Suffering from asthma
Living with bronchial asthma for many years, the 55-year-old woman continuously suffered from severe shortness of breath. Despite being treated with advanced asthma regimens, she still had to be hospitalized many times each month. Every time she had a asthma attack, she often had to use oral corticosteroids to control symptoms.
Repeated hospitalizations not only reduced her health but also seriously affected her spirit. She always lived in fear of asthma recurrence, prolonged insomnia, and even having to undergo further treatment for psychological problems.
After a process of in-depth assessment, doctors determined that this was a severe bronchial asthma case with allergic phenotype. The patient was supplemented with biological drugs into the basic regimen that had been optimized. After 3 months of treatment, the patient was recorded to have significantly improved symptoms, no longer had to be hospitalized regularly and could return to normal life, even confidently visiting his daughter after many years of being "stuck".
Another case is a male patient over 40 years old in Ho Chi Minh City. Although he adheres to treatment, completely quits smoking and is assessed and treated for common diseases, treated with a high-level asthma protocol, he still often has difficulty breathing at night, especially near dawn.
The fear of asthma attacks appearing at any time makes patients always in a state of stress, insomnia and fear. After being comprehensively assessed and identified as belonging to the severe asthma group, patients are supplemented with biological drugs for underlying treatment after being identified as meeting sufficient standards. After treatment, symptoms are better controlled, and the quality of life is significantly improved.
Patients should not abuse corticosteroids to treat asthma
Sharing about the two cases above, Dr. Le Thi Thu Huong, Head of the Respiratory Department, Gia Dinh People's Hospital, said that not everyone with poor asthma control is severe asthma; at the same time, not everyone with severe asthma needs or is suitable for biological drugs.
According to doctors, before identifying a case as truly severe asthma, doctors must perform many in-depth evaluation steps such as checking the technique of using inhaling medication, treatment compliance, confirming the correct asthma diagnosis, measuring respiratory function, detecting and treating co-infected diseases; imaging diagnosis can be performed when other diseases or complications are needed, testing the inflammation status and determining the type of asthma. Only when treatment at a higher level is optimized and related factors are handled but the disease is still uncontrolled, or worsens when treatment is reduced, can it be classified as truly severe asthma.
Dr. Le Thi Thu Huong emphasized that biological medicine is a complementary treatment, targeted for some severe asthma patients who meet the standards, not "a regimen for everyone". The doctor's goal is to choose the right patient, the right type of medicine and at the right time, thereby optimizing treatment effectiveness and avoiding unnecessary costs. The selection is based on the outbreak phase, inflammatory pattern, biological markers, co-infection and accessibility. Biological medicine does not replace basal inhalers with anti-inflammatory drugs; patients do not arbitrarily reduce or stop taking medicine.
According to doctors, short-term oral corticosteroids still play a role in treating acute asthma episodes. However, in some severe asthma patients, having to use oral corticosteroids repeatedly or for a long time to control the episode increases the risk of infection, high blood pressure, diabetes, osteoporosis, cushing's syndrome, cataracts and many other dangerous complications.
Currently, severe asthma accounts for only a small percentage of asthma patients: a study in the Netherlands estimates that about 3.7% of asthma patients meet the standards for severe asthma, but this is the group that bears the greatest burden of disease if they do not have access to specialized treatment methods. Therefore, when patients still frequently have asthma attacks even though they have been treated according to the correct protocol, they need to go to a specialized facility for comprehensive assessment instead of arbitrarily increasing medication or abusing corticosteroids; and do not arbitrarily reduce or stop inhaling medications prescribed by doctors.
