By: Dr Jim Kreindler; Medical Director, Respiratory Biologics at AstraZeneca
The history of asthma is as old as the history of medicine itself. In fact, there’s record of people experiencing asthma attacks in as early as the 2nd century, and evidence of structural disorders in the lungs as far back as the 17th century.
But the ancients could never have predicted how science would advance our understanding of asthma, ultimately resulting in new ways of diagnosing and treating this debilitating condition. Of course, there is still much more work to be done, but living with asthma is now manageable for millions of people because of several important discoveries:
1. The use of corticosteroids in asthma
The introduction of inhaled corticosteroids (ICS) helped to change the history of how asthma is treated. Long-positioned as the mainstay and gold standard for asthma therapy, ICS has helped to significantly improve patients’ symptoms, and has allowed them to gain better control over their asthma. In fact, the effectiveness of ICS—an anti-inflammatory therapy—helped researchers recognize that airway inflammation was a factor in asthma.
Asthma patients also commonly rely on oral corticosteroids (OCS) to help them breathe better. However, while OCS are an important tool in managing asthma in certain cases, frequent use can cause potentially serious health risks, and has become a signal that a patient’s asthma remains uncontrolled and that they may need an updated treatment plan. That’s why AstraZeneca, along with 10 patient advocacy groups, professional societies and other members of industry, is embarking on a collaborative effort through the release of a stewardship statement to raise awareness about additional treatment approaches that can help protect severe asthma patients from potential overexposure to OCS.
2. Recognizing the role that eosinophils play in asthma
Another key discovery was acknowledging that not all asthma is the same, and there are many different causes and levels of severity of the disease. In fact, many patients don’t know that their asthma may be driven by something inside of their own body. According to an analysis of the National Health and Nutrition Examination Survey (NHANES), 69% of adult patients may have a type of asthma called eosinophilic asthma (or e-asthma).*
E-asthma is caused by an excess of a type of white blood cell called eosinophils. Eosinophils are a normal part of the body’s immune system, but for some people with severe asthma, they can lead to airway inflammation and severe asthma attacks, making it difficult for patients to breathe. Without an e-asthma diagnosis, patients often continue to follow treatment plans that aren’t tailored to their specific asthma type and as a result, continue to experience asthma attacks and difficulty controlling their asthma symptoms. That’s why understanding the specific cause of a patient’s asthma is an important step in being able to successfully manage their condition.
3. The entrance of biologics in the respiratory world
As researchers and healthcare professionals continued to learn more about the different types of asthma, a larger emphasis was put on discovering treatment approaches that are specifically tailored for patients’ unique asthma experiences, including for e-asthma. The entrance of biologics—a class of therapies produced from living cells—as an approach to managing a patient’s e-asthma helps to achieve just that. Biologics target a source of patients’ airway inflammation, such as eosinophils, and has allowed patients to gain better control of their asthma symptoms and reduce their need for OCS.
A simple, routine blood test can help to diagnose e-asthma, so patients should talk to their doctors to ask for the test. By reviewing their test results along with their asthma history, patients and their doctors—usually an allergist or pulmonologist—can explore a personalized treatment plan that addresses their specific type of asthma.
While there is currently no cure for asthma, continued scientific progress will bring us closer to that reality. The knowledge we gain through research and innovative approaches will continue to help answer questions and evolve medicines for the treatment of asthma.
*In a 2005-2006 Centers for Disease Control survey, of the 310 people who said they had asthma, 214 had a higher than normal type of a white blood cell called eosinophils in their blood (150 cells per microliter or more) and were considered to have eosinophilic asthma.
US-25820 Last Updated 1/19