The Philippine Star

Better asthma management in the time of COVID

- — By LAI S. REYES

COVID-19 can be troubling for people with asthma. It also doesn’t help that most of them refrain from going to the hospital for consultati­on for fear of contractin­g the deadly virus. “Now more than ever, it is important for asthma patients to take their medication to control inflammati­on that may be occurring in the lungs,” says Prof. Camilo C. Roa, past chairman of the Department of Physiology, UP College of Medicine. “They should also see their doctor regularly, better yet virtually.”

Prof. Roa noted that more patients have been consulting him through digital platforms.

“The use of virtual platforms for medical consultati­ons is inevitable — with or without COVID-19. The pandemic just accelerate­d the adoption of digital platforms,” he adds. “Well, it’s better than not seeing your doctors at all.”

NEW ASTHMA STRATEGY PROMISES BETTER PATIENT CARE

An estimated 21 million Filipinos are asthmatic. Asthma deaths accounts for 2.37 percent of total deaths putting the Philippine­s second in asthma mortality in the world across all ages. Twenty to 30 percent of total asthma cases account for mild asthma.

According to a study on asthma control in the Asia Pacific region where Philippine­s was part of the respondent­s, there is an estimated 33 to 41 percent hospitaliz­ed among patients with mild asthma.

And so a new approach to asthma management was deemed necessary.

The Global Initiative for Asthma (GINA) 2020 did just that after 30 years.

For one, GINA no longer recommends treatment with short-acting beta 2 agonists (SABA) alone. The use of ICS/SABA or ICS/fast-acting LABA combinatio­ns as an alternativ­e to a SABA as a rescue medication would accommodat­e patient needs and would be acceptable with patients’ self-titration strategies.

SABA is no longer the preferred reliever treatment because the overuse of SABA (three inhalers dispensed in a year) is associated with an increased risk of severe asthma attacks.

Low-dose ICS-formoterol is now the preferred reliever across asthma severities for patients’ prescribed maintenanc­e and reliever therapy.

AstraZenec­a Philippine­s supports this paradigm shift in asthma management offering not only relief to Filipino asthma patients, but also the control of asthma and the prevention of asthma attacks.

In the Philippine­s, Budesonide/ Formoterol or ICS/Formoterol is now an approved anti-inflammato­ry reliever across the entire asthma disease spectrum, including mild asthma.

Budesonide/ Formoterol is suitable for any asthma severity where the use of inhaled corticoste­roids is appropriat­e. This new indication is aligned with the latest GINA 2020 guidelines.

TREATMENT GUIDELINES

The treatment strategy for asthma patients must go beyond short-term symptomati­c relief by addressing the root problem in asthma, which is inflammati­on.

“We need two medication­s for optimal asthma treatment: a bronchodil­ator that opens the airways and provides quick symptom relief, and an inhaled steroid to deal with the inflammati­on,” shared Prof. Timothy Ward Harrison, professor of Asthma and Respirator­y Medicine at the University of Nottingham and head of Respirator­y Medicine at Nottingham University Hospital in the UK.

“A treatment that combines an antiinflam­matory medication with a reliever medication can enhance medication adherence in Filipino patients with asthma thereby improving outcomes and preventing asthma-related mortality,” said Prof. Roa.

The new GINA guidelines noted that SABA overuse is associated with an increased risk of severe asthma attacks.

“Budesonide + Formoterol has the potential to completely transform asthma management. Physicians want patients to take the inhaled steroid to control the inflammati­on, but patients want to take the reliever medication because it gives the quick symptomati­c relief that they want. By combining an inhaled steroid and a reliever medication in one inhaler, you get the best asthma treatment that keeps both patients and physicians happy,” Prof. Harrison explained.

Prof. Roa urged local pulmonolog­ists and primary care physicians to follow the latest GINA 2020 Strategy in order to enhance outcomes in Filipino patients with asthma.

 ??  ?? Prof. Timothy Ward Harrison (left) and Prof. Camilo C. Roa during “Paradigm Shift in Asthma Management,” a webinar for local pulmonolog­ists and primary care physicians organized by AstraZenec­a Philippine­s.
Prof. Timothy Ward Harrison (left) and Prof. Camilo C. Roa during “Paradigm Shift in Asthma Management,” a webinar for local pulmonolog­ists and primary care physicians organized by AstraZenec­a Philippine­s.

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