Asthma is the most frequent chronic inflammatory disease of the lower airways affecting children, and it can still be considered a challenge for pediatricians.Although most asthmatic patients are symptom-free with standard treatments, a hats small percentage of them suffer from uncontrolled persistent asthma.In these children, a multidisciplinary systematic assessment, including comorbidities, treatment-related issues, environmental exposures, and psychosocial factors is needed.
The identification of modifiable factors is important to differentiate children with difficult asthma from those with true severe therapy-resistant asthma.Early intervention on modifiable earrings factors for children with difficult asthma allows for better control of asthma without the need for invasive investigation and further escalation of treatment.Otherwise, addressing a correct diagnosis of true severe therapy-resistant asthma avoids diagnostic and therapeutic delays, allowing patients to benefit from using new and advanced biological therapies.