Children with severe asthma lead healthier lives today than they did a decade ago, thanks to improved treatment and earlier diagnosis.
Their lungs work better and they rely less on oral steroids and rescue inhalers than children did in the mid-1990s, according to a new study from National Jewish Health in Denver.
“It’s really great news because kids are healthier with less use of oral steroids, which have such potential for so many side effects like reduced growth, bone thinning, and increased risk of cataracts,” said James Merrick, MD, a Pennsylvania Medical Society member who treats children with asthma.
Researchers believe two medications in particular led to the improvements—a combination inhaled steroid and long-acting bronchodilator, which sells under the brand names Advair and Symbicort, and leukotriene receptor antagonist, which sells under the brand name Singulair.
In addition to new drugs, we now have better ways to get inhaled medications where they need to go—the lungs, Dr. Merrick said.
Physicians also better understand the variety of conditions that can aggravate asthma, such as acid reflux, sinus problems, a weak immune system, airway structure, and allergies. Asthma often improves with successful treatment of these underlying problems.
“Two important pieces of the puzzle are having asthma and any contributing factors diagnosed right,” Dr. Merrick said.
Children’s primary care doctors often make the asthma diagnosis well before they see specialists like Dr. Merrick.
“When kids come to me nowadays, the asthma has usually been identified, and I’m trying to come up with a way to more successfully keep it under control and use a safer treatment,” he said.
As a result, Dr. Merrick sees fewer asthmatic children in the hospital.
In another decade, children with severe asthma could be doing even better as we learn more about asthma.
“It’s been neat to see how things are working better, but there’s a lot out there that we don’t know,” Dr. Merrick said.
Researchers are testing new drugs and creating better drug delivery methods. At the same time, they are exploring new theories about what causes asthma, including one theory that our immune systems are underworked and are attacking harmless things like ragweed and cat dander.