Asthma Treatment

How is Asthma Diagnosed?

Asthma is diagnosed by a pulmonologist or respiratory doctor. Diagnosis is made on the basis of medical history, physical examination, spirometry with bronchodilator reversibility testing, and peak expiratory flow measurements.

FeNo testing, allergy evaluation or blood eosinophil testing may help identify the most appropriate treatment approach in selected patients.

How is Asthma Treated Based on Severity?

Treatment for asthma follows a stepwise approach based on its severity, as listed below:

Types of Asthma and Their Treatment

The treatment of asthma is based on its clinical types and the underlying trigger:

Inhaled Treatments (Inhalers) for Asthma

Inhalers provide medication directly to the respiratory tract. They are the basis of asthma treatment and include:

Other Treatments for Asthma

Some people with asthma need more than just an inhaler for treatment. Biologics can be effective in severe type-2 asthma because they target specific inflammatory pathways. Acute attacks may require nebulisation, oxygen or hospitalisation, while allergen immunotherapy may be helpful in allergic asthma. In severe cases, a minimally invasive procedure called bronchial thermoplasty may be recommended.

Note: Use of biologic therapies is recommended in eligible patients with severe uncontrolled asthma despite maximal inhaled therapy, as per Global Initiative for Asthma (GINA) 2024.

Oral Medications for Asthma Treatment

Oral medications for asthma are used in specific circumstances, and supplement inhaled therapy, and include:

• Oral corticosteroids (short courses)

• Leukotriene receptor antagonists (Montelukast)

• Theophylline

• Oral antihistamines (selected patients)

Ayurvedic and Alternative Treatments for Asthma

Some asthma patients explore alternative supportive treatment options to manage their condition. It is important to understand that these should support, not replace, prescribed asthma medication. Some alternative treatments for asthma include:

• Vasaka (Adhatoda Vasica): It is traditionally used for respiratory relief.

• Tulsi and Ginger: Can soothe the airways.

• Yoga & Pranayama: Breathing exercises may help control asthma.

Note: These options are to be used only after consultation with a qualified Ayurveda practitioner and a pulmonologist.

Home Care for Managing Asthma

Good home care keeps asthma under control and lowers the risk of attacks. Some home care tips to manage asthma are:

• Use Inhalers Correctly: Follow the prescribed technique and use a spacer.

• Follow an Action Plan: Keep a written asthma action plan ready.

• Monitor Peak Flow: Track lung function at home regularly.

• Avoid Triggers: Reduce exposure to dust, smoke and allergens.

• Keep Reliever Handy: Carry the reliever inhaler at all times.

Latest Treatment for Asthma

The biggest advancement for severe asthma in recent years is biologic therapy. According to a review article in the Journal of Allergy and Clinical Immunology, dupilumab and tezepelumab now lead new biologic prescriptions. While dupilumab is approved for asthma treatment in India, tezepelumab is still undergoing clinical trials.

Note: Research is underway on newer long-acting biologics that may further reduce exacerbations and dependence on oral steroids.

How Long Does Asthma Treatment Take?

Asthma treatment is usually long-term. The table below shows approximate timelines for different treatments of asthma:

Asthma is a lifelong condition. Treatment is stepped up or down based on the management of the condition and the health of the patient.

Asthma Treatment Side Effects

Most asthma medicines are safe when used correctly. However, some may cause side effects, such as:

• Oral thrush

• Hoarseness

• Tremor

• Palpitations

• Weight gain (long-term oral steroids)

• Bone thinning

• Mood changes

• Injection-site reactions

Lifestyle Changes for Managing Asthma

Some simple lifestyle steps can improve asthma symptoms, such as:

• Quit smoking

• Maintain a healthy body weight

• Exercise safely

• Manage allergies

• Get recommended vaccinations (flu or pneumonia)

Triggers That Can Worsen Symptoms of Asthma

Certain factors can set off asthma symptoms, so it is important to consider them to avoid flare-ups. These include:

• Allergens: Dust mites, pollen, mould and pet dander.

• Air Pollution: Smoke, vehicle fumes and industrial pollutants.

• Respiratory Infections: Colds and flu can trigger symptoms.

• Cold, Dry Air: Sudden weather changes may provoke attacks.

• Exercise: Strenuous activity can cause exercise-induced symptoms.

• Strong Odours and Stress: Perfumes, chemicals and emotional stress.

Asthma Treatment Cost

The treatment cost of asthma in India depends on its severity. Inhalers are the main ongoing expense, which may range between ₹100 to ₹1800 per piece. A pulmonology consultation and spirometry add to initial costs. Treatment for acute attacks requiring nebulisation or hospitalisation is more expensive. Biologics for severe asthma are expensive as well and can run into lakhs per year.

Overall, mild cases of asthma can be managed affordably, while severe cases can cost significantly more.

Does Health Insurance Cover Asthma Treatment in India?

Yes, Most health insurance policies in India cover the treatment cost of asthma, including hospitalisation. Several health insurance for asthma offer day 1 coverage for pre-existing asthma. Therefore, make sure to read the policy terms and conditions carefully. Coverage of ₹5 lakh to ₹10 lakh is usually sufficient to cover hospitalisation expenses for severe asthma.

However, routine outpatient consultations and the cost of inhalers are covered under OPD health insurance.