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Expert Q&A

Prevalence and Management of Allergic Asthma

Asthma is one of the most common respiratory diseases in the United States, and most people with asthma are successfully managed in the primary care setting.1

Consultant360 reached out to Payel Gupta, MD, to learn more about the difference between allergic asthma and non-allergic asthma, including the symptoms, common comorbidities, prevalence, and management of allergic asthma.

Dr Gupta is an allergy, asthma, and immunology specialist affiliated with Mount Sinai Hospital and SUNY Downstate Medical Center in New York, New York. She is also a co-founder and the chief medical officer of getcleared.com and a volunteer national spokesperson for the American Lung Association.

Consultant360: What is allergic asthma?

PG: Asthma is triggered or made worse by different things like exercise, cigarette smoke, stress, and environmental allergens.

When someone has allergic asthma, that means their asthma is triggered by their environmental allergies. Environmental allergies include dust mites, pollen, mold, cockroaches, or animals, such as a cat or a dog.

Allergic asthma and other forms of asthma have the same symptoms. These symptoms include cough, chest tightness, wheezing, and shortness of breath, rhinitis, epiphora, and sinus pressure. 

C360: What are the risk factors of allergic asthma?

Dr Payal PG: If your patient has a family history of allergies or asthma, your patient is more likely to develop asthma. In addition, if your patient has environmental allergies of the eyes, nose, or skin, your patient has a higher risk of developing asthma.

Smoking, exposure to smoke, exposure to air pollution, obesity, or work exposures, such as chemical fumes, vapors, molds, industrial dust, or wood dust can cause asthma to develop.

Common comorbidities associated with allergic asthma include allergies of the eyes, nose and/or skin. 

C360: What is the prevalence of allergic asthma in children and in adults?

PG: Approximately 235 million people worldwide have asthma. In the United States, the condition affects an estimated 8% of the population. In nearly 90% of children and 50% of adults with asthma, the condition is classified as allergic asthma.2

The difference between allergic asthma and non-allergic asthma is that allergic asthma is triggered by allergies, and non-allergic asthma is not affected by environmental allergies. 

C360: How should allergic asthma be managed?

PG: Allergic asthma should be managed like other forms of asthma with appropriate reliever medications and controller medications. Your patients with allergic asthma will also need to be aware of their allergic triggers and control for what they are allergic to or manage them with immunotherapy. To find out what your patient is allergic to, you can do a skin-prick test. The results of the test will be available after 15-minutes, or you can perform a blood test. Knowing what your patient is allergic to can help your patient manage symptoms by reducing exposure to allergens or starting allergy immunotherapy.

There are 2 allergy immunotherapy options: allergen-specific immunotherapy and sublingual tablets. Both treatments are approved by the US Food and Drug Administration. Allergy immunotherapy uses natural allergen substances, such as pollen from plants or pet dander from animals, to gradually expose the immune system to the allergen. The body gets used to the allergen over time and becomes less sensitive to the allergen, therefore reducing the symptoms of allergy when the person is exposed. This way, your patient’s body will stop overreacting to the allergen and will experience fewer symptoms, such as rhinitis, epiphora, and sinus pressure. 

References:

  1. Wu TD, Brigham EP, McCormack MC. Asthma in the primary care setting. Med Clin North Am. 2019;103(3):435-452. doi:10.1016/j.mcna.2018.12.004
  2. Asthma. MedlinePlus. Updated October 28, 2021. Accessed February 22, 2022. https://medlineplus.gov/asthma.html