Latest news with #GlobalInitiativeforAsthma
Medscape
29-07-2025
- Health
- Medscape
Asthma Care: Must-Know Insights for Primary Practice
Asthma is a respiratory condition that requires individualized care, considering each patient's unique characteristics and therapeutic opportunities. Both primary care professionals and specialists are responsible for managing asthma in both adults and children. The new Manejo Integral del Asma (MIA 2.0) guidelines, based on the best international recommendations and adapted to the Mexican healthcare context, including costs and local realities, are aimed at healthcare professionals across various levels of care. These guidelines highlight the importance of multidisciplinary management and continued efforts to improve asthma care in Mexico and Latin America. The project was led by the Mexican College of Clinical Immunology and Allergy and endorsed by 16 scientific institutions or specialty societies, which manage asthma in fields such as allergy, pulmonology, otorhinolaryngology, emergency medicine, general and family medicine, internal medicine, and pediatrics. The general coordination was carried out by Désirée Larenas-Linnemann, MD, an international expert who represents Mexico for the Global Initiative for Asthma, coordinates the International Severe Asthma Registry, and leads the Center of Excellence in Asthma and Allergy at Médica Sur Hospital in Mexico City, Mexico. In an interview with Univadis Spain , a Medscape Network platform, Larenas-Linnemann emphasized, 'It is important to understand that asthma is an inflammatory process of the bronchial tubes.' This means that prescribing only salbutamol is insufficient, as both maintenance and rescue therapy require dual therapy: one drug to open the bronchi and another to reduce inflammation. Another critical point concerns allergic asthma, which constitutes the majority of cases in both children and adults. In these cases, Larenas-Linnemann recommends co-management with an allergy specialist to apply immunotherapy alongside the specific treatment once symptoms are controlled. Primary Care Challenges in Mexico Larenas-Linnemann noted that many patients who are well treated during an asthma crisis in emergency departments often leave without essential maintenance treatment to prevent future flare-ups. 'Follow-up care is very important,' she emphasized. Abril Daniella Alemán Ortega, DO, pediatrician at the Hospital Regional de Alta Especialidad de Zumpango, Mexico, who did not participate in drafting the guidelines, mentioned that diagnosing and managing asthma is more challenging in children than in adults. However, early management is crucial to prevent these children from developing severe respiratory issues as adults. When asked about common mistakes made by her colleagues, Alemán pointed out the misuse of pharmacologic treatment, often involving incomplete regimens or short-term use. She also noted areas for improvement in medication administration and in providing information to families. Alemán emphasized the importance of the guidelines because they encompass everyone from primary care physicians to subspecialists involved in pediatric care. She also stressed that the primary care doctor must recognize that a patient with recurrent respiratory symptoms likely doesn't have recurrent infections, and that prescribing repeated antibiotics rarely solves the problem. 'This is a good point to review,' she concluded. The guidelines also provide specific recommendations for diagnosing and treating asthma under less-than-ideal conditions. For example, in settings where only beclomethasone and salbutamol are available, specific strategies have been outlined for appropriate use. 10 Recommendations Based on MIA 2.0 Guidelines When to suspect asthma. Suspecting asthma can be challenging due to the varied ways it can present, often without the classic wheezing. However, recognizing key symptoms and understanding their variations make raising suspicion straightforward. The four key signs/symptoms that suggest asthma are cough, dyspnea (shortness of breath), wheezing, and chest tightness. If two or more of these symptoms are present, particularly with variation in time, intensity, and exacerbation with environmental factors (such as exercise, laughing or crying, temperature or humidity changes, or allergen exposure), asthma should be suspected. The likelihood of asthma increases if these symptoms are frequent or worsen at night or in the early morning. What doesn't help in diagnosis. Chest x-rays are generally not useful for diagnosing asthma because they typically do not show changes outside of an acute asthma crisis. They are only useful for excluding alternative diagnoses. In patients with well-controlled asthma who are symptom free, spirometry results are usually normal. While spirometry with classic abnormalities confirms asthma, a normal result does not rule it out. What helps. Clinical manifestations should be combined with respiratory function tests that demonstrate airflow obstruction, particularly during exhalation and its variability. Useful tests include spirometry before and after administering a bronchodilator, peak flow measurement over 5-15 days, oscillometry before and after bronchodilator administration, and, in rare cases, bronchial challenge tests. When possible, especially if pulmonary function tests are inconclusive, testing for positive type 2 inflammation biomarkers is recommended because most asthma cases involve type 2 inflammation. In children younger than 5 