Is Your Asthma e-Asthma? New Medicine!
* e-Asthma is category of severe asthma
* Patients with e-Asthma have difficulty getting asthma control with usual treatment
* e-Asthma responds well to a new type of injected medicine
* In such patients, this new medicine can decrease their asthma attacks and allow them to use less oral steroid.
e-Asthma is a type of severe asthma that responds well to a new kind of control medicine that you inject under skin, usually monthly.
Severe Asthma means:
- You’ve been on a high dose of inhaled corticosteroid (ICS) and a long-acting bronchodilator or theophylline for in the past year; and/or
- You’ve been treated with steroids (like Prednisone) by mouth for more than half of the past year.
Wondering what “high dose” ICS means?
|Definition of high dose*|
|ICS||Age 6 – 12 years||Age > 12 yrs|
|Beclomethasone (Qvar)||≥ 320 mcg/day||≥ 1000 mcg/day|
|Budesonide (Pulmicort)||≥ 800 mcg/day||≥ 1600 mcg/day|
|Ciclesonide (Alvesco)||≥ 160 mcg/day||≥ 320 mcg/day|
|Fluticasone (Flovent)||≥ 500 mcg/day||≥ 1000 mcg/day|
|Mometasone (Asmanex)||≥ 500 mcg/day||≥ 800 mcg/day|
|*European Respiratory Society: Eur Respir J Feb 2014 43:343-373|
This new type of injectable asthma medicine has been shown to dramatically:
1. Reduce the number of asthma attacks you will have
2. Reduce how much oral steroid (like Prednisone) and ICS you need to stay controlled.
How do we know if your asthma is the type that will respond to this medicine? You would be likely to get a good response to this new medicine if:
- Your eosinophils are elevated in your bloodstream, and
- Your allergy testing shows that you are triggered by seasonal allergens.
So, let’s review:
You have been on high dose ICS (see above) or oral steroid for more than half of the year,
You have skin allergy tests that show a problem
I would recommend having your blood drawn to measure your eosinophil count.
If your eosinophil count is elevated (35-700 IU/mL), you would be a good candidate to try this new type of medicine.
What medications would be considered?
Here is a list of subcutaneous medications that can be ordered for e-Asthma:
Omallzumab (Xolair) injected every 2 or 4 weeks depending on your eosinophil count and age
Dupilumab (Dupixent) injected every 2 weeks
Mepolizumab (Nucala) injected every 4 weeks
Benralizumab (Fasenra) injected every 4 weeks for 3 doses, then every 8 weeks.
Tezepelumab (Tezspire) injected every 4 weeks. This medicine does not require any history of elevated eosinophils or prior testing for allergic asthma.
These medications are quite new and it will take some time for general practitioners to become educated about prescribing them.
But, they are available RIGHT NOW and if you are suffering from severe asthma, they could be a really good solution for getting your severe asthma under control.
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* Medicine administered by a dry powder inhaler does not require a spacer since the design of the inhaler stirs and suspends the dry powder particles so they can be inhaled deeply.
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