Abstract
Bronchial asthma is chronic inflammatory disease with qrowing incidence in developed countries. Achievement of full asthma control is reality in most patients due to availability of up-to-date anti-inflammatory and bronchodilatation drugs.
However, there still remains 5 % of patients with severe asthma, where control of the disease is not gained and this situation is currently described as problematic severe asthma. Problematic severe asthma (PSA) entity could be divided into two clinical situations - difficult-to-control asthma (DCA) or severe refractory asthma (SRA).
DCA is described as uncontrolled asthma due to unrecognized and/or untreated complicating factors and comorbidities and/or non-compliance of the patient. SRA is situation when the patient has got uncontrolled asthma despite full compliance to asthma therapy according to GINA quidelines, comorbidities and complicating factors are solved and treated.
Asthma phenotype recognition in SRA is necessary for phenotype-specific therapeutic approach. All patients with sespected problematic severe asthma should be reffered for consultation in a center experienced in severe asthma therapy.