years, pulmonary function tests are limited, and symptoms are often linked to other age-specific conditions. However, between ages 2 and 3, a subgroup of children who will have poor long-term outcomes can be identified, and by age 5, these children typically show significant reductions in lung function. A specific tool, the Asthma Predictive Index, can help predict which preschool children with wheezing will likely develop asthma. If symptoms are highly suspicious, a therapeutic trial should be performed to assess response. After confirming the diagnosis, categorize the disease. Define the level of asthma control. The Asthma Control Test includes five simple questions about symptoms and medication use over the past 4 weeks, allowing patients to evaluate their own control. Versions are available for both adults and children. Individualize treatment by assessing future risk, severity, phenotype, and endotype. For example, in suspected allergic asthma, skin or serum tests with allergens should be conducted to confirm sensitization. What if a full assessment isn't possible? A positive clinical response to a therapeutic trial is a strong indication of asthma. This means symptom improvement with low-dose inhaled corticosteroids and a rapid-acting bronchodilator, administered as needed, for at least 4-6 weeks, with symptoms worsening upon discontinuation. Avoid prescribing diets without justification. Patients with asthma and documented food allergies are at a higher risk for complications. If food allergies are suspected, a diet free of the specific allergen should only be prescribed after confirming the allergy through the presence of specific immunoglobulin E levels. Unnecessary dietary restrictions should be avoided because they can lead to nutritional imbalances. Define medications and devices. In addition to selecting the appropriate medication — such as bronchodilators, anti-inflammatories, and biologics — it is crucial to choose the right device for drug administration based on the patient's preferences and capabilities. It is important to note that synergistic therapy differs from combination therapy. Synergistic therapy refers to the combination of two drugs in one device, such as inhaled corticosteroids with long-acting beta-2 agonists, which theoretically offers greater efficacy than using the two separately. An example is the maintenance and reliever therapy approach, where a dual inhaler is used for both maintenance and rescue, reducing the frequency of crises. However, salbutamol-ipratropium bromide is not considered synergistic because both are bronchodilators without an anti-inflammatory component. MIA 2.0 includes a treatment algorithm for each age group, integrating maintenance-rescue management blocks, with preferred and alternative options for each of the five treatment steps. Educate the patient: Action plan and rescue treatment. Every asthma patient should have a written action plan outlining what to do when symptoms worsen and the risk for exacerbation arises. A key aspect of rescue treatment is that patients must always have access to an anti-inflammatory (such as a corticosteroid or, potentially, a leukotriene antagonist) and should never rely solely on short-acting beta-2 agonists. Sole use of these can lead to more frequent asthma attacks and increased mortality. For rescue treatment, budesonide-formoterol, or beclomethasone-formoterol, or salbutamol with inhaled corticosteroids in two separate devices is recommended. Managing a patient with severe exacerbation (crisis). Assess whether the patient is experiencing a life-threatening crisis with imminent respiratory failure or has risk factors for fatal asthma. If so, initiate high-dose inhaled bronchodilators, oxygen therapy, and systemic corticosteroids immediately, and transfer the patient to a facility capable of managing a potentially fatal asthma crisis. If a life-threatening crisis or risk factors are ruled out, evaluate the severity of the attack and determine treatment for the first 60 minutes, with reassessment at 1 hour. For patients with oxygen saturation below 94% (at sea level), administer oxygen therapy and inhaled medications via nebulization with pressurized oxygen. If the response is not favorable within an hour, and no more than 3 hours, hospitalize the patient. During an asthma crisis, pulse oximetry and pulmonary function test values are more reliable than symptoms alone. However, these objective measures should always be incorporated into the overall clinical picture. When to refer to a specialist. Children and adults with recurrent respiratory symptoms but a low likelihood of asthma. Difficulty confirming an asthma diagnosis even after a therapeutic trial with inhaled or oral corticosteroids. Patients with asthma and chronic obstructive pulmonary disease, particularly if treatment priorities are unclear, or if they show signs of chronic infection, hemodynamic or cardiovascular issues, or other pulmonary diseases. Persistently uncontrolled or severe asthma with frequent exacerbations — two or more crises per year despite proper inhaler use — requiring step 4 treatment, high-dose inhaled corticosteroids, or long-term use of oral corticosteroids (corticosteroid-dependent asthma). Risk for fatal asthma, including crises triggered by nonsteroidal anti-inflammatory drugs, aeroallergens, food allergens, or anaphylaxis. Patients with severe asthma should be treated in specialized centers with expertise in managing complex cases. Evidence or risk for serious side effects from treatment or