Advances and challenges in treating asthma

Different types of asthma: The early onset asthma which starts in childhood is typically a reaction to allergens such as dust mites, mould or grass pollens.
Different types of asthma: The early onset asthma which starts in childhood is typically a reaction to allergens such as dust mites, mould or grass pollens.

Nearly 2.7 million Australians live with asthma, a breathing disorder that affects the airways in different ways but can make some people feel like they are breathing through a straw.

Treatment has come a long way over the years, with respiratory physician Dr David Freiberg saying the majority of his patients live a normal life when their asthma is well managed. However, a few key issues have meant that people with chronic asthma have been experiencing unnecessary flare-ups in their symptoms.

Preventer medications need to be taken daily and can be an effective way to avoid asthma attacks in moderate to severe cases. This almost always involves inhaled corticosteroids which are prescribed to reduce inflammation.

As with medications for many conditions, studies have shown some adults worry about the cost of filling prescriptions for regular medications as well as the time and monetary cost of visiting the GP for repeat scripts. This has led to some people 'stretching out' their doses to save costs, however this reduces the effectiveness of the medicine - as it needs to build up in the body in order to work properly.

Dr Freiberg said some people fear the side-effects of the inhaled corticosteroid medications, however he said these are safe and effective, and similar to substances produced in the body.

Asthma Australia outlines ways to minimise the common side effects associated with inhaling medications, such as using a spacer, gargling and rinsing your mouth after each dose. All side effects should be discussed with a doctor.

"People who continue to smoke while using treatment for asthma may not experience sufficient response to their treatment," said Dr Freiberg.

How does asthma occur?

People can develop asthma due to genetic factors, such as in families with hayfever and eczema, through environmental factors like living or working in polluted or mouldy facilities, and sometimes it can be triggered by allergens in the air, as we learned with the thunderstorm asthma epidemic in 2016.

"It can come at any age. There are different types of asthma. The early onset asthma which starts in childhood is typically a reaction to allergens such as dust mites, mould or grass pollens. The late onset asthma that starts as an adult may have less identifiable triggers but similar features of shortness of breath, wheeze and cough," said Dr Freiberg.

Asthma symptoms can start at any age, and have similar characteristics to a range of conditions including hayfever, chronic obstructive pulmonary disease, anaphylaxis and even reflux - so professional diagnosis is important to ensure the correct tests are applied and treatment is tailored to the patient's needs.

Life with asthma

"Medications can vary from a reliever inhaler before exercise only, to a regular preventer inhaler every day, to very advanced biologic therapy. Biologics have been a major breakthrough for severe asthma," said Dr Freiberg.

Biologic therapy for asthma has been helpful for patients with severe asthma, who are on multiple inhaler medications are still poorly controlled. These patients may require frequent rescue courses of cortisone tablets or even admissions to hospital. Biologic therapy is made from naturally occurring antibodies, and are administered by injection every two to four weeks.

People diagnosed with asthma are encouraged to manage their life with the condition through the use of an asthma action plan, which outlines their medications through various stages of feeling well to flare-ups. The use of pollen counts through national weather services will also help those with allergic conditions to stay on top of their triggers.

Diagnosis

"If you are experiencing restricted breathing especially with exercise, a flu that won't settle, persistent cough and wheeze, please see your GP to be checked for asthma," said Dr Freiberg.

For more information visit HealthShare, a joint venture with Fairfax to improve the health of regional Australians. Or you can find a specialist near you using the health tool below.