Asthma: Maintenance Treatments Allow For Greater Control And Prevent Attacks

May 2 marks World Asthma Day, a disease that affects more than 339 million people worldwide, according to the 2018 World Asthma Report.

This disease can occur at any stage of life, due to various factors such as genetic predisposition, chemical irritants, air pollution, and environmental exposure to inhaled substances and particles that can cause allergic reactions or irritate the respiratory tract.

Triggers, according to the National Heart, Lung, and Blood Institute30, include:

• Dust, animal fur, cockroaches, mold and pollen
• Cigarette smoke
• Aspirin, ibuprofen, and certain heart medications.
• Physical activity
• Sleep apnea
• Heartburn
• Preservatives in food and beverages

Common asthma symptoms include coughing at night or in the morning, which makes it difficult for the patient to sleep, wheezing when breathing, chest tightness, and difficulty breathing.

Global figures estimate that 60% of patients have poor control of their disease and there is a relationship between the overuse of rescue inhalers known as SABA and the appearance of severe exacerbations.

“Asthmatic patients tend to seek rapid relief of symptoms with treatment, so a large percentage prefer the use of immediate relief treatment (SABA) rather than a maintenance treatment that allows them to prevent and control asthma, which leads to an overuse of these medications. It is important to clarify that, although these rescue inhalers quickly relieve symptoms, they do not reduce inflammation in the airways, generating a greater risk of severe asthma exacerbations and decreasing lung function,” says Dr. Andrés Rojas, Medical Director of AstraZeneca for Central America and the Caribbean.

The disease varies according to the patient; there is mild, moderate, and severe asthma, the latter being the most difficult to control, even when the treatment is used correctly and the instructions of the treating physician are followed.

It is estimated that 5 to 10 out of every 100 people with asthma have severe asthma, and 50% of these patients may develop eosinophilic asthma, which means that a type of white blood cell called eosinophils is present in greater numbers in the airways, irritating or inflaming them and even damaging the lungs.

Eosinophilic asthma causes decreased lung function, leading to repeated emergency room visits and hospitalizations for patients.

According to the National Institute of Respiratory Diseases (INER), timely diagnosis, adequate treatment, and good patient education can achieve optimal control of the disease.

To perform a phenotype evaluation, a series of laboratory and lung function tests are necessary to enable the specialist to offer personalized treatment.

These tests include a complete blood count with differential white blood cell count and a review of total IgE levels in the blood, which allows us to determine if there is a total presence of immunoglobulin E (IgE) antibodies in the blood that suggest the presence of allergic diseases. Both tests are performed by drawing blood.

Additionally, there is spirometry, a test that measures lung function, and finally, the measurement of the exhaled fraction of nitric oxide (FeNO), which is performed through a portable device in which the patient must blow through a mouthpiece for a few seconds.