Diagnosis, severity and control
Diagnosing severe asthma is not always straightforward
Identifying severe asthma can be problematic. It is important to differentiate between severity and control: as mild asthma can be poorly controlled, and severe asthma can be well controlled. 1-2
Patients may also present with asthma that is difficult to treat. Although both difficult-to-treat asthma and severe refractory asthma could present with severe symptoms and poor control, they are different conditions with different underlying causes. 3
Difficult-to-treat asthma can have multiple confounding factors that complicate diagnosis, such as comorbidities or poor adherence to medication. 3Severe asthma can only be diagnosed once difficult-to-treat asthma has been excluded. 3-4 The recent recommendations by the ATS/ERS Task Force suggest that a patient presenting with difficult-to-treat asthma has their asthma diagnosis confirmed, evaluated and managed by an asthma specialist for more than 3 months. 4After addressing confounding factors, patients remaining refractory and requiring a second inhaled controller and/or OCS can be diagnosed with severe asthma. 4
- GINA 2016 © 2016 Global Initiative for Asthma, all rights reserved. Use is by express license from the owner. www.ginasthma.org (Last accessed December 2016).
- Peters SP, et al. Respir Med 2006;100:1139–51.
- Bel EH, et al. Thorax 2011;66:910–7
- Chung KF, et al. Eur Respir J 2014;43:343–73.