symptoms suggesting complications. If moderate-dose maintenance and reliever therapy does not control asthma and the dose of corticosteroid inhalers is increased, refer to a specialist if levels of exhaled nitric oxide or eosinophils are elevated. At-risk groups, including pregnant patients, those suspected of having occupational asthma, patients who frequently utilize healthcare insurance, or those with excessive anxiety from the patient or caregiver. In children aged 5 years or younger, if there is no clear association between symptoms and typical triggers or if there is a lack of response to treatment, delayed growth and development, early onset of symptoms, vomiting associated with respiratory symptoms outside of an asthma crisis, continuous wheezing, hypoxemia unrelated to viral illness, focal pulmonary or cardiovascular signs, clubbing of fingers, a history of hospitalization, or multiple emergency department visits for wheezing within a 12-month period. The MIA 2.0 guidelines were endorsed by the Mexican College of Pediatric Pulmonology, Latin American Society of Respiratory Physiology, National Pulmonology Council, Mexican College of Clinical Immunology and Allergy, and several other medical societies.
Medscape
14-05-2025
- Health
- Medscape
Can Chronic Asthma Be Reversed? Experts Reopen the Debate
A new clinical horizon is emerging in asthma management, with the possibility of achieving sustained reversal of the disease and even remission. This involves altering and reversing the progression of diseases that are traditionally considered chronic. This possibility has led to significant therapeutic advances and sparked a clinical debate: Should sustained reversibility be considered a therapeutic goal in its own right or merely as an indirect marker of effective disease control? Reversibility in asthma, understood as the ability to recover pulmonary function and maintain the absence of symptoms, has historically been an elusive goal. Recent research suggests that this challenge may be closer to resolution due to advances in biological therapies and a deeper understanding of the inflammatory phenotypes of asthma. While reversibility remains a central marker in the diagnosis and monitoring of asthma, the scientific community emphasizes that not all patients with asthma experience complete reversibility. The persistence of obstruction may be attributed to structural remodeling of the airways. Clinical Remission Clinical remission is defined as the absence of symptoms and exacerbations for at least 12 months, even without medication. Complete remission is defined as the normalization of pulmonary function and disappearance of bronchial hyper-responsiveness and airway inflammation. However, patients in clinical remission who continue to show elevated inflammatory biomarker levels may still be at risk for future functional decline. Although increasingly achievable in patients treated with biologics, complete remission is still limited by the persistence of certain pathophysiological processes. Airway remodeling in asthma, once it occurs, is difficult to reverse. Achieving complete and sustained disease control is considered the most ambitious goal, while reversibility is a more practical indicator of therapeutic response. Guidelines such as the Global Initiative for Asthma (GINA) and Spanish Guide for Asthma Management (GEMA), recognize the prognostic value of sustained bronchodilator reversibility and its ability to help predict exacerbations but caution against using it alone. Therefore, we recommend incorporating it into a comprehensive assessment that includes symptoms, pulmonary function, rescue medication use, and quality of life. Inflammatory Phenotypes This integrated approach is particularly relevant when considering the dynamic variability of inflammatory phenotypes in asthma. The Spanish MEGA (Mechanism underlying the genesis and evolution of asthma) project analyzed the stability of inflammatory biomarkers and asthma phenotypes. The results confirmed the instability of these phenotypes; although they remained stable during the first year, their instability increased thereafter. The study, led by the Spanish national research consortium CIBERES (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias), showed that while 88% of patients initially presented a high T2 phenotype, only 61.3% maintained this classification after 2 years. Similarly, 53.3% of patients had eosinophilic sputum at baseline, but only 37.5% maintained this at 24 months. These findings highlight the need for aggressive therapeutic adjustments. Moreover, the correlations between different inflammatory phenotypes were moderate in the first 2 years but significantly decreased in the third year. Other biomarkers, such as fractional exhaled nitric oxide, total immunoglobulin E, and lung function, did not show significant variations during the study period. These results highlight the fluctuating nature of this disease and the necessity to adapt the therapeutic strategy to each patient's changing inflammatory profile. Mechanical Damage Another recent international study conducted by King's College London, London, England, identified a new pathophysiological mechanism in asthma that should be considered in clinical management. Published in Science , the study revealed that pathological crowding of a broncho constrictive attack causes so much epithelial cell extrusion that it damages the airways, resulting in inflammation and mucous secretion. This previously overlooked process perpetuates the