Petros Bakakos and Stelios Loukides
Asthma is a common disease affecting more than 300 million people worldwide [1]. According to the recent ERS/ATS consensus severe asthma is defined as asthma that requires treatment with high dose Inhaled corticosteroids (ICS) plus one more controller (and/or oral corticosteroids) in order to be controlled or remains uncontrolled despite the above treatment or becomes uncontrolled with the reduction of high dose ICS or oral corticosteroids [2]. It is a prerequisite that the correct diagnosis of asthma has been confirmed and comorbidities have been identified and treated properly [2]. It is also extremely important to check inhaler technique and ensure good adherence to treatment. Current GINA document suggests that a referral to a specialist with expertise in the management of severe asthma is strongly encouraged for patients not controlled with treatment step 3 [1].