Treatment for eosinophilic asthma helps address inflammation due to high levels of a type of white blood cell, called eosinophils, in the airways.
Eosinophilic asthma, also known as e-asthma or eos asthma, is a serious subtype of asthma that links with an increased number of eosinophils in the lungs and airways.
Eosinophilic asthma often begins in adulthood, but it can also affect children. Researchers do not yet know the exact prevalence of eosinophilic asthma, but it may account for around 50% of people with asthma.
Due to the severity of this condition, it can potentially lower a person’s quality of life. However, treatments can help reduce the amount of eosinophils in the airways and help improve breathing and other symptoms.
This article reviews the different treatment options for people living with eosinophilic asthma, including corticosteroids, leukotriene modifiers, biologics, rescue inhalers, and anticholinergics.
Corticosteroids are a type of steroid available as both oral and inhaler medications. They can cause mild to severe side effects that people should discuss with a doctor.
Research indicates that the use and effectiveness of corticosteroids in treating eosinophilic asthma can be inconsistent. The Asthma and Allergy Foundation of America (AAFA) notes that inhaled corticosteroids may not prove effective for some people with this asthma subtype.
An older study from 2010 notes that people with eosinophilic asthma responded most to inhaled corticosteroids. However, they also found that using the inhaled steroid could cause misidentification of the subtype of asthma a person has if they develop the condition later in life. Smoking also produces the same potential misidentification, according to the study.
If a doctor prescribes corticosteroids, they will likely be in the form of an inhaled controller medication. Controller medications help prevent the onset of asthma symptoms over long periods.
Some common side effects of corticosteroids include:
- a cough
- oral thrush
- a sore throat
Leukotriene modifiers provide preventive, long-term treatment for asthma. They are not a form of rescue medication.
The oral forms available for asthma include:
- montelukast (Singulair)
- zileuton (Zyflo)
- zafirlukast (Accolate)
- a cough
- abdominal pain
- influenza infection
- suicidal thoughts
- trouble sleeping
In children, it can cause:
- viral infections
- pharyngitis, a sore throat
Biologics are a type of medication made from proteins and other living components. They are a type of targeted therapy that can help find and block inflammatory processes within the immune system. Doctors also sometimes call biologics “monoclonal antibody therapy.”
The current biologics available for eosinophilic asthma include:
Another type of biologic, omalizumab, works well for many other children and adults with asthma, but it has not received FDA approval to treat eosinophilic asthma.
Doctors inject biologics or introduce them to the bloodstream directly through a needle or intravenous (IV) line. Though generally effective and safe, they can cause side effects, such as:
- sinus infections
- conjunctivitis, also known as pink eye
- cold-like symptoms
- irritation at the injection site
Rescue inhalers provide fast-acting medication to reduce swelling in the airways, allowing a person going through an asthma attack to breathe again. They deliver a medication known as bronchodilators directly to the lungs.
Doctors typically prescribe rescue inhalers or quick-relief medicine alongside controller medications for an acute attack. A person typically carries a rescue inhaler with them at all times to provide immediate, emergency treatment if they have an attack.
Though generally safe and effective, they may cause side effects, such as:
- a rapid heart rate
- feeling shaky or anxious
Anticholinergics are used in both asthma and chronic obstructive pulmonary disease (COPD) and
Anticholinergics are a type of bronchodilator that comes in both short-acting and long-acting formulas. Examples include ipratropium and tiotropium. Most people can take anticholinergics as an inhaled medication, but others may use them in a nebulizer.
Though generally safe, the medications can cause some side effects, particularly in children. Children may experience reduced growth and bone density.
Some common side effects may include:
- a cough
- dry mouth
Eosinophilic asthma is a severe form of asthma that often starts in adulthood. Several treatments may help a person improve their quality of life, prevent symptoms, and provide emergency, rescue treatment.
Though most medications can be effective and generally safe, they can all cause side effects. A person should discuss their treatment options and let a doctor know if they experience unwanted side effects from medication use.