by Martha White, MD
It’s a different world than it was 25 years ago. When The MA Report was first published in 1985, almost none of the asthma and allergy medications that we commonly use today were available. All of the metered dose inhalers contained CFCs (chlorofluorocarbon propellants, now banned). Dry powder inhalers weren’t available. Wheezing babies were treated with Intal (cromolyn sodium, which is rarely used anymore), albuterol (still a standard bronchodilator) and prednisone (oral only, with bitter taste and more side effects than the inhaled versions we have now).
Now we have the NIH Asthma Guidelines – a vital document that helps healthcare providers and patients alike understand their asthma better. It spells out specific steps to take on the road to self-management and a healthy lifestyle.
Since that first MA Report, we’ve seen the emergence of more accurate allergy testing and more effective allergy shots. The pharmaceutical industry has provided us with new ways to treat nasal allergies, including nonsedating and long-acting antihistamines; a wide range of anti-inflammatory and corticosteroid nasal sprays; and leukotriene modifiers. And for asthma, we’ve seen approval of several inhaled corticosteroids to reduce airway inflammation; 12-hour bronchodilators; and combined medications.
Looking back, I think that the pharmaceutical advances for asthma that have had the most impact on my patients were the development of a nebulizable corticosteroid (Pulmicort® Respules) and of combination therapy for asthma (Advair®, Symbicort® and now Dulera®). The availability of nebulized corticosteroids has reduced the need for oral corticosteroid use in infants and toddlers and allowed for better control of asthma in this age group.
Combination therapy with inhaled corticosteroids and long-acting bronchodilators has improved compliance with inhaled corticosteroids, and – at least in my patients – has led to improvements in both asthma control and quality of life.
One thing that I see as remaining constant is the concern that our parent readers have for
(1) their children’s quality of life,
(2) the need to fully understand their child’s asthma triggers and how to implement the treatment plan,
(3) their need to be able to monitor their children’s asthma, and
(4) their need to feel comfortable about the safety of their children’s medications.
AANMA answers these questions daily. We remain steadfast, helping families understand and manage asthma and allergies, and increasing community awareness about asthma and allergy conditions and treatment options. We are active on Capitol Hill, and with state legislators.
Many of us at AANMA, including myself, have asthma and/or have family members with asthma. We share your passion, and I hope that through our various programs, Allergy & Asthma Today magazine, The MA Report newsletter and the “Ask Dr. White” column, that we’ve helped all of you to breathe a little easier.
Martha White, MD, is a board-certified allergist with an active private practice and director of research at the Institute of Asthma and Allergy in Wheaton, MD. She was part of the research team that treated Brooke Sander (daughter of AANMA Founder and President Nancy Sander) in the early 1980s and helped Nancy learn the asthma and allergy management techniques that put Brooke on the road to recovery.
Dr. White is a founding AANMA Board of Directors member and editor of The MA Report from the very first issue.
–>Do you have a medical question you’d like to ask Dr. White? E-mail firstname.lastname@example.org or write to Ask Dr. White, 8201 Greensboro Dr., Suite 300, McLean, VA 22102.
This article was first published in AANMA’s The MA Report, November 2010.