Current treatment options for severe ASTHMA

Many drugs can be prescribed to manage asthma symptoms. The severity of a patient’s asthma often plays a large role in how successful a medication will be. Some major types of currently-used asthma medications include:

Inhaled corticosteroids are the key drugs used for controlling the underlying inflammation in asthma. Bronchodilators widen the airways by relaxing airway smooth muscle, though they do not reverse airway inflammation. Bronchodilators come in 2 basic forms:

  • Maintenance medications, such as long-acting beta-agonists that work up to 12 hours.
  • Rescue (short-acting) medications that work quickly to ease severe asthma symptoms for 4 to 6 hours.

Medications for long-term control, including methylxanthines, anticholinergics, leukotriene inhibitors, and IgE inhibitors such as Xolair™.  Oral corticosteroids such as prednisone, when used for maintenance, are reserved for patients with severe asthma. These drugs typically serve as maintenance medications.

These medications treat asthma symptoms, but there are limitations—especially for patients with severe asthma. Studies show how hard it can be to manage asthma:

Limited efficacy in patients with severe asthma: A number of recent surveys show that symptoms are poorly controlled by asthma medications in patients with severe asthma. These patients often continue to experience frequent and serious symptoms despite taking regular doses of asthma medications.¹ Even this limited efficacy is only possible when the patient takes his or her medicine as prescribed, typically twice a day, every day.
Not taking medications as prescribed
A 2012 report by the Global Initiative for Asthma estimated that approximately 50% of patients with asthma do not take their medications as prescribed.² Non-compliance may be a reason for an increase in emergency room visits and hospitalizations among patients with severe asthma.

Asthma medications can have potentially serious side effects. As with any medication, side effects become a greater concern when treatment is ongoing and as dosages increase, which is the case for patients with severe asthma.

Corticosteroids (oral steroids):  Side effects of prednisone and other oral corticosteroids range from mild annoyances to serious, irreversible damage. These side effects occur more frequently with higher doses and longer treatment. Side effects with ongoing use include suppression of the immune system, adrenal system, and growth; osteoporosis; skin thinning; hypertension; cataracts; glaucoma; muscle weakness; and increased risk of infection. Short-term side effects include stomach upset, headache, dizziness, trouble sleeping, fluid retention, weight gain, high blood pressure, loss of potassium, elevation of cholesterol levels and vision changes.
Bronchodilators: The possible side effects of short-acting rescue medications include rapid heartbeat, skeletal muscle tremor, potassium deficiency, increased lactic acid, headache and hyperglycemia. Long-acting beta-agonists may even cause severe asthma symptoms in some patients, and death when those episodes occur2.

Other drugs : The side effects of omalizumab (Xolair™) include anaphylaxis, injection-site reactions, and viral infections.
Lifestyle burdens

Because existing medications provide poor symptom control for some patients with severe asthma, they often must miss work or school. In addition, severe symptoms can require unscheduled doctor office visits, emergency room visits, and hospitalizations.

Bronchial Thermoplasty:

Bronchial Thermoplasty (BT) is a safe procedure clinically proven to provide a long-lasting reduction in asthma attacks for patients with severe asthma.

BT, delivered by the Alair™ System, works by safely applying mild heat inside the airways to reduce excessive smooth muscle. 

Learn more about Bronchial Thermoplasty