A survey conducted by the Home Observatory (House dust mite observatory for the first evidence-based immunotherapy), sponsored by FederAsma and Allergie onlus and the five leading national scientific companies dealing with respiratory diseases, showed that one in two asthmatic patients, with a personal perception of being better, interrupts the prescribed treatments independently.

In a recent interview, Professor Giorgio Walter Canonica, Director of the Centre for Personalized Asthma and Allergy Medicine at Humanitas and President of the Italian Society of Allergy, Asthma and Clinical Immunology (Siaaic), stressed: “Better does not mean well, because the symptoms that are temporarily attenuated will sooner or later reappear. The problem is that the attention threshold is falling in the long run, so we prefer to tolerate disorders and have a lower quality of life rather than follow continuous therapy.

Asthma should be carefully monitored and the specialist’s instructions should be followed.


What is Asthma?

Allergic asthma is the most common form of asthma and often occurs during childhood. “The allergens responsible are mainly inhalative (pollens, mites, dog and cat epithelia, alternaria), and the so-called cross reactions with food are not uncommon. Food, on the other hand, rarely causes asthma on its own,” explains Prof. Canonica.

Symptoms can be chronic or intermittent and involve the bronchi, with sudden narrowing of the airways (called bronchospasm) and excessive production of mucus. The two phenomena, individually or together, complicate breathing, create a “hunger” for air (breathlessness), cause wheezing with a typical whistle or wheeze, and often cause coughing that further worsen breathing.


Treatment options

“The therapy aims to control the disease in the medium and long term and should therefore always be monitored. Since asthma can change over time, for example due to changes in environmental factors, treatment must always be personalized: it is important that the patient recognizes any improvements, to avoid taking unnecessary drugs, or worsening, to increase doses,” stresses Prof. Canonica.

For the treatment of mild intermittent asthma beta 2-agonists with short duration of action may be helpful, as they are taken by inhalation. These act on some receptors of the smooth muscles of the bronchi and relax them, resulting in bronchodilatation.

The inhaler should be chosen carefully to ensure maximum patient benefit by improving adherence to the prescribed therapy.

In the case of moderate and severe asthma, on the other hand, it is necessary to take corticosteroids by inhalations – which have an anti-inflammatory effect – and beta-agonists with a long duration of action, capable of promoting bronchodilatation. If the patient suffers from a severe form, additional medications may be needed in addition.

Monoclonal antibodies are also available which, by binding to circulating E immunoglobulins, prevent the release of histamine and leukotrienes, which are responsible for asthma symptoms. The administration is done by injection every two to four weeks.

“Other biological therapies based on monoclonal antibodies, such as anti-Interleukin 5, are already available to us today,” concluded Professor Canonica.