by Controller Medications
Controller medications are taken daily to keep asthma under control. Inhaled corticosteroids (ICS) are the most commonly prescribed controller medication for allergic asthma. ICS work by reducing inflammation in the airways. Common ICS medications include fluticasone propionate (Flovent), budesonide (Pulmicort), beclomethasone dipropionate (QVAR), ciclesonide (Alvesco) and mometasone furoate (Asmanex).
Leukotriene receptor antagonists (LTRA) are also frequently used as controller medications. Popular LTRA drugs include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo). LTRAs work by blocking the action of leukotrienes, substances in the body that cause inflammation and narrowing of the airways.
Some patients require two controller medications for adequate control of their asthma. Combination low-dose ICS and LTRA formulations are available such as mometasone/formoterol (Dulera) and fluticasone/salmeterol (Advair). For severe asthma unresponsive to other controllers, biologics targeting specific immune pathways may be prescribed.
Reliever Medications
Reliever or rescue medications are used to provide quick relief from asthma symptoms as they occur. Short-acting beta2 agonists (SABA) like albuterol (ProAir HFA, Ventolin HFA, Proventil HFA) and levalbuterol (Xopenex HFA) work within minutes to relax and open airway muscles during an asthma attack.
Some patients use an as-needed low-dose ICS/long-acting beta2 agonist (LABA) combination as a reliever. Medications combining fluticasone propionate/salmeterol (Advair HFA) or mometasone/formoterol (Dulera) can provide both quick symptom relief and ongoing inflammation control with one inhaler.
Allergen Immunotherapy
Allergen immunotherapy, also called desensitization or hypo-sensitization, aims to reduce a person’s sensitivity to specific allergens through controlled exposure over time. During subcutaneous immunotherapy (SCIT), tiny amounts of allergen extracts are injected just under the skin. Sublingual immunotherapy (SLIT) involves placing allergen drops or tablets under the tongue.
Research shows both SCIT and SLIT can lead to reduced Allergic Asthma Therapeutics symptoms, less need for medications and fewer asthma attacks over three to five years of treatment. Allergen immunotherapy is especially beneficial for people whose asthma is triggered by perennial indoor allergens like dust mites, pet dander or mold. However, it requires a significant time commitment and may cause some local injection site reactions or oral itching with SLIT.
Emerging Therapies
Scientists continue to investigate new therapeutic targets and technologies for allergic asthma. Biologics are a major area of research focus. These treatments aim to neutralize specific molecules involved in triggering inflammation, like immunoglobulin E (IgE), interleukin-5 (IL-5) and interleukin-13 (IL-13).
Dupilumab (Dupixent), the first biologic approved by the FDA for moderate-to-severe asthma, works by blocking the IL-4 and IL-13 pathways. In clinical trials, dupilumab significantly improved asthma control and reduced exacerbations compared to placebo for patients with type 2 inflammation marked by elevated blood eosinophils or existing type 2 biomarkers.
Mepolizumab (Nucala) targets IL-5 and is approved to treat eosinophilic asthma. Reslizumab (Cinqair) also targets IL-5. Benralizumab (Fasenra) targets the IL-5 receptor on eosinophils. These biologics show effectiveness at reducing exacerbations in patients with an eosinophilic phenotype of severe asthma. Tezepelumab, blocking the thymic stromal lymphopoietin pathway, also shows promise as an orally administered asthma therapy.
Stem cell therapy aims to restore lung tissue damage through various methods including cell transplantation. Researchers have made progress growing alveolar epithelial cells in the lab to heal injured lungs. 3D bioprinting may one day enable printing of replacement lung structures tailored to individual patients. Gene therapy approaches introduce genetic material to alter disease-causing genes or boost protective genes within the body. Overall, many innovative therapeutic concepts are being explored to better manage and potentially cure allergic asthma in the future.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
