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Clin Med Insights Circ Respir Pulm Med. 2011;5:37-47. doi: 10.4137/CCRPM.S5535. Epub 2011 Aug 31.

Optimal management of severe/refractory asthma.

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The Ottawa Hospital at the University of Ottawa, Ottawa, ON, Canada.


Asthma is a chronic inflammatory disease of the airways, affecting approximately 300 million people worldwide. Asthma results in airway hyperresponsiveness, leading to paroxysmal symptoms of wheeze, cough, shortness of breath, and chest tightness. When these symptoms remain uncontrolled, despite treatment with high doses of inhaled and ingested corticosteroids, asthmatic patients are predisposed to greater morbidity and require more health care support. Treating patients with severe asthma can be difficult and often poses a challenge to physicians when providing ongoing management. This clinical review aims to discuss the definition, prevalence and evaluation of severe asthmatics, and provides a review of the existing pharmacologic and non-pharmacologic treatment options.


asthma management; difficult asthma; refractory asthma; severe asthma

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