Personalized Approach Helps Treat Severe Asthma

In spite of better medications and treatment guidelines, up to half of asthma patients continue to suffer from poorly controlled disease; they wake up at night, make urgent trips to the emergency room and miss work and school. National Jewish Health physicians James Good, MD, and Richard Martin, MD, have developed an individualized approach to asthma care that guides effective treatment for many of the most difficult-to-treat asthma cases, known as refractory asthma. They use a bronchoscope to actually look at the airways and to obtain tissue samples.

This approach provides much better information than relying solely on measurements of breathing capacity and has allowed the physicians to divide asthma patients into five specific categories: those with gastroesophageal reflux, subacute bacterial infections, tissue eosinophilia (high numbers of immune cells known as eosinophils), a combination of categories and nonspecific. Each subtype suggests a specific therapeutic strategy in addition to standard therapy.

Using this personalized approach for patients with refractory asthma improves their lung function, on average, by 25 percent and asthma control by 60 percent. With their scientific publications describing the approach and new educational programs, more physicians around the country are learning how to help their most difficult-to-treat asthma patients.