In this article, we will discuss the Refractory Asthma. So, let’s get started.
Refractory Asthma
Although most patients with asthma are controlled with appropriate medication. Persistence of asthmatic symptoms despite maximum inhaled therapy is termed as refractory asthma. The causes or factors that make the asthma resistant are:
1. Poor compliance or non compliance with medication.
2. Exposure to high, ambient levels of allergens or unidentified occupational agents.
3. Gastroesophageal reflux.
4. Chronic infection with mycoplasma or Chlamydophila pneumoniae.
5. Drugs, e.g. beta blockers, aspirin, NSAIDs.
6. Systemic diseases, e.g. hyper or hypothyroidism
7. Premenstrual tension worsen asthma
Treatment
- Correct use of inhalers to improve compliance
- Identify and eliminate the underlying trigger
- Low dose of theophylline may be helpful. Most patients may require maintenance treatment with oral steroids.
- In some patients with allergic asthma omalizumab (anti-IgE) is effective particularly when there are frequent exacerbations.
- A few patients may get benefit with infusion of beta-agonists (salbutamol or terbutaline)
- Anti-TNF therapy may also be effective.