Asthma > Respiratory

What is severe uncontrolled asthma?

What is severe uncontrolled asthma?1-5

It is a type of asthma that does not improve sufficiently even when the correct treatment is being used, including daily inhalers and control of external factors.

You may have severe uncontrolled asthma if:1-5

• You have had 2 or more serious flare-ups in the last year.

• You have been to the emergency room or been hospitalized for asthma.

• You need to use your rescue inhaler more than twice a week.

• You wake up at night feeling short of breath.

• Your asthma prevents you from exercising or carrying out your normal activities.

What should the doctor check before confirming this diagnosis?1,2,5

Before saying you have severe asthma, your doctor must make sure that:

• That you are using your inhaler correctly.
• That you are not forgetting to take your daily treatment.
• That there are no other conditions worsening your asthma (such as reflux or rhinitis).
• That you are not exposed to factors that trigger asthma (smoke, dust, mold, etc.).

Did you know that there are different types of severe asthma?1,2,5,7,8

Yes, not all cases of severe asthma are the same. Your doctor needs to know what type of asthma you have in order to best decide how to treat it.

Allergic asthma:1,2,5

• It usually begins in childhood or adolescence.
• It is common to have a family history of allergies or asthma.
• It is related to allergies (such as pollen, dust, or animal hair).

Non-allergic asthma:1,2,5

• It is not related to allergies.
• It can begin in adulthood.
• It tends to worsen with infections, cold air, or stress.

Asthma with fixed airway obstruction:7,8

• It occurs when the airways have been inflamed for so long that they become damaged.
• Lung function does not improve even with bronchodilators.

Eosinophilic asthma:1,2,5

• A type of asthma that does not present the typical markers of allergic inflammation.
• It does not respond well to inhaled corticosteroids.
• It is less well known and more difficult to treat.

What can you do if you think your asthma is not under control?5

If you notice that you have frequent symptoms such as coughing, shortness of breath, wheezing, or need to use your rescue inhaler more than twice a week, your asthma may not be well controlled. 1,2

• Talking to your doctor: Communication is key.

• Complete clinical review: Sometimes the problem isn’t the medication, but how you’re using it.

• Request a more specialized evaluation if the treatment is not working.

• Keep track of your symptoms and flare-ups.

Remember:

Having asthma does not mean living with fear, fatigue, or limitations. If your asthma remains uncontrolled, it may be a more complex form that requires a different approach. A correct and timely diagnosis can improve your quality of life.

• A correct and timely diagnosis can improve your quality of life.

• It’s not your fault if the current treatment isn’t enough.

• The first step is to seek medical attention.

CC-16878 / MAY 2028

1. Spanish Guideline on the Management of Asthma (GEMA) 5.3. 2023.
2. Chung KF, et al. Characteristics, Phenotypes, Mechanisms, and Management of Severe Asthma. Chinese Medical Journal. 2022.
3. Chung KF. Diagnosis and Management of Severe Asthma. Seminars in Respiratory and Critical Care Medicine. 2018.
4. Lommatzsch M, Virchow JC. Severe Asthma: Definition, Diagnosis, and Treatment. Deutsches Ärzteblatt International. 2014.
5. Global Strategy for Asthma Management and Prevention (GINA). 2023.
6. Wenzel SE. Severe Adult Asthmas. American Journal of Respiratory and Critical Care Medicine. 2021.
7. Rutting S, et al. Fixed Airflow Obstruction in Asthma. Frontiers in Physiology. 2022.
8. Konstantellou E, et al. Persistent Airflow Obstruction in Patients With Asthma. Respiratory Medicine. 2015.
9. Grunwell JR, Fitzpatrick AM. Asthma Phenotypes and Biomarkers. Respiratory Care. 2025.

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