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There’s No ‘One Size Fits All’ Treatment for Asthma

For example, Dr. Wechsler said, “Even what is used to clean can be irritating to a person with asthma.”

For some people with asthma, a viral infection, like the flu or common cold, or use of a medication like aspirin, an Nsaid or beta-blocker, can enhance inflammation in the airways and result in labored breathing. Still others experience constricted airways when they exercise, especially in cold weather.

Even strong emotions, like fear, anger, excitement or laughter, and sudden changes in the weather are problems for some people with asthma.

Although several people I know with asthma feared they would be especially susceptible to contracting Covid-19 and becoming severely ill, the evidence has not shown an increased risk either in contracting the coronavirus or developing a worse infection if they did, Dr. Wechsler said. In fact, he added, “treating asthma may even protect against Covid.”

Researchers now recognize that the triggering event of an asthma attack can have different manifestations within the airways and therefore respond better to different treatments. As Dr. Cloutier explained, in allergic asthma, inflammatory cells called eosinophils collect in the airways, but when a viral infection triggers the inflammation, cells called neutrophils are released, warranting a different treatment.

The new guidelines highlight the value of a measurement called FENO that stands for fractional exhaled nitric oxide, a biomarker described as useful in correctly diagnosing and adequately treating asthma in different patients. For children aged 5 and older, a nitric oxide measurement can help confirm the diagnosis of asthma and evaluate the effectiveness of treatment.

Although the guidelines do not provide hard-and-fast rules, they offer valuable treatment suggestions when currently used remedies do not result in the best relief possible. For example, the panel stated unequivocally that encasing mattresses and pillows in allergy-protective covers is not in itself an adequate remedy for someone allergic to dust mites.

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