Topical inhaled corticosteroids are currently the most common treatment for asthma control. They reduce swelling in the airway and result in better control of symptoms. Despite their effectiveness, however, corticosteroid inhalers do not provide a cure for asthma. In addition, these treatments must be used regularly, can cause occasional side effects, and may become costly. Patients with both asthma and allergies see a significantly higher need for medication as symptoms become more difficult to control. This can lead to higher health care costs overall as well as an increase in medication side effects. While inhaled corticosteroids remain the standard of care for asthma management, treating your allergy symptoms with treatments such as specific allergen immunotherapy can reduce the need for these medications over time. Allergen Immunotherapy (allergy injections) is a clinically documented treatment that can significantly reduce your allergy symptoms. By treating the cause of your allergies, studies show your asthma can become less severe and more manageable, while lowering your overall healthcare costs.
Immunotherapy for Asthma Patients
Since asthma symptom control is correlated with the severity of your allergies, and vice versa, any treatment that can reduce the symptoms of one will lead to improvement in both conditions. Allergen immunotherapy shows potential to reduce allergy symptoms by lowering the body’s allergic response. By reducing chronic allergic inflammation, immunotherapy can contribute to the improvement of asthma symptoms and can potentially slow or halt the progression of asthma. In a number of clinical studies, asthma patients receiving immunotherapy in addition to standard pharmaceutical treatment reported fewer asthma symptoms, required less asthma medication, and demonstrated improved lung function compared to those receiving asthma treatment alone.
Indications for immunotherapy in allergic asthma include:
- The presence of a clinically diagnosed allergic condition
- Side effects or suboptimal control with medications alone
- The patient’s desire to avoid long-term pharmaceutical treatment
- Inadequacy of environmental control measures.
WARNING: Severe, uncontrolled asthma is a counter-indication for immunotherapy. Only patients with controlled asthma are candidates for immunotherapy. With these patients, a lung function test should be performed prior to injection to ensure they are not at an increased risk of anaphylaxis. Immunotherapy treats the underlying allergic inflammation that can influence the course of asthma. However, asthma is a complex disease and should be treated with a comprehensive strategy that also involves standard pharmaceutical treatment, patient education and environmental control. Ask your doctor if you are a candidate for this treatment. If the allergic component of your asthma is complicated by the long term effects of irreversible chronic inflammation (such as remodeling of the airways), then the beneficial effects of immunotherapy are likely to be minimal. This demonstrates the importance of early detection. Treating allergy symptoms early in life has been shown to change the course of asthma development starting in childhood. Immunotherapy is a long-term investment in your respiratory health that requires dedication and consistency to achieve the full beneficial effects. Over time, the benefits of immunotherapy will likely become evident in reduced medication costs and increased periods of good symptom control.
Pulmonary Function Tests
Doctor and patient perceptions of asthma often underestimate the condition. Objective measures of lung function need to be used to understand the patient’s risk and prognosis. Since allergy plays such a significant role in asthma development and control, pulmonary function tests are justified in allergic patients to screen for possible asthma symptoms. Objective measures such as these are required to check for the presence of a lung dysfunction, to assess the severity of the condition, to see if the condition is reversible and to measure the patient’s response to treatment.
Spirometry is a technique that uses a device called a spirometer to measure a patient’s lung capacity and flow volume. The patient inhales to their peak lung capacity then exhales into the spirometer as forcefully, quickly and completely as possible. The spirometer then produces a graph that objectively shows the patient’s lung capacity, maximum expiration and time to complete expiration. By comparing these values to clinical standards, signs of lung dysfunction become apparent, even if the patient is convinced they have no symptoms. The test requires some staff training to perform properly since the patient must exhale forcefully and consistently. However, with training, this is worth adding to your practice to ensure you catch potential asthmatic patients while they are treatable.