Difficult to treatment asthma, is it really asthma? Is it really difficult?

With the judicious use of inhaled corticosteroids (ICS) and B-2 agonists most patients with asthma are easily controlled and managed. However, approximately 5-10% of asthmatics did not respond to standard therapy and are classified as "difficult to treat asthma, DTA". Many factors can contribute to poor response to conventional therapy. For these patients, a systematic approach is needed to identify false (non-genuine) DTA from true (genuine) intractable DTA. It is essential to sort through and address the above issues before reverting to other therapy.& para;& para;Objectives: The aim of the present study is to evaluate a systematic approach to indentify the patients of false (non-genuine) to true (genuine) DTA and to recognize the underlying different precipitating factors.& para;& para;Conclusion: In apparently DTA there is a high prevalence of false (non-genuine) cases. Identification and management can be achieved by detailed systematic assessment. (C) 2014 Production and hosting by Elsevier B.V. on behalf of The Egyptian Society of Chest Diseases and Tuberculosis.