Severe asthma

Abstract

Severe asthma is a heterogenous condition with several distinct phenotypes and endotypes. The diagnosis and treatment of severe asthma is time consuming and requires special experience. There is a need for competent treatment centers, continuing medical education, and research on the prevalence of severe asthma. To achieve and maintain control in severe asthma high dose inhaled corticosteroids with a second and a third controller are usually needed. Before any further treatments are evaluated, differential diagnoses of asthma should be ruled out, comorbidities should be treated, persistent triggers should be eliminated, and patient adherence should be optimized. Targeted treatment with biologicals and small molecules has revolutionized the management of severe asthma.