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ACAAI president busts common asthma ‘myths’
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In support of Asthma and Allergy Awareness Month in May, Healio Pulmonology spoke with Todd A. Mahr, MD, president of the American College of Allergy, Asthma and Immunology, about current challenges in the management and treatment of asthma in children and adults.
“Asthma is a serious condition that affects more than 26 million Americans — more than 8% of the population,” Mahr, who is also director of pediatric allergy and clinical immunology at Gundersen Health System in La Crosse, Wisconsin, and adjunct clinical professor of pediatrics at University of Wisconsin School of Medicine and Public Health, said in a release issued by the American College of Allergy, Asthma and Immunology (ACAAI). “One of the biggest dangers with asthma is that so many people who have asthma think it’s well-controlled, when it actually isn’t. When people have good, solid information about how to control their asthma and reduce symptoms, they are better able to live the kind of active lives they want.”
However, “myths” surrounding asthma, and its management and treatment, persist. Healio Pulmonology spoke with Mahr about busting some of the common myths and increasing awareness among providers and patients.
Myth: You can “outgrow” your asthma
There is no cure for asthma, but it is possible to control it and be able to participate in daily life and activities. Asthma does not go away on its own, but together, patients and providers can identify asthma triggers and build a plan to avoid and manage those triggers. In other cases, medication and/or allergy immunotherapy are appropriate, according to the ACAAI.
“Everyone needs to control their asthma,” Mahr told Healio Pulmonology. “Over time, it is possible that some people may lose that sensitivity, but the data show that most people do not outgrow their asthma. Rather, people outgrow their pediatrician or family practitioner and then change locations, or oftentimes in teenage years and early adulthood people become less active. So, their asthma may look like it is better, but the explanation may be that they have started to avoid triggers that have been a problem in the past, and they may have done this subconsciously, which can be misleading.”
Myth: If you have asthma, you should not exercise
Even elite athletes — including those competing at professional or Olympic levels — have asthma and can perform when their asthma is under control. There are myriad benefits of exercise, including for the lungs, heart and immune system. Some exercises that work particularly well for people with asthma include swimming, walking, hiking, and indoor and outdoor biking, according to the ACAAI.
Mahr told Healio Pulmonology this is one of the most common misconceptions he hears from patients.
“People with asthma should be able to do everything they want to do, including participating in sports and other activities, when their asthma is controlled,” he said.
Myth: Steroids used to treat asthma are the same steroids athletes use to bulk up
“Steroid phobia” is common, according to Mahr. “Many people hear the word ‘steroid’ when discussing treatment with an inhaled steroid for asthma and become concerned that they, or their child, will be bulky.”
It is important to discuss with patients and parents that “the inhaled steroids used to treat asthma are not anabolic steroids, which are the kind used to build muscle,” Mahr told Healio Pulmonology.
Steroids used for asthma are anti-inflammatory drugs, not hormones. Nasal steroid sprays are proved to be effective and are associated with low risk for adverse events. These treatments are available in over-the-counter and prescription forms, according to the ACAAI.
Myth: Asthma medications are habit - forming and dangerous
There are a variety of different asthma medications — some used regularly to prevent symptoms and other used only during asthma exacerbations. As with any medication, providers and patients must consider the risks and benefits of treatment.
None of the medications used for asthma in the United States are habit-forming or addicting, according to the ACAAI. These are not controlled substances.
Concerns remain about long-term use in children, as these medications may affect how fast a child grows; however, available data do not suggest an effect on final adult height, according to the ACAAI.
Myth: You can stop taking your medications if you feel good
It is important for providers and patients to work together to determine optimal medication and dosage. A patient could report feeling better simply because his or her controller medications are working. Patients should not use quick-relief medications if asthma is under control; these medications should be used only in urgent situations or as preparation before exercise, according to the ACAAI.
“We, as providers, should be talking with all patients, and parents, about the pathophysiology of asthma, what’s going on behind the scenes in the lungs and how we can control it, providing options for treatment and determining what the patient is most comfortable with,” Mahr told Healio Pulmonology.
Expanding awareness
Asthma and Allergy Awareness Month is important so patients and the public can understand more about their asthma and also dispel common misconceptions, Mahr said.
“The provider-patient-parent relationship is vital for open dialogue to determine what is best for the patient,” he told Healio Pulmonology.
For providers, Mahr said it is important to stay as up to date as possible on current treatment options and research, attending medical meetings when possible and utilizing tools such as the ACAAI’s Asthma Yardstick to understand which controller treatments are right for which age groups and more.
“Unfortunately, there are nearly 4,000 people in the United States per year who die from asthma,” he said. “Fortunately, we’ve made a dent in the number of deaths since I’ve started my career, and we have many new therapies and important research coming out that has an impact. But, 4,000 people per year still shouldn’t die of asthma. Much of this change is going to come from education and awareness — and getting that information to the patient so they know what they can do to manage their asthma correctly.” – by Melissa Foster
Disclosure: Mahr reports no relevant financial disclosures.