characteristic inflammatory cycle of asthma, as repeated damage to the epithelium promotes chronic inflammation. It also results in scarring and permanent narrowing of the airways, contributing to the progression and severity of the disease. Researchers, including Elena Ortiz-Zapater, PhD, from the University of Valencia, Valencia, Spain, have demonstrated that traditional treatments do not prevent this damage. In contrast, gadolinium, a cell extrusion inhibitor, counteracts mechanical damage and significantly reduces the inflammatory response. Although this breakthrough has only been demonstrated in animal models, it opens new avenues for therapies that not only alleviate asthma symptoms but also prevent structural damage in the airways, offering hope for more durable remission. Biological Therapies Focusing on treatments, biological therapies have marked a turning point in the treatment of severe asthma and type 2 inflammatory phenotypes. This allows many patients to achieve a sustained clinical remission. Some biologics target different inflammatory pathways, demonstrating improvements in baseline pulmonary function and reducing persistent obstruction. Thus, they facilitate more sustained reversibility and even remission in selected subgroups of patients. Targeted drugs, such as omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab, have shown remarkable efficacy. Sustained improvements in pulmonary function, reduced exacerbations, and decreased systemic corticosteroid use have been observed. Recent registries and multicenter studies have shown an increasing number of patients treated with biologics who meet the partial or clinical remission criteria. For instance, the PrecISE trial is evaluating how therapies targeting specific biomarkers such as interleukin (IL)-4/IL-13 and thymic stromal lymphopoietin can induce sustained reversibility in cases of refractory severe asthma. In parallel, new molecules, such as amlitelimab, currently in phase 2 trials, demonstrate prolonged effects, even in phenotypes with mixed inflammation. These agents employ innovative mechanisms, such as targeting the OX40 pathway and using less frequent dosing, which could also facilitate adherence and sustainability of remission. The latest updates from GINA and GEMA have formally incorporated remission as a treatment goal for patients with severe asthma, particularly in the context of biological therapies. A major challenge remains the achievement of complete and sustained remission without chronic treatment, guided by biomarkers, new drugs, and more personalized clinical follow-ups. Short-Acting Beta-2 Agonists (SABAs) Alongside pharmacological advances and strategies for remission, the SABINA study highlights a critical aspect of asthma management. It addresses the inappropriate use of SABAs and their effect on disease control. With over a million patients from 40 countries, including Spain, this is the largest real-world observational analysis of this therapeutic class. The findings showed that approximately 28%-30% of patients with asthma in the country used three or more SABA inhalers annually. This is associated with a higher risk for exacerbations, poor symptom control, and increased mortality. In contrast, 13%-15% of patients use fewer than four inhalers of inhaled corticosteroids annually, which compromises the control of the underlying inflammation. SABAs provide immediate and temporary relief, which may contribute to a cycle of suboptimal control and symptom recurrence. Consequently, the GINA and GEMA guidelines discourage the use of SABA as monotherapy. These guidelines recommend combining inhaled corticosteroids with formoterol (a long-acting beta-2 agonist) as both maintenance and reliever therapy. This combination ensures improved disease management through prevention and continuous anti-inflammatory treatment, which is essential for sustained functional reversibility and clinical remission. Diagnostic Techniques Recent updates in diagnostic techniques have improved the ability to assess asthma reversibility and remission, particularly in patients with nearly normal baseline lung function. The joint guidelines from the European Respiratory Society and the American Thoracic Society recommend that a significant bronchodilator response is an increase of more than 10% in forced expiratory volume in 1 second or forced vital capacity. This adjustment improves the diagnostic sensitivity in patients with asthma, helping to identify cases that might have been previously overlooked and allowing earlier intervention. Additionally, serial spirometry has become a key tool for confirming sustained reversibility, particularly when the initial response to bronchodilators is unclear. This practice of monitoring pulmonary function over time helps assess the effectiveness of treatment and the potential for achieving remission. The integration of these updated diagnostic techniques into clinical practice improves diagnostic accuracy and regulates more personalized therapeutic strategies, increasing the chances of achieving sustained reversibility and, in some cases, complete remission of asthma. In conclusion, the updated assessment of asthma reversibility and remission integrates functional testing, including spirometry, peak expiratory flow, and bronchial provocation testing, inflammatory biomarkers such as fractional exhaled nitric oxide and blood eosinophil counts, and structured clinical follow-up, enabling a more accurate and personalized evaluation of disease status and progression.
