Britain has one of the highest asthma attack death rates in Europe.
Latest figures show we are now the sixth worst out of 33 countries.
While death rates have gone down in most, here they’ve shot up by 20% over the last five years.
Experts blame a lack of basic NHS care and poor awareness of the seriousness of the condition.
It’s believed that two-thirds of around 1,500 deaths a year could be avoided.
But Dr Andy Whittamore, Clinical Lead at Asthma UK, says there is hope on the horizon – in the shape of smartphone health apps, smart inhalers and research into groundbreaking drugs.
The condition has many different triggers – from dust mites and tobacco smoke to air pollution and family pets – and it can change in intensity.
“Asthma can vary across a person’s lifetime, and attacks can be sudden, unpredictable and life-threatening,” Dr Whittamore says.
Inhalers were revolutionary in coping with the illness when they became routinely available in the 70s, but there is still a lot of room for improvement if the death rates are to be cut, he says.
“Progress has not been as fast with asthma as with other long-term conditions, which is why more funding and research is needed to find better treatments, better diagnostic tools and, ultimately, a cure for asthma,” explains Dr Whittamore.
He says there is no “one size fits all” approach to asthma care, and he believes that sufferers’ best chance of avoiding a killer attack lies in breakthroughs in medication and technology, which can help them manage their condition more effectively.
Technology
Smartphone health apps could become a valuable weapon in the fight against asthma, says Dr Whittamore. They can remind people to take their medications, track whether they are taking them regularly and, in future, could communicate this information to their GP or asthma nurse.
Apps could also give information on how to avoid triggers such as air pollution or pollen.
They could also be used to keep track of asthmatics’ symptoms and peak flow, which measures how quickly someone can blow air out of their lungs.
The Asthma UKs WhatsApp Chat Helpline is already working as a new way for specialist nurses to provide one-to-one advice and support for people with asthma.
The service launched in mid-March and allows people with asthma to contact the charity’s nurses with any questions they have about their condition, such as taking their medications or understanding asthma triggers.
So far nearly 300 people with asthma have used the service.
Many sufferers may not have time in their busy lives to call a helpline, and some people feel more comfortable talking about difficult issues using a messaging app than they would discussing them over a phone.
In the near future, the latest technology may even be able to detect when sufferers’ asthma is getting worse, so they can respond quickly to prevent an attack.
Smart inhalers are still some way off being publicly available – but that day can’t come soon enough.
Dr Whittamore says: “They are devices with sensors that attach to existing inhalers and record when they’re used. The data can be sent wirelessly to your smartphone so you have a vital record tracking your usage.
“And it could also be shared with your GP, asthma nurse or hospital team to help tailor care to your needs.
“Knowing when and where your symptoms flare up may help identify personal triggers and allow a more individually tailored self-management plan.”
Artificial Intelligence (AI) could also be used in the future to predict the likelihood of attacks before they happen and offer helpful health advice to sufferers around the clock.
Medication
There are currently around a quarter of a million people in the UK with a diagnosis of severe asthma, which means that regular treatments don’t work for them, says Dr Whittamore.
Medication options for people with severe asthma are extremely limited.
Most rely on high-dose oral steroids which can have serious side effects, including diabetes, osteoporosis (thinning of the bones) and depression if taken long-term. And even with these drastic medications, some sufferers find their asthma hard to control.
But scientists are working on new treatments for severe asthma, many through research programmes supported by Asthma UK.
The latest types of medicine used to treat it are monoclonal antibodies – known as MABs – which help keep specific types of the condition under control.
Names to look out for are Xolair (omalizumab), which has been available for some time, and newer ones such as Nucala (mepolizumab) and Cinqaero (reslizumab).
But it is becoming clear that asthma is not one condition, but a cluster of respiratory conditions – and unfortunately not all MABs will be effective for everyone.
This is why experts say urgent research is needed to understand the biology of asthma and work towards new and better treatments for different types of the illness.
Meanwhile, Dr Whittamore emphasises it’s vital that patients attend their annual asthma check-up and ensure they have a written action plan. They should also be constantly aware of signs their asthma is getting worse.
“And patients should also always carry around their blue reliever inhaler with them just in case,” he says. “Ideally they won’t need to use it, but they should keep it to hand in case a trigger catches them unawares.”
Research
Asthma UK funds world-leading research at the cutting edge of science to understand the biology of asthma, work towards better treatments and a cure, and to improve diagnosis and the care that people with asthma receive.
Worms
- Research led by the University of Edinburgh and funded by Asthma UK found that parasitic worms that live in the intestines, known as roundworms, release a protein molecule called HpARI which prevents its host from having an allergic reaction.
- Asthma attacks are often triggered by allergies such as pollen, pets and house dust mites, so finding a way to dampen this allergic reaction could stop sufferers’ airways from becoming inflamed. This could prevent potentially life-threatening flare-ups.
Circadian (24-hour) rhythm
- Research conducted by Dr Hannah Durrington, Senior Clinical Lecturer and Honorary Respiratory Physician at the University of Manchester, has found that inflammation in the airways – which causes typical asthma symptoms – varies depending on the time of day.
- The results found that the inflammation is worse at around 4am, which could mean certain times of the day are better to take asthma prevention medications which address inflammation.
Vitamin D
- A number of studies have looked into how vitamin D supplements could help asthmatics, including offering protection against attacks. Vitamin D is a promising area of research, and is a fairly cheap dietary supplement, but much more evidence is needed before it is recommended for people with asthma.
The future
The new developments in asthma care, treatments and research are very promising, but there’s a lot more work
to do.
- Drugs for severe asthma still don’t work for everyone with the debilitating condition, so more investment is needed to continue developing better and more targeted treatments. Tests to diagnose asthma have also not kept pace with our understanding of it, and there are still no tests that can accurately diagnose asthma or differentiate between different types of the condition. This means people can be left confused and often on the wrong treatment.
- It’s hoped that with new advances doctors can get closer to stopping asthma attacks and curing it.
Asthma UK funds cutting-edge research into better treatments and a cure, provides online health advice and works with digital health innovators developing digital products for people with asthma. For advice on how to manage your asthma, visit asthma.org.uk
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