available data have documented the potential for such interactions, these issues are largely unappreciated by clinicians who treat asthma, or those dispensing COVID-19 interventions in patients who happen to have asthma. Because these drug-drug interactions have not previously been relevant to patient care, clinicians have had no guidance on management strategies to reduce potentially serious interactions between treatments for asthma and COVID-19. The Precision Interventions for Severe and/or Exacerbation-Prone Asthma network considered the available literature and product information, and herein share our considerations and plans for treating asthma within the context of these novel COVID-19–related therapies.

Original languageEnglish (US)
Pages (from-to)809-817
Number of pages9
JournalJournal of Allergy and Clinical Immunology
Issue number4
StatePublished - Apr 2023
Externally publishedYes


  • Asthma
  • COVID-19
  • CYP3A4
  • corticosteroids
  • cytochrome P450
  • interaction
  • long-acting beta-adrenergic agonist
  • ritonavir
  • salmeterol

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


Dive into the research topics of 'Treating asthma in the time of COVID'. Together they form a unique fingerprint.

Cite this