Severe Asthma: Recognizing Symptoms, Diagnosis, and Management Strategies
For individuals living with severe asthma, effective management is crucial to maintaining a good quality of life and preventing life-threatening attacks. Healthcare professionals employ a multi-faceted approach to control symptoms, prevent exacerbations, and improve lung function.
Key pharmacologic treatments for severe asthma include high-dose inhaled corticosteroids (ICS) combined with long-acting beta-agonists (LABA), which form the foundation of therapy. This combination, often administered as maintenance and reliever therapy (MART) with ICS-formoterol, helps reduce the risk of exacerbations. In severe cases, oral corticosteroids may be used for maintenance, but their use is minimized due to potential side effects and they are typically a last resort. Leukotriene modifiers, such as montelukast, can also be added to reduce inflammation and bronchoconstriction. Tiotropium, a long-acting muscarinic antagonist, may be used for additional bronchodilation in severe cases.
Biologic therapies offer targeted treatment for patients with specific severe asthma phenotypes, particularly those with type 2 inflammation. Omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab are examples of biologic agents that have transformed severe asthma management by targeting the inflammatory pathways driving symptoms and reducing reliance on steroids.
Bronchial thermoplasty is a non-pharmacologic procedure that uses controlled thermal energy to reduce airway smooth muscle mass, improving symptoms in patients with severe, uncontrolled asthma not responding adequately to medications.
Immunotherapy and lifestyle modifications play an essential role in managing severe asthma. Immunotherapy can help reduce sensitivity to allergens in individuals with allergic asthma, while lifestyle interventions such as smoking cessation, avoiding triggers, and adherence to treatment are critical.
Regular monitoring and adjustment are also crucial components of severe asthma management. Asthma control and lung function must be regularly assessed, and treatment should be stepped up or down based on control, adherence, inhaler technique, and comorbidities. Infection control is particularly important during exacerbations or aerosol-generating procedures.
Severe asthma can interfere with daily activities and make sleeping difficult. It can significantly limit a person's regular activities. Despite therapy, severe asthma can still be uncontrolled. FEV1, or forced expiratory volume, is a measurement of how much air a person can force from their lungs in 1 second, and a value of less than 60% may indicate severe asthma.
For those experiencing severe asthma symptoms throughout the day and night, it is essential to seek immediate medical attention, as asthma attacks can be life-threatening. Quick relief asthma medications, such as albuterol, can be taken when symptoms occur.
For more evidence-based information and resources for living with asthma and allergies, visit a dedicated hub. A diagnosis of asthma may take some time and may require trying various treatments. The best way to reduce the risk of severe attacks and uncontrolled symptoms is to avoid triggers as much as possible and take prescribed treatments.
- For naive personas with severe asthma, following a prescribed treatment plan is crucial to manage symptoms, prevent life-threatening attacks, and maintain a good quality of life.
- High-dose inhaled corticosteroids (ICS) combined with long-acting beta-agonists (LABA) form the foundation of therapy for severe asthma, significantly reducing the risk of exacerbations.
- In severest cases, scientific advancements like biologic therapies offer targeted treatment for individuals with specific severe asthma phenotypes, particularly those with type 2 inflammation.
- Bronchial thermoplasty, a non-pharmacologic procedure, can improve symptoms in patients with severe, uncontrolled asthma not responding adequately to medications.
- Immunotherapy and lifestyle modifications are essential in managing severe asthma, reducing sensitivity to allergens and enhancing adherence to treatment.
- Regular monitoring and adjustment of treatment regimens, along with early identification of comorbidities such as chronic kidney disease, COPD, type-2 diabetes, rheumatoid arthritis, and mental health conditions, are essential components of severe asthma management.
- Due to the potentially life-threatening nature of severe asthma, fitness and exercise, mental health, nutrition, and smoking cessation are crucial for overall health and wellness.
- Quick relief asthma medications like albuterol can be taken when symptoms occur, but in case of persistent severe asthma symptoms throughout the day and night, immediate medical attention is required.
