Personalized Treatments For Severe Asthma

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For many asthma sufferers, the condition can be a minor annoyance, causing them shortness of breath or wheezing. But for a small subset, asthma can be downright debilitating, and sometimes even deadly. In the past, when traditional treatment options failed, these individuals had nowhere to turn. But now there is hope that could have them breathing a little easier.

In the U.S. more than 26 million people, or 1 in 13, have asthma, which causes swelling and narrowing of the airways. More Americans suffer from asthma than ever before, making it one of the country’s most common and costly diseases, according to the Asthma & Allergy Foundation of America. It is a common cause of time away from work and school.

Symptoms include:

    •       Shortness of breath

    •       Chest tightness

    •       Trouble sleeping caused by shortness of breath, coughing or wheezing

    •       A whistling or wheezing sound when exhaling

    •       Coughing or wheezing attacks

When asthma is suspected, doctors first work to identify what type of asthma their patient has, allergic or non-allergic, and what specifically brings on symptoms. Triggers can include airborne substances like pollen or mold, irritants in the workplace like fumes or dust, or exercise, which may be worse when the air is cold or dry.

Once that piece of the puzzle is solved, the focus turns to treatment options.

A majority of sufferers experience relief through steroid medication given by inhalers. But for those with severe asthma, about 5-10% of sufferers, doctors are now able to tailor treatments to their body.

“When it comes to asthma, there is no one size fits all approach to treatment,” says Dr. Sucharita Kher, Director of the Outpatient Pulmonary Clinic at Tufts Medical Center. “We now have options for patients with severe asthma who have been doing all the right things, like taking their inhalers and avoiding triggers, but their asthma is still so bad they can’t function and it affects their daily life.”

Blood tests look at a patient’s individual biomarkers, such as eosinophil (a form of white blood cell) and immunoglobulin E. The results help identify the therapy he/she can best benefit from. For example, patients with severe asthma who have flare ups despite using appropriate inhaler therapy and have a high eosinophil count, may benefit from treatment targeting these eosinophils, which play a big role in inflammation in asthma. 

So far, the results of the customized treatments have been encouraging.

“We’ve had patients here who have had their lives changed,” says Dr. Kher. “It’s hard because they’re trying to do their best, but their breathing is failing them. If you get short of breath climbing stairs, you can’t do your laundry if it’s in the basement, for example. I had a patient who was a baker, but flour affected his breathing and he wouldn’t have been able to continue working if we didn't treat him,” she says.

While research is ongoing, the future of personalized treatments for asthma appears promising.

“You feel like you’re making a huge difference, allowing someone to carry on a life that’s a normal life, something many of us take for granted,” says Kher.

Posted August 2018

The above content is provided for educational purposes by Tufts Medical Center. It is free for educational use. For information about your own health, contact your physician.

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