Diagnosis and investigation in the severe asthma clinic

ABSTRACT

Severe asthma is recognised as an important and emerging area of unmet need in asthma. The assessment of severe asthma should include three steps; (1) determining the diagnosis of asthma, including verification that the disease is severe asthma, (2) assessing comorbidities and contributing factors that will impact on clinical severity, as well as (3) assessing asthma phenotypes. These steps recognize the importance of heterogeneity in asthma as a key factor that determines the disease course and increasingly the choice of successful therapy. This assessment should be undertaken systematically and is best done by an expert multidisciplinary team. Here, we will outline the important aspects that should be included in the clinical assessment of the patient in the severe asthma clinic, including diagnosis, clinical history, the assessment of important comorbidities and the key investigations needed to support them.

KEYWORDS:

• Severe asthma
• difficult asthma
• treatment-refractory asthma
• asthma phenotypes
• comorbidities and severe asthma
• multidimensional assessment
• severe asthma biomarkers

Declaration of interest

The authors were supported by NHMRC Centre of Excellence in Severe Asthma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.