Asthma is a common disease. It has increased significantly over the last hundred years and now affects between 1 in 10 and 1 in 20 people in Europe. In most sufferers asthma can be treated successfully, and as a result emergency room consultation and hospitalization are rarely needed. However, in a minority of patients asthma can be only partially controlled, or even prove impossible to control, despite intensive treatment. In a new review article published in Deutsches Ärzteblatt International (Dtsch Arztebl Int 2014; 111: 847-55), Marek Lommatzsch and J. Christian Virchow describe the points that require consideration when diagnosing and treating such cases, known as severe asthma, and the areas in which further research is required.
When a patient presents with symptoms of severe asthma, it is important to investigate the possible causes of his or her symptoms. These may be other diseases, allergies, or lack of treatment compliance by the patient. If treatment is inadequate despite such intensive investigation and therapy, additional measures such as appropriate rehabilitation or specific medication are needed. In the opinion of the authors, severe asthma requires physicians with relevant experience and intensive treatment; sometimes the required treatment has not yet been authorized. Because of this, they say, severe asthma is not always adequately diagnosed or treated. They therefore recommend that patients present to specialized facilities so that they have the opportunity to participate in clinical trials and be included in Germany's nationwide severe asthma registry.