Practical phenotyping of difficult asthma

Practical phenotyping of difficult asthma.

Department of Respiratory Medicine, University Hospital of North Staffordshire, Stoke-on-Trent, UK Department of Respiratory Medicine, Glenfield Hospital, Leicester, UK North West Lung Centre, University Hospital of South Manchester, Wythenshawe Hospital, Manchester, UK Sheffield Thoracic Institute, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK Division of Therapeutics and Mo...

Difficult asthma

Most patients with asthma are easily diagnosed and respond to standard treatment with a short-acting inhaled β2agonist for symptom control and long-term treatment with an inhaled corticosteroid in doses of up to 2,000 μg daily. Approximately 5% of patients do not respond to this regime and require further investigation to establish the reasons for the lack of response. "Difficult asthma" may be...

Difficult asthma.

Asthma is usually easy to manage, but approximately 5% of patients are not controlled even on high doses of inhaled corticosteroids. It is important to assess these patients carefully in order to identify whether there are any correctable factors that may contribute to their poor control. It is critical to make a diagnosis of asthma and to exclude other airway diseases, particularly chronic obs...

Difficult asthma: beyond the guidelines.

How is difficult asthma managed?

Most patients with asthma can be easily treated. Some have difficult asthma; in some because the diagnosis is erroneous, in others because of comorbidity or noncompliance. A European Respiratory Society Task Force has called for an integrated approach for these patients, and positive results have been reported using protocols. In the UK, there is no overall understanding of the size of this pro...