Life alongside asthma attacks can be difficult – from having to use an inhaler, to significantly limit your physical activity and routine. Nearly 5% of asthma patients feel that the symptoms of the disease affect them on a daily basis. Do you also feel that your or your children’s disease, despite the treatment, remains uncontrolled? New clinical studies may improve this situation.
Asthma is a common disease in children, but not only. Although its presence is about 8% among adolescents, a similar rate has also been observed among young adults. In fact, asthma can be observed at any age, and there is a recurring increase in the incidence of the disease towards the age of 60 years old.
Whether it is only mild-grade asthma or symptoms that appear frequently, asthma is characterized by bouts of shortness of breath, coughing, and wheezing. Sometimes the symptoms appear because of an obvious trigger like physical exertion, cold air, or viral infection; They are sometimes aggravated at night or cyclically around the seasons.
You may have experienced an asthma attack or asthma exacerbation at work or in the middle of the night that interfered with your daily routine. You may be actively refraining from going for a walk or even exercising outside by fear of having a seizure.
The effect of asthma attacks on the quality of life can be significant. Some patients experience seizures so severe that inhalers fail to help them and they need advanced medical care. For severe asthma where the quality of life is affected, existing treatment lines may not be sufficient.
3 out of 4 asthma patients are diagnosed before the age of 7.
The cause of asthma is probably a combination of genetic (hereditary) and environmental characteristics.
Other medical conditions, such as reflux, allergies, and obesity, can aggravate asthma.
Severe asthma is defined as a disease that requires a combination of therapies with a high-dose of inhaled steroids, along with other types of inhalers.
Asthma can improve or worsen over time and at different times in life.
New drugs for the treatment of severe or resistant asthma are constantly being developed. – Check here if you can be eligible for one of them.
The typical symptoms of asthma can also appear in other respiratory diseases. To know for sure that bouts of shortness of breath and wheezing are caused by asthma, one must undergo a lung function test called spirometry – a test that examines the value of the desired lung function for a person at a certain age, and compares it to actual lung function.
This test can reveal that there is a limit to the intake of air into the lungs.
If a blockage has been demonstrated in the spirometry test, the second stage of the test involves taking an inhaler – the purpose of which is to dilate the airways and bronchial lungs. Unlike other obstructive pulmonary diseases, asthma patients will respond well to bronchodilation by the inhaler, as demonstrated in the test with an increase in healthy airflow after treatment.
While experimental inhalation therapy can sometimes be started for patients with symptoms suggestive of asthma, the official recommendation is to perform a diagnostic test using spirometry – especially for severe cases or for patients who do not respond to treatment. Spirometry is an external measure that indicates not only the existence of the obstructive disease but also its severity.
In cases of uncontrolled asthma, it is sometimes necessary to be referred to a specialist in pulmonary medicine or allergies for a further medical follow-up.
Spirometry is a test that examines the standard lung function value of a person at a certain age, and compares it to the actual lung function, to diagnose Asthma.
Pros and cons:
Achieving control of asthma attacks alongside managing the disease over time, are significant therapeutic challenges.
Some patients get along with short-term inhalers that are used for momentary relief, during an attack for example. These inhalers contain active ingredients that dilate the airways and facilitate breathing. There are various inhalers for this purpose including Ventolin®.
For patients with more severe asthma – usually patients that require frequent use of inhalers at least once or twice a week – long-term treatment can also be added.
The goal of long-term treatment is to reduce the chronic inflammatory response that occurs in the airways, as it is the one that leads to recurrent seizures. Inhalers containing steroids (glucocorticoids) are most often used for this purpose. For uncontrolled disease, the inhaled steroid dose can be increased.
In cases of severe asthma, you can add another inhaler, or use a combined inhaler, with another active ingredient called a long-acting beta receptor antagonist. The mechanism of action of these inhalers is similar to the active ingredient found in short-term inhalers: they dilate the pulmonary bronchi, but unlike short-term inhalers, these substances act for a longer time.
Asthma patients that do not respond to combination therapy can also be treated with oral steroids (pills). Sometimes the pills should be taken only during the exacerbation periods, but some patients are forced to take them for a longer period of time. Long-term treatment with steroids, especially taking oral, involves various side effects that affect, among other things, bone density, blood sugar levels, and more.
There are many different inhalers on the market that differ from each other, including the dosages of the active ingredients that are in each one. Adjusting the inhaler and choosing the appropriate treatment for managing asthma may take some time.
For patients with uncontrolled asthma, newer treatments are also offered, including immunological drugs that directly attack the inflammatory process through antibodies such as Xolair® (omalizumab), Nuclea® (mepolizumab), and more. These drugs are given by subcutaneous injection and are effective for about 50% of patients with severe asthma only.
Once all the treatment lines have been exhausted – what is the next step?
Like other chronic diseases, there is no cure for asthma. Because of this, living alongside it can include milder periods together with significant exacerbations that can make your daily life difficult.
New drugs for the treatment of severe or resistant asthma are constantly being developed. For example, the immunological treatments mentioned above have entered as a new treatment line for severe asthma patients only in the last decade.
Clinical studies in asthma patients continue to test new drugs for those patients who do not get satisfactory responses with existing treatments. These medications may be able to help you or your child – who is suffering from severe seizures and are unable to stabilize or manage them.
Clinical studies in asthma patients continue to test new drugs for those who do not get along with existing treatments. – Check your trial eligibility here.
Clinical studies in Israel for asthma:
The treatments as part of clinical trials are performed at a number of medical centers in Israel, with continuous medical accompaniment free of charge, and without a single out-of-pocket expense.
Much of the research focuses on additional therapies that act through the immune system, following hypotheses that have already been found to be safe and effective in previous trials in the laboratory and in smaller groups of patients. The experimental treatments differ from each other regarding the patients’ profile they want to support, the medical centers where they are performed, the frequency of treatment, and some additional data that our staff will be happy to explain to you.
By filling out a short questionnaire under the “Match me trial” button, you can check if a clinical study is currently underway in asthma patients that may be suitable for you or your child.
You can read more on our website about clinical trials to better understand how they are performed and what they involve.
If we find you a suitable trial, our team will connect you to the corresponding medical staff to explain to you the advantages and disadvantages of participating in the research.