Your Relief Blog

Having asthma can be difficult. The recurrent cough, shortness of breath, sleepless nights trying to breathe, the missed sports or family events, and much more is always waiting to strike.

We have many options available for treatment. Many of these involve steroids. While topical steroids have minimal side effects, systemic steroids have many. Recurrent rounds of prednisone or steroid shots are commonly used to get a patient back into control, preventing hospitalization or worse.

Unfortunately, this comes with the risk of long-term effects on the body. These long-term issues are now being better recognized by physicians and include weaker bones, cataracts, weight gain, diabetes, thinning and bruising of the skin, glaucoma, hypertension, and increased risk of infections.

The Goal: Daily Asthma Control

Doctors and patients know the best way to avoid the need for systemic steroids is to keep the asthma under control day to day.

Many choices are available and depend upon the type of asthma the patient has, along with the patient’s preferences. Controllers are often stacked upon each other until control is reached. By working together and sticking to the idea of control, success can be achieved!

Better Asthma Control and Fewer Side Effects

Controller options include the all-important inhaled corticosteroid inhalers. For most patients, they are the key to success. Allergic asthmatics can use avoidance measures, allergy shots, and anti-allergy antibody biologic therapy.

Inhaled corticosteroids are often combined with a second, and at times a third, medication to improve control and make the flares milder and shorter.

For the toughest of the asthmatics, we often have to go to a biologic. These medications target part of the asthma pathway, thus blocking the worsening of asthmatic inflammation. Each is specific to a critical target. This makes it important for the allergist to identify what type of asthma the patient has! This typically involves allergy testing and blood work.

Treatment Options to Reduce Steroid Use

There are several treatment options available to help control asthma. These are often used together to reduce symptoms and limit the need for systemic steroids.

• Allergy Avoidance
• Allergy Immunotherapy (allergy shots or sublingual tablets)
• Inhaled corticosteroids
• Long-acting bronchodilators
• Long-acting muscarinic antagonists
• Leukotriene inhibitors
• Anti-IgE
• Anti-IL5
• Anti-IL4/13
• Anti-TSLP (thymic stromal lymphopoietin)
• Theophylline
• Systemic steroids

Looking Ahead

Your future self will appreciate the work you do now to control your asthma and reduce the long-term toll of systemic steroids!