Sorry state of affairs in Asthma management

It is gut wrenching when you read in the news all these medical advances in a variety of different conditions such as advancements in type 1 diabetes management, new techniques for donor nephrectomies in kidney transplants. better understanding treatment of HIV but then you see that since NRAD (National Review of Asthma Deaths) nothing has changed infant things have got worse. In Edinburgh the Lothians and Fife 34 people have died from asthma attacks in the last year alone. A record high. It is really scary to see that after a national report was released nothing has changed infact its got worse.

Its hard to sit back and watch these other chronic conditions have advancements which potentially could benefit the majority of those with the condition but with asthma there hasn’t been a widely available drug since the 90’s which is montelukast or singulair. there have been drugs such and omalizumab (Xolair) which if you are lucky or unlucky enough to have an IgE between 30 and 700, but it has to be between those levels. Its not licences if they are over or under, and its the same with mepolizumab (Nucala) except it is based on eosinophils and again you need very specific blood markers to qualify for these drugs. You also don know that they are going work and at £250-£500 per injection which you need every 2-4 weeks its an expensive process to not be guaranteed if its going to work or not.

In all chronic conditions monoclonal therapies seem to be the way pharmaceuticals are going. It is where the money is at but its not where the best treatment is at in conditions so complex as asthma. If you are an allergic asthmatic you stand a good chance of getting a treatment which will suit your asthma and phenotype. There are a number of new monoclonal treatments in the pipeline which hopefully will be approved by NICE if they are not too expensive.

But where does that leave the rest of us?? I really can’t see any change happening soon. Its been 20 years now since montelukast came out and yes it is good but its only so good. For me it is just another tablet I take which I know has some effect but I am not really sure how much it is contributing to my treatment. My consultant wants me to keep taking it so she must have some faith in it so I must to.

I can’t imagine how similar asthmatics in my situation feel. I know many though support groups and we share tips etc about how best to try and live “normal” life and we can share our trials, tribulations, accomplishments, but also fears of how bad asthma can get and seeing people die from it because after all 3 people die each day from it in the UK. It scary.

It prays on my mind a lot about the severity of asthma and what it can do. Especially when you have a Respiratory Registrar tell you in front of your youngest brother that you need to be in ICU because you need to be near a ventilator because thats how brittle your asthma is. But that is for another blog post.

I do think I am lucky and don’t lose all hope in asthma treatment but I think thats because I work so closely with researchers who are dedicating their lives to asthma and to improve the lives of people with asthma that I can see people are trying. I am also dipping my toes in the basic science world so will see what they are doing besides monoclonal therapies.

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