An investigation by Home Observatory (House dust mite observatory for the first evidence-based immunotherapy), sponsored by FederAsma, Allergie ONLUS and the five major national scientific societies dealing with respiratory diseases, has shown that one in two asthmatic patients, stops the treatment on their own after they start feeling better.

Professor Giorgio Walter Canonica, Director of the Personalized Medicine Center – Asthma and Allergology at Humanitas and President of the Italian Society for Allergology, Asthma and Clinical Immunology (SIAAIC), talked abou it in a recent interview. “Getting better does not mean getting well, because the symptoms will eventually come back. The problem is that attention falls in the long term, and thus patients prefer to tolerate their problems and have an inferior life quality instead of observing their treatment plan”.

On the contrary, asthma has to be carefully monitored, and patients have to respect the suggestions of their specialist.

What is asthma?

Allergic asthma is the most common type of asthma, and it often arises in childhood. “Allergens are mainly inhaled (pollens, mites, dog and cat skin, Alternaria spores). Sometimes there are cross-reactions with alimentary allergens. Instead, foods alone are rarely able to cause asthma”, as Prof. Canonica says.

Symptoms may be chronic or intermittent. They involve the bronchi, suddenly shrinking the airway (the so-called bronchospasm) and producing excess mucus. These two phenomena, individually or together, make it difficult to breathe (dyspnea), cause wheezing (with the typical wheeze or rattle) and often cause coughing, thus making it even harder to breathe.

Treatment options

“The goal of therapy is keeping the disease under control in the medium to long term. This is why it has to be constantly in monitor. Asthma can change over time. For instance, after a change in environmental factors, we always have to personalize the treatment. In fact, it is important that patients recognize their own improvements (thus avoiding taking unnecessary medications) or worsening (in order to take more medications)”, Prof. Canonica highlights.

To mild intermittent asthma we prescribe short-acting beta-2-agonists, taken by inhalation. These ones act on some receptors on the smooth muscles of the bronchi and relax them, thus leading to bronchodilation.

Patients should choose the inhaler carefully, in order to guarantee them the best result thanks to a better adherence to the prescribed therapy.

Those suffering from moderate and severe asthma, instead, should take corticosteroids (that work as anti-inflammatories) by inhalation and long-acting beta-2-agonists, able to favor bronchodilation. Patients suffering from severe asthma may need other medications in addition to these.

Monoclonal antibodies are another option. They bind to immunoglobulins E found in the blood stream and hinder the release of histamine and leukotrienes, responsible of the symptoms of asthma. They are administered by injection once every two or four weeks.

“Other biological therapies based on monoclonal antibodies, such as anti-interleukin-5, are already at our disposal”, Professor Canonica said.