Saturday, 19 October 2019

The Top 4 Treatments for Asthma - How Effective Are They?


*Guest post
Whilst children who suffer from asthma often exhibit similar symptoms, treatments for the condition vary and there is no one single perfect treatment for asthma. The best treatment for a child’s asthma will ultimately depend on how severe it is and how their symptoms display. Children who suffer from severe asthma will often require specific treatment for their condition.
Usually, most children with asthma will need to carry a rescue medication in case of an asthma-attack. Most will also need a ‘controller’ medication which seeks to prevent asthma attacks in the first place and needs to be taken daily, even if the child is not experiencing symptoms. There is a wide array of asthma controller and rescue medications out there, and they vary in how effective they are at treating symptoms. Here are the top four treatments for asthma and an assessment of their effectiveness, as well as a recommendation as to which patients should be using them.

Immunotherapy

Immunotherapy is a viable treatment for those with allergy-induced asthma. Allergy induced asthma can be treated using allergy injections, or by taking oral allergy medications. The downside of these medications is that they must be continued indefinitely in order to prevent asthma attacks.
Another popular type of immunotherapy treatment used for allergies is Xolair. Xolair, also known by its clinical name Omalizumab, is a specific type of antibody that inhibits the production of immunoglobulin E. Used as a controller medication, Xolair can prevent allergens from causing asthma attacks. One negative point about Xolair, however, is that it is often delivered by injection and is not recommended for use in children.
Immunotherapy treatments are often used to counteract the underlying issues which are causing the symptoms, that cannot be prevented by using drugs. For instance, children suffering from eosinophilic asthma often suffer severe symptoms that tend to require more frequent emergency visits when controller medication is not working. This is because the disorder is caused by an underlying systemic issue of too many eosinophils in the blood, eosinophils being a specific type of white blood cell that can cause inflammation when found in excessive amounts.
New research has found that Mepolizumab, a monoclonal antibody, was able to effectively target Interleukin 5, which is responsible for eosinophil production. The treatment reduced the number of yearly exacerbations leading to hospitalisation for those with this form of asthma by more than 75%, while patients saw a 69% reduction in clinically significant exacerbations.

Leukotriene Blockers

Leukotriene Receptor Antagonists (LTRAs) or Leukotriene Blockers are an 'add-on' treatment, meaning your child would need to carry on taking their usual preventer medicine as well. LTRAs come in tablet form for adults, or granules for children. 
Unfortunately, some of the most popular leukotriene blockers are not effective for everyone, meaning it advisable to try this form of treatment and then reassess your child’s asthma control after a few weeks. It should be noted that some people have to stop taking these medications because they experience behavioural changes like agitation, depression, hallucinations, and suicidal thoughts. These are rare but need to be reported to a doctor as soon as they arise.

Steroids

Most inhaled steroids have to be taken twice per day. This form of treatment is the best choice for children with uncontrolled asthma, as it more effective at controlling asthma symptoms and is generally better at preventing future attacks than leukotriene blockers. Yet some patients are unable to control their asthma with an inhaled steroid. In fact, between five and ten percent don’t respond to it at all. Others have asthma so severe that inhaled steroids are not enough, and require combination therapy, which will be outlined in the next section.
There are a few other reasons someone may not use steroids. For example, steroids can suppress growth, increase blood pressure and thin bones, which may be a worry for parents. It can also result in a decreased resistance to infection, making it a poor choice in some circumstances. However, normally the benefits outweigh the risks, and so it is better for your child to take the medication than risk a potentially fatal asthma attack.

Combination Therapies

Combination medications combine two medications in one inhaler, normally a corticosteroid and a bronchodilator. The bronchodilator relaxes the airways, making it easier to breathe, whilst the inhaled corticosteroid reduces inflammation in the airways. Evidence has shown that a number of people with asthma find that this sort of treatment gives them better control of their condition.
The combination therapies are called for when the previously outlined treatment options are not enough to eliminate most of the need for rescue medications. They can also improve long-term lung function. However as with all medications, they can come with side effects including a rapid heart-beat, cough and irritation of the throat.

A Few Words About the Use of Medication

Please note that when using an inhaler, the way it is used will also have a direct effect on its effectiveness. One study found that more than 30% of all people who used inhalers did so incorrectly. This is why it is important to ensure your child is using their inhaler properly, and it is always advisable to check with your doctor that they are using the right technique. If you require further information about how to use your inhaler the right way, you can also take a look at this tutorial by Asthma UK.

Conclusion

While every child with asthma should carry fast-acting rescue medication, in case of an emergency, there are a growing number of options available to prevent and minimise the severity of asthma attacks. Each treatment has its own positive and negative points. Your GP should create a personalised action plan for your child upon diagnosis, but it is always worth staying up to date with new treatment developments, and look to see if a certain medication could be a better option for your child, depending on their c

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