What Are the Treatments for Eosinophilic Asthma?

Because it's a rare condition, nailing down a diagnosis for eosinophilic asthma can take time. But once doctors reach a conclusion, they turn to treatments specifically focused on this kind of asthma.

When you have eosinophilic asthma, you have a larger than normal number of eosinophils -- or white blood cells that fight diseases -- in your blood, lung tissue, and the mucus you cough up from your respiratory tract. The goal of treatment is to improve and control your asthma symptoms.

Depending on your condition, your doctor may use one of these treatments to prevent asthma attacks and help you breathe easier.

Corticosteroids

These are maintenance drugs, which means they help you maintain normal breathing and prevent asthma symptoms from taking control. Their job is to keep certain cells in the lungs and airways from releasing chemicals that cause asthma attacks to act up.

Inhaled corticosteroids are generally safe and are meant to be used daily. They can be used with another inhaler called a long-acting beta agonist (LABA). The amount you absorb into your bloodstream is small. But doctors suggest you rinse your mouth out after you use them, because having steroids in your mouth can lead to thrush, a fungal condition in your mouth.

But the inhaled versions may not work well in eosinophilic asthma, so you may need to take corticosteroid pills. They have more side effects than the inhaled types.

Fast-Acting Inhalers

Also called bronchodilators or rescue medicine, these medicines open swollen airways quickly, and you can use them with the inhaled corticosteroids. Depending on which kind your doctor prescribes, side effects can include dry mouth, heart palpitations, or nervousness.

Leukotriene Modifiers

Some of the chemicals in your immune system that cause asthma symptoms are called leukotrienes. Eosinophils love to team up with leukotrienes and cause inflammation in your upper and lower airways.

Medicines called leukotriene modifiers -- such as montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo) -- relieve the effects of leukotrienes and ease asthma symptoms. It’s rare, but some people get agitated and anxious when taking these meds. If this happens to you, tell your doctor.

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Biologics

These medicines are made in a lab to act like a human antibody. Unlike inhalers or pills, you get them as shots or by IV infusion. Their job is to block the chemicals that cause inflammation in your lungs. Side effects include soreness at the injection site. It’s rare, but some people could have a severe allergic reaction called anaphylaxis.

The drugs are:

  • Benralizumab (Fasenra)
  • Dupilumab (Dupixent)
  • Mepolizumab (Nucala)
  • Reslizumab (Cinqair)

Bronchial Thermoplasty

Unlike the prescription medication, bronchial thermoplasty is a procedure that's being studied to treat eosinophilic asthma. Your doctor may recommend it if other methods haven't controlled your symptoms. A lung specialist uses a special probe and thermal heat to lessen the smooth muscle in your airways. This keeps the muscles from constricting during an asthma attack. To get the most benefit, bronchial thermoplasty may require multiple procedures over several weeks.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on December 17, 2018

Sources

SOURCES:

Asthma.net: "Asthma Subgroups: Diagnosing, Treating Persistent Eosinophilic Asthma.”

Mayo Clinic: "Eosinophilia."

American Partnership for Eosinophilic Disorders: “Eosinophilic Asthma.”

Mayo Clinic: "Corticosteroid (Inhalation Route)."

Albert A. Rizzo, MD, senior medical advisor to the American Lung Association; section chief of pulmonary medicine, Christiana Care Health System, Newark, DE.

Mayo Clinic: "Oral Thrush."

Mayo Clinic: "Anaphylaxis."

Mayo Clinic: "Asthma."

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