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Treating Asthma: Personalized Medicine

Are you getting care that's right for your body, your age, and your background?
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WebMD Feature

A lot of people think that treating asthma is simple: when you start wheezing, just take a puff from a rescue inhaler.

But it's not so straightforward for most people. Every case of asthma is different and the disease can take many forms. So each person's treatment needs to be different too. The medicines that work for your relative or your friend or your neighbor may not work for you.

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"Every person who has been diagnosed with asthma needs a treatment plan that's custom-tailored to his or her specific needs," says allergist Jonathan A. Bernstein, MD, associate professor of clinical medicine at the University of Cincinnati College of Medicine.

What's more, your asthma treatment may need to be adjusted regularly. Because the disease is constantly changing -- along with your life and related influences -- the treatment that once worked very well may no longer be the best choice.

"Your past experience of asthma isn't always predictive of what your asthma will be like in the future," says Hugh H. Windom, MD, associate clinical professor of immunology at the University of South Florida, Tampa. And as your symptoms change, your treatment needs to keep up.

So it's key that you and your doctor develop a personalized treatment program. When it comes to asthma treatment, one size does not fit all.

Misunderstanding Asthma

Many people with asthma only think about it when they are having an attack. But controlling asthma does not just mean treating flare-ups with a rescue inhaler. It's not like taking aspirin for the occasional headache.

"If you're just using a bronchodilator -- a rescue medicine -- you're not dealing with the real disease," Bernstein tells WebMD. "You're not treating the underlying inflammation in the airways."

Michael S. Blaiss, MD, past president of the American College of Allergy, Asthma & Immunology, says that some people don't really understand asthma.

"Many people -- and some doctors -- still don't realize that asthma is a chronic disease," he says. "It's still there even when you're feeling well."

In fact, the inflammation in the airways can worsen without causing any symptoms -- only lung function tests may detect it, says Bernstein. Even if you do have worsening symptoms, the changes may happen so slowly that you don't notice.

"As with any chronic disease, people get used to their asthma," says Windom. "They think living with debilitating symptoms is normal."

Studies bear this out. According to the Asthma and Allergy Foundation, the majority of people with asthma (88%) said that their condition was "under control." But doctors would disagree. Of the patients polled, 50% said that asthma made them stop exercising, and 48% said that it woke them at night. If your asthma is under control, you should not be having these problems.

"I explain to my patients that asthma is really more like diabetes or hypertension," says Blaiss, who is also clinical professor of pediatrics and medicine at the University of Tennessee Health Science Center, Memphis. "We can't cure it, but we can control it with the right daily medication."

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