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Managing Severe Asthma, One Breath at a Time

If you are among the 25+ million people living with asthma, then you know how important it is to keep your symptoms under control.


Most asthma can be controlled by avoiding triggers and taking prescribed inhaler medications for treatment. For some, however, the coughing, wheezing, and shortness of breath continue — and inhalers do not help. This is a sign your asthma is not under good control.

It could also mean you have severe asthma. Studies show that 5-10% of people with asthma have severe asthma. Severe asthma is the diagnosis when symptoms are uncontrolled and do not respond to traditional medications (quick-relief or controller inhalers).

Understanding uncontrolled asthma

Do you have asthma symptoms more than two days a week? Do you wake up at night due to asthma two or more times a month? Do you refill your quick-relief inhaler prescription more than two times per year? Are you prescribed oral corticosteroids to calm an asthma attack two or more times per year?

If you answer “yes” to any of these questions, your asthma may be uncontrolled. Make an appointment to see your doctor — preferably an asthma specialist such as an allergist or pulmonologist. A specialist can talk with you about other medications that may help.

People with uncontrolled or severe asthma may need more specialized treatment. Ask for a referral to see an asthma specialist if your symptoms are uncontrolled or you have frequent asthma attacks. 

What is eosinophilic asthma?

Asthma involves inflammation in the airways. Some people have a type of severe asthma that involves increased inflammatory cells called eosinophils.

Eosinophils are white blood cells that help fight certain viruses and infections. They can cause swelling in the airways. People with eosinophilic asthma have an increased number of these white blood cells. They show up in the bloodstream, lung tissue, and mucus. Research shows a link between high levels of eosinophils in the blood and the risk and severity of asthma attacks.

Eosinophilic asthma is more common in adults than children. It is often first diagnosed in adults 35-50 years old. Doctors can diagnose eosinophilic asthma using a blood test, a test that checks your mucus or saliva, or a bronchial biopsy or bronchial fluid examined under a microscope.

People with eosinophilic asthma should receive regular medical care from an asthma specialist to help control their symptoms and maintain good health.

Eosinophilic asthma treatment

If you have eosinophilic asthma, you may have asthma attacks more often. Your doctor may recommend a more targeted therapy called biologic medications. They are personalized to your specific type of severe asthma.

Biologics target the cells and pathways that can cause airway inflammation and lead to asthma symptoms. Four biologics are available to treat eosinophilic asthma. They work by blocking the proteins that activate eosinophils and cause inflammation. They can also block the production and survival of eosinophils. Biologics for asthma are typically prescribed by allergists or pulmonologists.

If you have severe eosinophilic asthma, you will need a treatment plan created by you and your asthma specialist. Discuss how asthma affects your quality of life and what you want out of treatment. The treatment plan should be more than just effective; it should be one that you can and will follow.

Getting the right treatment plan is the first step towards getting control of your asthma. Getting control of your asthma is the first step toward living a healthy, active life.

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