Time of India
06-05-2025
- Health
- Time of India
World Asthma Day 2025: What are the early signs of the disease and what breathing exercises can help
What is Asthma? Airway inflammation: Airway narrowing: Triggers: Asthma Attacks: What are the early signs of asthma? Coughing: Wheezing: Shortness of breath: Chest tightness: Exercise-induced asthma: Nighttime asthma: Fatigue and mood changes: Trigger-related symptoms: Can any previous disease trigger asthma? Colds and flu: Allergies: Hormonal changes: Viral infections: Air pollution: Tobacco smoke: Occupational exposure: What breathing exercises can help? Diaphragmatic breathing: Pursed-lip breathing: Buteyko breathing method: What are the treatments for asthma? Medications: Quick-relief inhalers (bronchodilators): Long-term control medications: Biologics: Leukotriene modifiers: Cromolyn sodium: Other treatments: Allergy shots (immunotherapy): Inhalers with spacers: Nebulizers: Hospital treatment: World Asthma Day-Why asthma cases are on a surge and what we need to do? For people who struggle with breathing, the 'breathe easy' reminder doesn't seem like a comforting one. Asthma , one of the most common breathing troubles, is a chronic inflammatory disorder of the airways. However, it is classified as a disease because it is a condition that causes specific, identifiable changes in the body's physiology and can lead to a variety of symptoms and health problems. World Asthma Day (the second Tuesday of May) is an annual event organized by the Global Initiative for Asthma to improve asthma awareness and care around the is a chronic lung disease characterized by inflammation and narrowing of the airways, making it difficult to breathe. This condition can cause symptoms like coughing, wheezing, shortness of breath, and chest tightness, which can range from mild to severe and come and go over a more detailed explanation:Asthma triggers the airways to become inflamed, leading to swelling and increased mucus inflammation and muscle contractions around the airways cause them to narrow, making it harder for air to flow in and out of the can be triggered by various factors, including allergens, irritants, respiratory infections, exercise, and even symptoms become severe, it's called an asthma attack or flare-up, which can be signs of asthma include frequent coughing, especially at night, wheezing (a whistling sound when breathing out), shortness of breath, and chest tightness. These symptoms may worsen during exercise or with respiratory infections like colds or flu. Other signs include feeling tired or moody, and trouble sleeping due to breathing a detailed look.A persistent cough, especially at night, is a common early sign. It may be dry or produce is a whistling or squeaking sound when breathing, particularly when exhaling. It's a hallmark of breathing, feeling out of breath, or needing to breathe faster than usual can be an early warning.A feeling of tightness or pain in the chest, making it difficult to breathe deeply, is another like wheezing or coughing during or after exercise can indicate asthma. Asthma symptoms are often worse at night, leading to difficulty tired, irritable, or easily upset can be related to asthma, especially if breathing is symptoms can be triggered by various factors, including allergens, irritants, exercise, and respiratory infections like colds or previous diseases or conditions can potentially trigger or worsen asthma symptoms. Respiratory infections like colds and flu are common triggers, and viral infections can also predispose individuals to developing asthma later in life, especially in infants and young a more detailed explanation:These are among the most common causes of asthma flare-ups, especially in young children. Even mild colds can lead to wheezing and chest tightness. COVID-19, pneumonia, and respiratory syncytial virus (RSV) infections can also trigger asthma with allergies are more likely to develop asthma, and allergic reactions can exacerbate asthma fluctuations during the menstrual cycle or menopause can trigger asthma caused by viral infections, particularly RSV and human rhinovirus, may increase the risk of developing asthma later in to air pollution, especially in early life, can increase the risk of smoke, both first-hand and second-hand, is a significant risk factor for occupational exposures can also trigger or worsen reflux disease (GERD), obesity, and nasal polyps can be associated with asthma