Eosinophilic asthma is a subtype of asthma that often develops later in life. The average age of onset is between 35 and 50 years old. It can develop in people who haven’t been previously diagnosed with asthma.
This type of asthma is caused by an influx of eosinophil blood cells. While the exact cause is unknown, eosinophils can contribute to airway inflammation and constriction seen in traditional forms of asthma.
Eosinophilic asthma may pose more severe symptoms than mild forms of asthma. You may also have more frequent flare-ups. Treatment options are similar to milder asthma, but your exact therapies are often more aggressive.
Talk to your doctor about the following options used in treating this type of asthma.
Inhaled corticosteroids are often the first line of treatment for persistent forms of, including eosinophilic, asthma. They work by reducing airway inflammation that contributes to constriction, which enables you to breathe easier.
You may also need some versions of corticosteroids for eosinophilic asthma by mouth if your symptoms are more severe.
However, oral steroids pose the risk of long-term side effects, including:
- weight gain
- diabetes mellitus
These oral medications are often prescribed for people who have both asthma and allergies. They work by reducing leukotrienes in the body, which contribute to inflammation.
Your doctor may prescribe one of the following:
- montelukast sodium (Singulair)
- zafirlukast (Accolate)
- zileuton (Zyflo)
Biologics are an emerging form of severe asthma treatment. These medications are delivered via an injection, typically by your doctor. They reduce inflammation by targeting inflammatory molecules, cells, and antibodies.
For this reason, biologics are considered to provide more “personalized” treatment compared to other asthma medications.
You may be a candidate for biologics if you continue to have flare-ups on a regular basis despite taking your controller medications and avoiding triggers.
Biologics may also alleviate nighttime asthma, as well as decrease the number of hospital visits from asthma attacks.
There are currently five types of biologics available for severe asthma treatment:
- benralizumab (Fasenra)
- dupilumab (Dupixent)
- mepolizumab (Nucala)
- omalizumab (Xolair)
- reslizumab (Cinqair)
Of these biologics, Fasenra, Nucala, and Cinqair all target eosinophils specifically. More biologics are in development for more targeted treatment.
If your doctor recommends biologics for your eosinophilic asthma, you may expect to get these injections every 2 to 8 weeks over the course of at least 4 months.
While not a long-term type of treatment, it’s still a good idea to have a rescue inhaler on hand if you have eosinophilic asthma.
Also called a quick-relief inhaler, these medications work by alleviating symptoms of flare-ups and opening your airways to help prevent an asthma attack.
The problem with rescue inhalers is that they won’t prevent asthma symptoms as long-term controllers do. Relying on these types of inhalers too often may also make them less effective because your lungs will become accustomed to them.
Call your doctor if you’re using your rescue inhaler more than a few times per week.
Anticholinergics are medications that block a neurotransmitter called acetylcholine. These drugs traditionally treat incontinence and overactive bladder, as well as chronic obstructive pulmonary disease (COPD).
These types of medications may also help treat severe asthma. Anticholinergics relax airway muscles and help you breathe easier.
Taking these medications might also make it less likely that you’ll need oral steroids over the long term.
Eosinophilic asthma is one of the most difficult subtypes of asthma to treat. You’ll likely need to try a variety of options to see what works best.
Your asthma is considered “well-controlled” if you have symptoms 2 days per week or fewer.
Talk to your doctor if you experience asthma symptoms regularly and if your condition interferes with everyday activities. They may prescribe stronger long-term medication or biologics to help improve your symptoms and quality of life.
Managing the symptoms of eosinophilic asthma could help reduce your risk for lung scarring and other long-term complications.
You can also improve your treatment outcome by taking care of your overall health as much as possible, including:
- healthy eating
- adequate sleep
- stress management
Avoiding triggers, such as stress, allergies, and chemical irritants, may also reduce your risk for flare-ups.