Abstract
Difficult-to-treat asthma is defined as asthma that remains uncontrolled despite therapy with high-dose inhaled corticosteroids (ICS) or chronic oral corticosteroids. The evaluation and management of patients with difficult-to-treat asthma should include properly diagnosing and addressing comorbid conditions which are commonly associated with poor asthma control. The conditions discussed in this chapter will be allergic rhinitis, chronic rhinosinusitis with or without nasal polyps, aspirin-exacerbated respiratory disease, obstructive sleep apnea, gastroesophageal reflux disease/laryngopharyngeal reflux disease, and vocal cord dysfunction. The management of these conditions can provide significant symptomatic relief to patients with difficult-to-treat asthma and potentially improve asthma control as well.
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