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Advancements in Treatment of Severe Asthma

December 12, 2018

Dr. Megan Panico is one of Starling’s leading pulmonary specialists. Below she discusses major advancements in the treatment of asthma that can dramatically improve the quality of life for asthma sufferers. She shares that we are now approaching a phase in asthma management is which we can target and tailor therapy to the individual asthmatic patient ,which is a very exciting development.

What are some of the major advancements in the treatment of asthma, especially the use of new medications?

The management of asthma has entered an exciting new phase away from traditional use of inhalers. New biologic agents (see note), including  anti-IL 5, anti-eosinophilic agents, can fundamentally change the trajectory in controlling asthma symptoms in a minimally invasive fashion. This can lead to a greatly improved quality of life. This pathway is a significant advancement in the management of asthma and may represent one of the most important breakthroughs in the management of asthma in the past several decades.

Researchers have identified biologic agents specifically targeted to block key inflammatory agents that worsen asthma. These medications are easy to administer, either at home or in the doctor’s office, and are in fact easier than getting a flu vaccine! The dosing of the medications is also very favorable and can be as infrequent as once every other month.

Further, we have identified specific new tests that can be done easily and noninvasively in the office, which can help us screen for patients who may respond to these biologic agents best, and who may be responsive to certain types of inhalers. 

What types of asthmatics can benefit most from these new advancements?

Many patients can benefit from these new advanced diagnostic tests and therapies. Specifically by measuring inflammatory markers in the lungs which can be done easily and noninvasively in the office, we can quickly identify patients who may qualify for biologic treatments. One specific group of patients who clearly benefit are those who have high levels of eosinophils. Eosinophils are a type of white blood cell that is the hallmark of inflammation and certain types of asthma. Eosinophils may also be present in a different group of patients who have chronic obstructive pulmonary disease from long-term smoking or secondhand smoke exposure and these individuals may also benefit from biologic agents.

How are these drugs administered?

Currently the drugs can be given either in the doctor’s office or in an infusion center. It is likely that patient’s will be able to self-administer these drugs in the near future.

Are there side effects?

Side effects are typically rare to report. In fact the newer biologic agents in contrast to some of the older agents available no longer require the purchase of an EpiPen for possible side effects.

How are these different/better than prior treatment options?

These newer treatment options offer tailored therapy to specific inflammatory molecules that drive asthma symptoms. Whereas older agents were more nonspecific, and oral agents such as prednisone have a host of side effects on bones, joints, skin, blood sugar, etc., the newer more specific agents do not have these limitations.

What kind of results are you seeing?

Patients report feeling much better, with decreasing asthma exacerbations, decreasing the use of oral and intravenous prednisone. We are seeing a 50% decrease in exacerbation rate and a 75% decrease in oral steroid use.

Are there other new treatment options?

In addition to the agents referred to above that can target the interleukin-5 pathway, a specific inflammatory marker, there are a variety of additional biologic agents in development and clinical trials that are likely to enter the asthma market over the course of the next six months to a few years. By having multiple specific biologic agents that can target multiple specific inflammatory markers, we have the best possibility yet of identifying and tailoring treatment to the specific individual – far more so than we did just two years ago. We are at the beginning of an exciting change in how we approach and manage asthma!

Call (860) 547-1876 to schedule a visit with a member of Starling’s Pulmonary team.
We see patients in Bloomfield, Farmington, Glastonbury, Hartford, Manchester, Enfield, and Wethersfield.
Starting in 2019, we will also see patient in Wallingford at the Gaylord Outpatient Clinic.


Note: A biologic drug is a product that is produced from living organisms or contains components of living organisms. Biologics include recombinant proteins, tissues, genes, allergens, cells, blood components, blood, and vaccines. Biologics are increasingly being used to treat numerous diseases and conditions.