as exercises like diaphragmatic breathing and pursed-lip breathing, as well as activities like walking, swimming, and sports, with short bursts of following are the breathing exercises that can prove helpful:This exercise helps strengthen the diaphragm, improving lung efficiency and reducing shallow breathing. It involves inhaling deeply through the nose, allowing the belly to rise while keeping the chest still, and exhaling slowly through the technique slows down breathing and helps keep airways open, particularly useful during shortness of breath. It involves inhaling slowly through the nose and exhaling slowly through pursed method focuses on reducing breath volume to prevent hyperventilation and improve carbon dioxide levels. It involves holding your breath after exhaling until you feel the urge to treatment focuses on controlling symptoms and preventing attacks through medications, inhalers, and, in some cases, allergy shots. The main types of treatment include quick-relief medications to open airways during attacks and long-term control medications to reduce inflammation and prevent future medications, like albuterol, relax the muscles around the airways, allowing for easier breathing during an asthma are taken daily to reduce inflammation and prevent asthma symptoms, including inhaled corticosteroids like are injections that target specific proteins involved in asthma to prevent airway swelling, particularly for severe oral medications prevent the body from making leukotrienes, which can trigger asthma mast cell stabilizer is used in a nebulizer to prevent the release of certain chemicals that can cause asthma allergic asthma, these shots can help desensitize the body to allergens and reduce asthma make it easier to use inhalers, especially for children and in devices convert liquid medication into a mist that can be inhaled, especially helpful for those who have difficulty using an severe cases, hospital treatment may include oxygen therapy, high-dose inhaled medications, steroids, and, in rare cases, mechanical ventilation.
&w=3840&q=100)
Business Standard
06-05-2025
- Health
- Business Standard
World Asthma Day 2025: Theme, treatment, and tips for better care
Observed globally on May 6, this year's asthma day stresses better access to inhalers, expert-backed prevention, and early diagnosis to reduce global health burden Barkha Mathur New Delhi For the millions living with asthma, the simple act of breathing can be a daily challenge. World Asthma Day 2025, on Tuesday, is a global reminder of the importance of respiratory health and the urgent need to make asthma care accessible to everyone. Whether you live with asthma, care for someone who does, or simply want to learn more, this day puts the spotlight on equitable treatment and empowering communities to take control of their health. What is World Asthma Day and why is it observed globally? World Asthma Day is observed annually on the first Tuesday of May to raise awareness about asthma, a chronic respiratory condition that affects millions of people globally. This year, it falls on May 6. Organised by the Global Initiative for Asthma (GINA), the day highlights the urgent need for accessible, equitable, and effective asthma treatment worldwide. Key asthma symptoms: What to watch for and when to seek help According to the World Health Organization (WHO), asthma is a chronic inflammatory disease of the airways that leads to recurring episodes of breathlessness, wheezing, chest tightness, and coughing. It can vary in severity and frequency, and often worsens during the night or early morning. WHO says the symptoms of asthma can vary from person to person and can sometimes get significantly worse. This is known as an asthma attack. Symptoms are often worse at night or during exercise. Common symptoms of asthma include: A persistent cough, especially at night Wheezing when exhaling and sometimes when inhaling Shortness of breath or difficulty breathing, sometimes even when resting Chest tightness, making it difficult to breathe deeply According to the WHO, over 260 million people are affected by asthma worldwide, and it remains one of the leading causes of non-communicable disease-related deaths, especially in children. Acute vs chronic asthma: Understanding the difference for better care Understanding the types of asthma is crucial for effective treatment. Acute asthma involves sudden and severe airway obstruction, often triggered