Trends in Asthma Care

Each person's asthma is different and how asthma is treated is constantly changing. To help patients and caregivers understand the latest trends in asthma care, the Lung Association hosted a webinar featuring pediatric pulmonologist, Jered Weinstock, MD. The webinar discussed the different types of asthma, new approaches to managing asthma, emerging treatment options and Lung Association resources aimed at helping patients and caregivers better manage their asthma.

Definition of Asthma: The Evolution

Asthma is no longer thought of as a single disease. In 1962, the American Thoracic Society characterized asthma as an episodic disease with reversible airway constriction and increased airway sensitivity. Now, over 40 years later we understand asthma is a chronic disease with multiple types consisting of three characteristics – airway inflammation, reversible airway obstruction and increased airway sensitivity. What does all of this mean?

Optimal Asthma Care

What should I expect when my doctor cares for my asthma?

First, your doctor should assess the severity of your asthma – intermittent asthma, mild persistent asthma, moderate persistent asthma or severe persistent asthma. Your doctor will also complete a patient assessment which includes a medical history, physical exam, additional tests as needed, such as a chest x-ray, spirometry, peak flow monitoring and allergy testing. Your doctor will use these measures to rule out any other conditions and confirm an official asthma diagnosis.

What Has Changed in Asthma Care?

In the past, asthma was treated almost with a “one size fits all” approach. For example, there was a standard approach to treating people with asthma who shared similar symptoms and triggers. Now, doctors recognize that not everyone with asthma responds well to a standard approach. Healthcare providers are now able to customize treatment to the individual that will improve responses to the treatment and overall health.

Different Treatments Work for Different Patients

Understanding your type of asthma can help with treatment and management. Depending on your specific type there are different management steps and treatment options available. Some of the new treatments in asthma care include Single Maintenance and Reliever Therapy (SMART), using a Long-Acting Muscarinic Antagonist (LAMA), allergy testing and shots, and biologics.

• SMART is a treatment option for people with moderate to severe persistent asthma. This approach uses a single inhaler that contains an inhaled corticosteroid (ICS)and an inhaled long-acting beta2-agonists (LABA) as the daily controller and as-needed quick-relief medicine. There are two combination inhalers, budesonide/ formoterol (Symbicort^®) or mometasone furoate/ formoterol (Dulera^®), currently available for this treatment option.
• LAMAs are maintenance or controller medicines that are taken daily to control the inflammation in the airways and help prevent symptoms.
• Allergy testing is used to help control your asthma when allergens increase your asthma symptoms and cause you to have asthma episodes. Once the allergens that affect your asthma are identified you may be asked to avoid or reduce your exposure to them, or you may be recommended to receive allergy shots (Immunotherapy) to increase your tolerance to the allergen.
• Biologic medicines (monoclonal antibodies) are used as add-on therapy for individuals with severe asthma to help block the response to specific cells that cause inflammation in the airways. This medicine is delivered either by injection in your doctor’s office, IV infusion in a clinic or hospital, or through self-injection at home.

The Goal is Control!

Whenever you start a new asthma treatment or therapy it is important to regularly assess and monitor your asthma control. This is done by tracking your symptoms, during the daytime and at night, how often you use your quick-relief inhaler, and if you experience any changes in how you are able to perform normal activities such as walking, climbing stairs, daily chores or playing with your children. If you need help assessing your asthma control, take the Asthma Control Test™! The test asks you five quick questions about your asthma to determine if your asthma is well controlled.