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Allergy and Asthma: Asthma Management.

FP Essentials 2018 September
Asthma is a heterogeneous condition involving various levels of chronic airway inflammation, bronchoconstriction, airway hyperresponsiveness, and mucus production. Although inhaled corticosteroids and long-acting bronchodilators have improved patient outcomes, asthma remains uncontrolled for at least 10% of patients, even when use of these therapies is maximized. Improved understanding of the biology, genetics, and role of immune cell signaling in asthma has led to the development of immunobiologic therapies. They are administered subcutaneously or intravenously and target immunoglobulin E or interleukins that are involved in the allergic response. In patients with allergic asthma, immunotherapy has been shown to reduce exacerbations, decrease the need for drug use, and reduce the overall cost of care. Allergy immunotherapy, traditionally administered via subcutaneous injections, can be effective in the management of allergic asthma. Sublingual allergy immunotherapy is an option for treating adults with asthma due to dust mite allergy. Bronchial thermoplasty is a procedure used to treat some patients with severe asthma that remains uncontrolled despite appropriate use of traditional asthma drugs. Asthma action plans have been shown to decrease exacerbations and emergency department admissions. These plans incorporate self-monitoring for symptoms, appropriate drug use, and self-management plans for acute symptoms.

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