Difficult-to-treat Asthma: Improving assessment and outcomes in the era of personalised medicine

Difficult asthma is common and associated with poor health-related quality of life, excess morbidity and a large economic burden. This thesis outlines the process for, and confirms the role of, systematic assessment for difficult asthma in the era of asthma monoclonal biologics. It explores the importance of breathing pattern disorder in difficult asthma patients and demonstrates an improvement in asthma outcomes following treatment for this condition. Finally, it explores the relationship between clinically utilised inflammatory biomarkers in an international severe asthma cohort and how these biomarkers relate to clinical characteristics in severe asthma patients.