by infections, allergens, cold air, or stress. It requires immediate intervention to prevent complications. Chronic asthma, on the other hand, is marked by long-standing inflammation and ongoing sensitivity to environmental triggers like dust, smoke, and air pollution. As Dr Anshula Tayal Bansal, Consultant – Paediatric Pulmonology & Intensive Care at Manipal Hospital Goa, explains, 'An understanding of acute and chronic asthma is important for timely and successful intervention in the treatment of a chronic inflammatory disease of the airways, known as asthma, with episodes of acute, reversible airway obstruction.' She underscores the need for accurate diagnosis and personalised care strategies for each type of asthma, especially as unmanaged chronic asthma can lead to irreversible changes in lung function. What causes asthma? Top risk factors you should know Asthma is a complex condition with no single, definitive cause. However, according to WHO, several risk factors have been identified that increase a person's likelihood of developing it: Family history and genetics: Having a close relative with asthma—such as a parent or sibling—significantly raises the risk Allergic conditions: Individuals with conditions like eczema or allergic rhinitis are more likely to develop asthma Urban lifestyle and pollution: Air pollution and limited green spaces contribute to higher asthma rates in urban areas Early life influences: Factors like premature birth, low birth weight, and early respiratory infections increase risk Environmental irritants: Exposure to dust, mould, fumes, and chemicals can worsen symptoms Obesity: Excess weight influences lung function and inflammation, raising asthma risk How to manage asthma: Doctor-recommended tips for symptom control Managing asthma effectively, especially during the warmer months and high-pollution periods, requires both preventive and reactive strategies. Here are expert-recommended tips to help manage symptoms and reduce the risk of attacks: Schedule outdoor activities early in the day when pollution and pollen levels are lower Consult your pulmonologist regularly to adjust medications based on seasonal or lifestyle changes Store inhalers in a cool, shaded place to maintain their efficacy Take controller medications as prescribed, and always keep a rescue inhaler handy Stay hydrated to help thin mucus and ease breathing Monitor local weather and air quality reports, especially during high-smog days Use High-Efficiency Particulate Air (HEPA) filters or air purifiers at home to minimise exposure to allergens and pollutants Why World Asthma Day matters: Global awareness and impact since 1998 World Asthma Day was first held in 1998, with participation from over 35 countries in the first World Asthma Meeting in Barcelona, Spain. It was initiated by GINA to enhance asthma awareness and education globally. Over the years, the day has become a crucial annual event aimed at: Educating the public and patients about asthma Promoting preventive measures and effective treatment Reducing stigma and misinformation Encouraging governments and stakeholders to prioritise asthma care in health policies World Asthma Day 2025 theme: Make inhaled treatments accessible for all This year's theme, 'Make Inhaled Treatments Accessible for ALL', emphasises the need to ensure that essential asthma medications such as inhaled corticosteroids and reliever inhalers are affordable and widely available, especially in low- and middle-income countries (LMICs). Inhaled treatments are crucial for both daily symptom control and emergency relief. Yet, millions around the world lack access due to economic, geographic, and systemic healthcare barriers. The 2025 theme calls on governments, pharmaceutical companies, and international health bodies to improve supply chains, reduce costs, and promote equitable distribution of these life-saving treatments. World Asthma Day initiatives: Awareness, screenings, and community action World Asthma Day sees a wide range of community outreach efforts, including: Free health screenings and lung function tests Public awareness campaigns in schools, workplaces, and public spaces Workshops and webinars by healthcare professionals Social media drives to spread accurate information and support networks These initiatives aim to empower individuals with knowledge about early symptoms, the importance of regular check-ups, and the availability of effective treatments.
