First, we start out by defining their disease severity, and then we start treatment, whether it’s a short-acting beta agonist or longer-acting inhalers, such as LAMAs, LABAs, and inhaled corticosteroids, or combination therapy of the three. We then move on to single agents, such as [montelukast], that are added on.

Once those fail, we have to move on to prednisone. We know staying on chronic prednisone is never a good thing for any individual. We do now have chronic prednisone steroid-sparing agents such as monoclonal antibodies. These have all been FDA approved for the treatment of moderate-to-severe asthma.

We test our patients these days by getting CBC with differential to specifically look at eosinophils and IgE levels. As we know, interleukins, IgE levels, and eosinophils are all elevated in patients who do have asthma, causing more inflammation, scarring, and narrowing of the airways. Some of these agents include [reslizumab], [benralizumab], [dupilumab], [mepolizumab], and [tezepelumab].

These specific agents can be administered one to two times a month, and they can be life-changing in many asthmatic patients.