A new asthma treatment has anti-inflammatory properties and a bronchodilating effect, revolutionising the way asthma can be treated - and changing the lives of people who live with the disease.
Asthma affects more people than ever before: one in every ten children and one in 20 adults.
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The severity of living with this condition has been reduced, however, with the correct use of the correct medication, according to Professor Klaus Rabe, Professor of Pulmonary Medicine and the Chairman of the Department of Pneumology at the University of Leiden. He was one of the main speakers at the South African Thoracic Society Conference in August at the Cape Town International Convention Centre.
"Asthma in a less severe form is much easier to manage. If this condition is adequately controlled, asthmatics can lead normal lives," he added. But controlling this condition adequately, especially in young children, is never easy.
Recognising asthma
"Children who come from high-risk families (such as when both parents are asthmatics) are genetically disposed to show asthmatic symptoms, such as wheezing, early on in life. It is often difficult to diagnose the disease in children, as wheezing could be a result of allergies or a viral infection. Some children grow out of it, some still have the occasional wheezing fit, and others just get worse. These are the ones who are then diagnosed as asthmatics," says Rabe.
He also pointed out that many adults who develop asthma later in life frequently had asthma as children, and often have symptoms of a viral infection, such as coughing and wheezing. People often mistake this condition for a common cold that is taking a long time to clear up. Many adults are unaware of the fact that they or their children suffer from this potentially dangerous condition.
Living with asthma
There are four different types of asthma: severe persistent, moderate persistent, mild persistent and mild intermittent.
Asthma attacks are typically episodic. The intervals between the attacks may be days, months or even years.
There are usually tell-tale signs before a full-blown attack, but these vary from person to person. Some people experience an itchy chin or throat and a dry mouth, while others may feel tired and irritable.
Common warning signs of an attack include light wheezing, pain when coughing, chest tightness, shortness of breath, or restlessness.
The best way to manage and control asthma is to identify and avoid triggers.
Common asthma triggers include animal dander, house dust mites, cockroaches, pollens and outdoor moulds, indoor mould, tobacco smoke and indoor pollutants.
Asthma treatment
When treating asthma, inflammation in the lungs and airways must be controlled, and shortness of breath be relieved.
Corticosteroids, cromolyns (a non-steroid treatment to reduce inflammation) and leukototriene inhibitors are long-term control medications that control and prevent inflammation in the lung of the bronchi and help stop or reduce swelling and mucus build up in the airways.
Short-acting bronchodilators are used to give immediate relief of shortness of breath. Long-acting bronchodilators can relieve symptoms for up to 12 hours.
The SMART approach
A new treatment that controls the condition as well as opens the airways, is now available for appropriate patients. The SMART approach provides patients with both asthma maintenance and reliever therapy together in one inhaler. It is recommended for adult use and for children ages 12 and up.
With the SMART management approach patients receive inhaled corticosteroid (ICS) and a long-acting bronchodilator (LABA) with every inhalation, even when it is used for rapid symptom relief. The difference between the SMART asthma treatment and other combination treatments is the fact that the LABA is able to provide immediate relief of bronchospasm – and therefore a separate SABA (short-acting bronchodilator) is therefore no longer needed.
This ensures better long-term asthma control as the inflammation is being treated every time the SMART medication is being taken to treat a breakthrough bronchospasm.
Mostly, breakthrough bronchospasm (i.e. breakthrough asthma attacks) are indicative of deteriorating asthma i.e. a sign that the inflammation is becoming worse. Thus, by treating the worsening inflammation early, better asthma control is achieved.
Rabe says that the problem most asthmatics have is that they don't stick to a treatment regime. Once there has been a decrease in asthma symptoms they cease taking any medication. The SMART treatment, to some extent, also overcomes this problem.
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