Disease State Overview

Asthma is a long-term condition that affects the airways in your lungs.  These airways can become inflamed and narrowed.  This makes it harder to move air in and out of the lungs.  It can affect people of all ages, although it often begins in childhood.  Certain things – called triggers – can worsen asthma symptoms.  When symptoms suddenly get worse, you may have an asthma attack.

There are several types of asthma, and each may require different treatment or management strategies.  These include:

• Allergic asthma.
• Aspirin-induced asthma.
• Cough-variant asthma.
• Exercise-induced asthma.
• Nighttime (or nocturnal) asthma.
• Steroid-resistant asthma.
• Occupational asthma (related to workplace exposure).

Experts have started to recognize the impact of inflammation in asthma.  Four biological pathways of inflammation have been identified: eosinophilic, neutrophilic, mixed eosinophilic and neutrophilic, and non-inflammatory.  

When asthma does not improve with long-term controller medications, it may be a sign of severe asthma.  There are two main types of severe asthma: Type-2 inflammation and Non-Type-2 inflammation.  

Eosinophilic asthma is the most common form of Type-2 severe asthma. It occurs when a type of white blood cell called an eosinophil builds up in the airways, driving inflammation. Patients with eosinophilic and other Type-2 severe asthma tend to respond well to biologic medications. These treatments target specific parts of the immune system driving the inflammation and may be obtained through your specialty pharmacy.

Related Health Symptoms and Health Concerns

Asthma can cause a variety of breathing problems.  Common symptoms include:

• Wheezing (a whistling sound when you breathe).
• Coughing.
• Shortness of breath.
• A feeling of tightness in your chest.

For some people, an asthma attack may begin with a cough that doesn’t go away.  Your chest may start to feel tight — some people describe it as having the air “sucked out” of them.  You may also begin to wheeze or feel lightheaded. 

Having and following your asthma action plan is very important.  It helps to know what steps to take when symptoms start, when to use your rescue medication, and when to seek emergency care. 

Call 9-1-1 right away if you are struggling to breathe, your symptoms are getting worse quickly, or your rescue inhaler is not helping.  

Treatment

While there is no cure for asthma, there are many treatments that can help you manage your symptoms and live a healthy, active life.  Treatment usually includes monitoring your breathing, avoiding triggers, and using medications to both prevent and treat symptoms.

Most people use a combination of medications to keep their asthma under control. You may have a quick relief (rescue) medication to help stop symptoms and a long-term control medication to help prevent symptoms from happening in the first place.

The types of medications include:

• Bronchodilators.
• Corticosteroids (steroids).
• Anticholinergics.
• Biologics.
• Antibiotics.

Treatment Goals

A few primary goals of treating severe asthma, including eosinophilic asthma, are things your pharmacist will check in on:

• Condition that’s improving or staying stable — not getting worse over time
• Fewer asthma attacks or exacerbations and less need for your rescue inhaler
• Staying on track with your treatment plan — taking your controller and/or biologic therapy consistently as prescribed helps reduce airway inflammation and prevent attacks before they start

Your Medication Guide

Your prescription comes with a medication guide specific to your prescribed therapy. Refer to it for:

• How to take or receive your specific medication and for how long.
• What to do if you miss a dose.
• Side effects specific to your medication and how to help prevent or manage them.
• Safe handling, storage, and disposal instructions.
• Precautions and contraindications specific to your medication.

Ask your pharmacist if you have questions about your medication guide or can’t find the information you need.

Tell Your Care Team About Any New or Changed Medications

Always tell your pharmacist and prescriber about any new prescription, over-the-counter (OTC) medication, vitamin, or supplement you start — even if it seems unrelated to your asthma. Some medications can worsen asthma symptoms, so keeping your full medication list current with your care team is important.

Vaccinations

Ask your pharmacist or care team about getting your annual flu vaccine and staying up to date on pneumonia vaccination — these are specifically recommended for people with asthma because respiratory infections can trigger or worsen asthma attacks. If you’re on a biologic therapy, your care team can also advise on any additional vaccination timing considerations specific to your treatment.

Strategies to Achieve Treatment Goals

• Have an asthma action plan and follow it.
• Adhere to your therapy.
• Monitor and follow up with your physician.
• Know and reduce asthma triggers.
• Report attacks, exacerbations, or increased rescue inhaler use to your pharmacist and healthcare team right away.
• Report any new or changed medications, including OTC products and supplements, to your pharmacist and healthcare team.
• Reduce the risk of additional lung damage through smoking cessation.
• Stay current on flu and pneumonia vaccines.
• Appropriately manage other underlying diseases such as allergies, high blood pressure, or anxiety.