&w=3840&q=100)
Business Standard
06-05-2025
- Health
- Business Standard
World Asthma Day 2025: India turns to smart tools to tackle high mortality
World Asthma Day 2025: As India battles rising asthma cases driven by pollution and lifestyle shifts, innovations in diagnosis, inhalers, and digital tools are redefining care Barkha Mathur New Delhi It's World Asthma Day 2025, and while millions across the globe are still learning to live with this chronic lung condition, India is seeing a shift in how asthma is understood and treated. From smart inhalers and digital health tools to better patient education, the country is inching closer to personalised, effective asthma care. But even as metros embrace smart tech and biologics, questions of access, awareness, and affordability still loom large, especially outside urban centres. Why World Asthma Day 2025 matters more than ever World Asthma Day, observed every year on the first Tuesday of May, is an initiative led by the Global Initiative for Asthma (GINA) to raise awareness and improve asthma care around the world. The theme for 2025, 'Make inhaled treatments accessible for all', emphasises the need for universal access to essential asthma medications. India accounts for highest asthma deaths despite lower prevalence According to GINA, asthma is one of the most common chronic non-communicable diseases that affects over 260 million people and is responsible for over 450,000 deaths each year worldwide. In India, the asthma burden is particularly alarming. The country accounts for nearly 13 per cent of the global asthma prevalence and a staggering 46 per cent of global asthma-related deaths, according to the latest Global Burden of Disease 2021 Report. ALSO READ | An April 2024 paper published in the PubMed Central journal at the US National Institutes of Health's National Library of Medicine explains that despite not having the highest number of asthma patients, India's mortality rate is disproportionately high due to underdiagnosis, poor disease control, and limited access to essential medications. A 2024 study noted that India's asthma-related mortality rate is three times higher than the global average, and the country also bears more than double the global burden in terms of disability-adjusted life years (DALYs). These numbers aren't just statistics, they represent millions of people whose daily lives are disrupted due to poor air quality, smoking, misinformation, and limited access to specialised care. 'Asthma is becoming increasingly common in India, especially in the northern parts, due to high pollution levels and rising rates of smoking among adolescents,' says Dr Gyanendra Agrawal, Director of Respiratory & Critical Care Medicine, Max Super Speciality Hospital, Noida. From diagnosis to drugs: India shifts to precision asthma treatment Asthma care in India has seen a major evolution in recent years, with a shift from generic treatments to personalised, technology-driven approaches. 'India has seen a noteworthy shift in asthma care, moving from symptomatic relief to precision-driven management,' says Dr Arjun Khanna, Senior Consultant & Head, Pulmonology Department, Amrita Hospital, Faridabad. 'Advances like FeNO testing (or exhaled nitric oxide test) to determine lung inflammation, impulse oscillometry, high-resolution CT scans and biologics like anti-IgE (antibody that specifically targets immunoglobulin E) and anti-IL5 therapies (such as mepolizumab, benralizumab, and reslizumab, are monoclonal antibodies that target interleukin-5) have transformed how we diagnose and treat asthma.' 'These biologics have significantly helped difficult-to-treat asthma patients. They reduce flare-ups and decrease the need for steroids,' Dr Agrawal explains. Asthma treatment cost in India: Biologics remain unaffordable for many The cost of asthma treatment in India varies widely depending on the severity of the condition and the specific treatment approach. Annual expenses can range from ₹18,737 to ₹1,18,303, influenced by factors such as medication requirements and hospitalisation needs. Asthma treatment costs Treatment Type Estimated cost Notes Standard Inhalers ₹380 – ₹1,100 Preventive inhalers; prices vary by brand and dosage. Smart Inhalers ₹850 – ₹1,050 Advanced inhalers with features like dose counters. Biologic Therapies ₹8,000 – ₹28,000 per dose Used for severe asthma; cost varies by medication type. Doctor Consultation ₹500 – ₹2,000 per visit Fees depend on the healthcare facility and specialist. Nebulizers (Home Use) ₹3,000 – ₹5,000 Devices for administering medication in mist form. Bronchial Thermoplasty Up to ₹10,00,000 Advanced procedure for severe cases; available in select centers. Smart inhalers and mobile apps improve medication adherence Inhalers remain the backbone of asthma treatment, but their design and delivery mechanisms have significantly improved. 'Next-generation inhalers such as Dry Powder Inhalers (DPIs) ensure better drug delivery and patient compliance,' Dr Khanna explains. 'Smart inhalers with Bluetooth connectivity are also helping doctors and patients track usage and effectiveness in real-time.' Dr Gyanendra Agrawal, Director–Respiratory & Critical Care Medicine, Max Hospital, Noida, agrees that modern tools are making asthma management easier and more effective. 'Mobile apps now allow patients to log symptoms, track peak flow rates, and receive reminders for medication,' Dr Agrawal says. 'This improves long-term adherence and allows doctors to adjust treatment based on real-world data.' India's asthma tech advances still slow to reach rural populations Despite these advances, a significant portion of India's population, especially in tier 2 and 3 cities and rural areas, still struggles with access. 'Urban centres have embraced advanced options, but tier 2 and 3 cities are catching up slowly,' Dr Khanna notes. 'Telepulmonology, mobile respiratory clinics, and government drug programs are beginning to bridge the gap.'
