Addressing Comorbidities in Difficult Asthma

  • Jason KwahEmail author
  • Anju Peters
  • Sumita Khatri
Part of the Respiratory Medicine book series (RM)


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.


Difficult asthma Allergic rhinitis Rhinosinusitis AERD Gastro-esophageal reflux disease Obstructive sleep apnea Laryngopharyngeal reflux Vocal cord dysfunction 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Northwestern University Feinberg School of Medicine, Division of Allergy and ImmunologyChicagoUSA
  2. 2.Cleveland Clinic Foundation, Department of Pulmonary MedicineRespiratory InstituteClevelandUSA

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