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

With the judicious use of inhaled corticosteroids (ICS) and B2 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.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.Conclusion: In apparently DTA there is a high prevalence of false (non-genuine) cases. Identification and management can be achieved by detailed systematic assessment