SEVERE ASTHMA

Asthma is a common inflammatory disease that has wide clinical characteristics of the airway of the lungs. Asthma symptoms can be prevented by avoiding triggers like allergens and by the effective inhaled treatment. The majority of asthma patients can be treated effectively by current medications. Difficult asthma is a distinct entity of asthma, comprising approximately %5-10 of asthmatic patients. Despite the high effective treatment, the patients with asthma have disease that is poorly controlled. Severe asthmatics account for up to half of the cost for asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant asthma patients. Asthma related deaths are seen especially in severe asthma group. Asthma is a heterogeneous disease, consisting of different phenotypes. It requires multidisciplinary approach for treatment management. Severe asthma may suddenly develop in early time in disease or overtime. There was an evidence that severe asthma related to genetic factors, environmental factors, age, inflammation, duration of disease The genetic and environmental factors may play a role in severe asthma management. Phenotypetargeted therapy has an important role in severe asthma, but it is associated with high treatment costs. At first diagnosis of asthma must be confirmed COPD and vocal cord dysfunction is needed to be particular interest in differential diagnosis. Triggering factors such as smoking, atopy, work place condition and aspirin hypersensitivity should be evaluated. Comorbidities that may affect asthma should be considered. This review examines the definition of asthma, its differential diagnosis, phenotypes and available treatment options