Be a control freak: Allergists outline new focus for asthmatics

October 24, 2005

ROCHESTER, Minn. -- A Mayo Clinic allergist and colleagues representing the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma and Immunology announce they are revising the old classification of asthma patients by disease severity to determine treatment and moving to a new expectation for all asthma patients: excellent symptom control. Complete or total control is also a realistic goal for a subset of patients, according to new guidelines for treating asthma published in the November issue of Journal of Allergy and Clinical Immunology.

"People with asthma can expect to control the asthma: not to have the asthma control them," says James Li, M.D., Ph.D., Mayo Clinic allergist and lead author of the paper. "It's all about asthmatics' quality of life: waking up in the middle of the night wheezing, constantly using rescue medications, having to excuse themselves from sports teams or needing to leave work due to an attack -- that's no life."

Dr. Li contends this is not just pie-in-the-sky thinking, but that these new goals can align with patients' disease reality. "It's definitely not only a goal and an ideal, but most people with asthma can have well or completely controlled asthma," he says. "People with asthma should not be satisfied with less than well or completely controlled asthma. We want to empower patients by letting them know this is the goal. We want them to know if they are not reaching this goal, they should see their doctors."

With the heretofore national practice guidelines for physicians treating asthmatics -- in use for about 15 years -- patients have been classified as having mild, moderate or severe asthma; treatment was based on disease severity.

"It's become clear, however, that there are limitations to this approach as asthma changes over time and individuals require different treatment," says Dr. Li. "The present classification of asthma severity tends to promote the erroneous idea that asthma 'class' is static. In fact, asthma symptoms, sleep disturbance, rescue medication use and pulmonary function may change significantly over time, which highlights the need for continual reassessment of a patient's asthma and the need for possible medication adjustment."

Asthma treatment should be individualized to achieve the target symptom control, according to Dr. Li, because not all patients respond similarly to medication. This customized approach requires regular visits to the doctor. Asthmatics who have not attained well or completely controlled asthma should see their doctors for a detailed assessment of asthma control (including lung function tests), confirmation of the diagnosis of asthma, assessment of asthma triggers (including allergy) and individualized treatment.

Well-controlled or excellent control of asthma is defined by the paper's authors as follows: The authors also assert that with proper symptom assessment and treatment, complete or total control is possible for a significant group of asthmatics.

"While well-controlled asthma is the recommended target for all patients with asthma, complete control may be attainable and appropriate for many patients," says Dr. Li.

Complete or total control of asthma is defined by Dr. Li and colleagues as follows: Asthma is a chronic condition that occurs when the main air passages of the lungs, the bronchial tubes, become inflamed. The muscles of the bronchial walls tighten and extra mucus is produced, causing the airways to narrow. This can lead to everything from minor wheezing to severe difficulty in breathing. Each year, nearly 500,000 Americans with asthma are hospitalized, and more than 4,000 die from disease-related causes.
-end-
To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. MayoClinic.com (www.mayoclinic.com) is available as a resource for your health stories.

Mayo Clinic

Related Asthma Articles from Brightsurf:

Breastfeeding and risks of allergies and asthma
In an Acta Paediatrica study, exclusive breastfeeding for the first 3 months was linked with a lower risk of respiratory allergies and asthma when children reached 6 years of age.

Researchers make asthma breakthrough
Researchers from Trinity College Dublin have made a breakthrough that may eventually lead to improved therapeutic options for people living with asthma.

Physics vs. asthma
A research team from the MIPT Center for Molecular Mechanisms of Aging and Age-Related Diseases has collaborated with colleagues from the U.S., Canada, France, and Germany to determine the spatial structure of the CysLT1 receptor.

New knowledge on the development of asthma
Researchers at Karolinska Institutet in Sweden have studied which genes are expressed in overactive immune cells in mice with asthma-like inflammation of the airways.

Eating fish may help prevent asthma
A scientist from James Cook University in Australia says an innovative study has revealed new evidence that eating fish can help prevent asthma.

Academic performance of urban children with asthma worse than peers without asthma
A new study published in Annals of Allergy, Asthma and Immunology shows urban children with poorly controlled asthma, particularly those who are ethnic minorities, also suffer academically.

Asthma Controller Step Down Yardstick -- treatment guidance for when asthma improves
The focus for asthma treatment is often stepping up treatment, but clinicians need to know how to step down therapy when symptoms improve.

Asthma management tools improve asthma control and reduce hospital visits
A set of comprehensive asthma management tools helps decrease asthma-related visits to the emergency department, urgent care or hospital and improves patients' asthma control.

Asthma linked to infertility but not among women taking regular asthma preventers
Women with asthma who only use short-acting asthma relievers take longer to become pregnant than other women, according to research published in the European Respiratory Journal.

What are the best ways to diagnose and manage asthma?
A team of experts from The University of Texas Medical Branch at Galveston examined the current information available from many different sources on diagnosing and managing mild to moderate asthma in adults and summarized them.

Read More: Asthma News and Asthma Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.