title: Guidelines for severe uncontrolled asthma.
abstract: Since the publication, 9 years ago, of the latest SEPAR (Spanish Society of Pulmonology and Thoracic Surgery) Guidelines on Difficult-to-Control Asthma (DCA), much progress has been made in the understanding of asthmatic disease. These new data need to be reviewed, analyzed and incorporated into the guidelines according to their level of evidence and recommendation. Recently, consensus documents and clinical practice guidelines (CPG) addressing this issue have been published. In these guidelines, specific mention will be made of what the previous DCA guidelines defined as "true difficult-to-control asthma". This is asthma that remains uncontrolled after diagnosis and a systematic evaluation to rule out factors unrelated to the disease itself that lead to poor control ("false difficult-to-control asthma"), and despite an appropriate treatment strategy (Spanish Guidelines for the Management of Asthma [GEMA] steps 5 and 6): severe uncontrolled asthma. In this respect, the guidelines propose a revised definition, an attempt to classify the various manifestations of this type of asthma, a proposal for a stepwise diagnostic procedure, and phenotype-targeted treatment. A specific section has also been included on DCA in childhood, aimed at assisting healthcare professionals to improve the care of these patients.
authors: Servicio de Neumología, Hospital Universitario La Princesa, Madrid, España. Electronic address: Carol9199@yahoo.es.
authors: Carolina
authors: C
authors: Cisneros Serrano
authors: Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España.
authors: Carlos
authors: C
authors: Melero Moreno
authors: Servicio de Neumología, Hospital Universitario de Guadalajara, Guadalajara, España.
authors: Carlos
authors: C
authors: Almonacid Sánchez
authors: Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors: Miguel
authors: M
authors: Perpiñá Tordera
authors: Servicio de Neumología y Alergia Respiratoria, Hospital Clinic, Universitat de Barcelona, Barcelona, España.
authors: César
authors: C
authors: Picado Valles
authors: Servicio de Neumología, Hospital Universitario Dr. Peset, Valencia, España.
authors: Eva
authors: E
authors: Martínez Moragón
authors: Servicio de Neumología, Hospital Lucus Augusti, Lugo, España.
authors: Luis
authors: L
authors: Pérez de Llano
authors: Servicio de Neumología, Hospital de Galdakao-Usansolo, Galdakao, España.
authors: José Gregorio
authors: JG
authors: Soto Campos
authors: UGC Neumología y Alergia, Hospital de Jerez, Cádiz, España.
authors: Isabel
authors: I
authors: Urrutia Landa
authors: Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España.
authors: Gloria
authors: G
authors: García Hernández
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000145:classification / Q000627:therapeutic use; D001249:Asthma / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D003937:Diagnosis, Differential; D004351:Drug Resistance; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D004781:Environmental Exposure; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000235:genetics; D012720:Severity of Illness Index; D064706:Vocal Cord Dysfunction / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents
keywords: Asma grave; Asma no controlada; Asthma phenotype; Asthma treatment; Fenotipado del asma; Severe asthma; Tratamiento del asma; Uncontrolled asthma