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Early diagnosis and treatment of these conditions with inhaled corticosteroids improves symptoms in the majority of patients. Up to 10% of patients with asthma remain poorly controlled in spite of optimal standard therapy. These patients have been encompassed under the term \u2018treatment-refractory asthma\u2019 (TRA), have the greatest morbidity and are responsible for more than 50% of healthcare costs. In this review we discuss investigations, management and pathophysiology of the various phenotypes of atypical presentations of asthma as well as novel biological agents licensed and those that have been reported in clinical trials in terms of their efficacy and safety in TRA.<\/jats:p>","DOI":"10.1177\/2040622311407542","type":"journal-article","created":{"date-parts":[[2011,6,7]],"date-time":"2011-06-07T23:56:58Z","timestamp":1307491018000},"page":"249-264","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Unusual asthma syndromes and their management"],"prefix":"10.1177","volume":"2","author":[{"given":"Jaymin B.","family":"Morjaria","sequence":"first","affiliation":[{"name":"IIR Division, School of Medicine, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack A.","family":"Kastelik","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Hull and East Yorkshire NHS Trust, University of Hull, Hull York Medical School, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,6,7]]},"reference":[{"key":"bibr1-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00004904"},{"key":"bibr2-2040622311407542","unstructured":"Asthma UK (2010) Asthma UK website, http:\/\/www.asthma.org.uk (accessed October 2010)."},{"key":"bibr3-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/145.6.1477"},{"key":"bibr4-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200401-033OC"},{"key":"bibr5-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e328012ce4b"},{"key":"bibr6-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050580"},{"key":"bibr7-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.2000.15b06.x"},{"key":"bibr8-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.6.9196083"},{"key":"bibr9-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2004.00770.x"},{"key":"bibr10-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1378\/chest.125.4.1378"},{"key":"bibr11-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.1_suppl.4S"},{"key":"bibr12-2040622311407542","doi-asserted-by":"publisher","DOI":"10.1016\/S0095-4543(21)01253-7"},{"key":"bibr13-2040622311407542","doi-asserted-by":"crossref","unstructured":"Brightling, C.E. 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