title: Diagnosis and definition of severe refractory asthma: an international consensus statement from the Innovative Medicine Initiative (IMI).
abstract: Patients with severe refractory asthma pose a major healthcare problem. Over the last decade it has become increasingly clear that, for the development of new targeted therapies, there is an urgent need for further characterisation and classification of these patients. The Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED) consortium is a pan-European public-private collaboration funded by the European Commission Innovative Medicines Initiative of the European Union. U-BIOPRED aims to subphenotype patients with severe refractory asthma by using an innovative systems biology approach. This paper presents the U-BIOPRED international consensus on the definition and diagnosis of severe asthma, aligning the latest concepts in adults as well as in children. The consensus is based on existing recommendations up to 2010 and will be used for the selection of patients for the upcoming U-BIOPRED study. It includes the differentiation between 'problematic', 'difficult' and 'severe refractory' asthma, and provides a systematic algorithmic approach to the evaluation of patients presenting with chronic severe asthma symptoms for use in clinical research and specialised care.
authors.affiliation: Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. e.h.bel@amc.uva.nl
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Bel
authors.forename: Ana
authors.initials: A
authors.lastname: Sousa
authors.forename: Louise
authors.initials: L
authors.lastname: Fleming
authors.forename: Andrew
authors.initials: A
authors.lastname: Bush
authors.forename: K Fan
authors.initials: KF
authors.lastname: Chung
authors.forename: Jennifer
authors.initials: J
authors.lastname: Versnel
authors.forename: Ariane H
authors.initials: AH
authors.lastname: Wagener
authors.forename: Scott S
authors.initials: SS
authors.lastname: Wagers
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Sterk
authors.forename: Chris H
authors.initials: CH
authors.lastname: Compton
mesh_terms: D001249:Asthma / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D003245:Consensus Statements as Topic; D003948:Diagnostic Techniques, Respiratory System / Q000592:standards*; D005060:Europe; D006801:Humans; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index