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Asthma – Degree of Severity

March 30, 2021


"So asthma is a very heterogeneous disease. This means there's various degrees of severity from patient to patient and care really should be dedicated depending on where a patient is on their degree of severity. Some patients will have very mild disease where they essentially feel normal almost all the time. These patients should really not be prescribed any maintenance medications and really should just be given an asthma short acting rescue inhaler, most commonly albuterol medication, to be used on an as needed basis. Now it's important to know that even for these patients, their asthma, you're never completely cured of asthma. So these patients can progress to a more severe disease of asthma later in their lives. What we don't know when it's going to happen, sometimes it's a viral infection that triggers us, but it's possible that these patients do progress to a more severe form of asthma later in their life. So for these patients, it's important to keep in mind that if you're having worsening symptoms, if you're feeling like you're having more chest tightness, cough, if you're not, as, you know, in doing activities, you're feeling more short of breath than usual. It's important for these patients then to seek medical care and decide if a maintenance therapy is needed for their case. Other patients will start out as more mild persistent or moderate persistent, or maybe even severe persistent asthma. For these patients, it's important that they are indeed on a maintenance inhaler asthma regimen. Most of the time, they actually should be on a combination inhaler regimen, including both a inhaled corticosteroid medication and long acting form of albuterol in essentially in one inhaler medication. Again, maintenance therapy should be used on a scheduled basis one or two times daily, depending on the specific inhaler that you've been prescribed. And finally, for our most severe patients for asthma definitely require the maintenance inhaler and workup should be done to see why their asthma is especially severe. Is there a particular trigger in their life? Is there a particular exposure at work or an occupational exposure that's causing their asthma to be particularly difficult to control? The discovery of these questions will really help guide us on how we can better control the symptoms for the patients with the most severe asthma. On top of this, we're learning more and more about the pathophysiology of asthma. There are some patients with more of a T2 high eosinophilic asthma versus a non-eosinophilic T2 low type asthma. Distinguishing between these two in the most severe asthmatics is important as patients with eosinophilic T2 high asthma can benefit from the newer biological injection medications to be used on a usually two, every two to four week basis."

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