Additional resources

• https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/types/severe-asthma
• https://www.nhlbi.nih.gov/health/asthma

Disclaimers

• The information provided in this post is for general educational and informational purposes only and does not constitute medical advice. Always seek the advice of a qualified physician, pharmacist, or other healthcare provider with any questions you may have regarding a medical condition or treatment.
• VytlOne uses AI responsibly and ethically in support of our editorial work. AI tools may assist with idea generation, outlining, drafting, and editing across a range of materials. All content – regardless of whether AI assists in its creation – is reviewed by marketing, clinical, and legal teams and governed by our editorial standards.

Rheumatology – Chronic Inflammatory Disease 

Ankylosing Spondylitis (AS),  Psoriatic Arthritis (PsA), Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE), Systemic Juvenile Idiopathic Arthritis (sJIA)

Disease State Overview

Chronic inflammatory diseases cause long-lasting inflammation in the body. This inflammation can hurt healthy cells and tissues over time.  Many areas of the body can be affected including, but not limited to, the digestive system, joints, skin, and respiratory system. Researchers believe that these conditions may be related to an overactive immune system, but they need more research to understand what triggers this disruption of the immune system. 

The term rheumatism describes many conditions that cause inflammation in the joints, muscles, and connective tissues.  It includes a wide range of diseases such as ankylosing spondylitis (AS), psoriatic arthritis (PsA), rheumatoid arthritis (RA), systemic juvenile idiopathic arthritis (sJIA), and systemic lupus erythematosus (SLE). The most common symptom of joint-related rheumatologic conditions is joint pain. Joints may also feel warm, tender, stiff, or swollen. Other symptoms may include feeling unusually tired, having low energy, occasional fevers, loss of appetite, skin rashes, and vision changes. In most cases, these conditions happen in cycles. There are times when symptoms are worse. These are called flares. When symptoms let up and feel better, it is called remission.

Related Symptoms and Health Concerns

If left untreated:

• Inflammation can lead to permanent joint damage or deformity.
• Physical disability, making everyday activities and work harder.
• Negative effect on mental and social well-being.
• Increased risk of heart, lung, and kidney problems.
• Increased risk of uveitis, which can cause eye pain, sensitivity to light, and blurry vision.

Treatment

Most chronic inflammatory diseases have no cure. Lifestyle changes and early treatment may help manage and prevent complications. Treatment largely depends on how severe the symptoms are. Research shows that people with RA who are diagnosed early and treated aggressively do better over the long term.

Topical creams or ointments as well as nonsteroidal anti-inflammatory drugs (NSAIDs) may help with pain and reduce inflammation. If symptoms are widespread, more aggressive treatment may be needed. Depending on the diagnosis, treatment options may include immunosuppressive therapies, like steroids, disease-modifying antirheumatic drugs (DMARDs), or immunomodulators.  Immunomodulators may help decrease the body’s hyperactive immune response in the skin, joints, and other organs. Suppressing inflammation not only offers relief from common symptoms, but it also allows tissues to heal.

Specialty medications used to treat chronic inflammatory rheumatologic conditions include, but are not limited to:

• Oral immunomodulators.
• Injectable immunomodulator therapies.

Treatment Goals

A few main treatment goals are things your care team will check in on and that you can notice for yourself, too:

• Disease-specific symptoms that are improving or better managed — your pharmacist will check in on and monitor symptoms specific to your condition (such as joint pain and stiffness)
• Overall condition that’s improving or staying stable — not getting worse over time
• Staying on track with your treatment plan — taking your medicine on a consistent basis as prescribed helps reduce flares and prevent long-term complications

Your Medication Guide

Your prescription comes with a medication guide specific to your prescribed therapy. Refer to it for:

• How to take or get your specific medication and for how long.
• What to do if you miss a dose.
• Side effects specific to your medication and how to help prevent or manage them.
• Safe handling, storage, and disposal instructions.
• Precautions and contraindications specific to your medicine.

Ask your pharmacist if you have questions about your medication guide or can’t find the information you need.

Tell Your Care Team About Any New or Changed Medications

Always tell your pharmacist and prescriber about any new prescription, over-the-counter (OTC) medication, vitamin, or supplement you start — even if it doesn’t seem related to your condition. . Keeping your full medication list current with your care team helps avoid interactions and keeps your treatment safe and effective.

Vaccinations

Ask your pharmacist or care team about your vaccination status before starting or during treatment. This is especially important if you are taking an immunosuppressive or immunomodulator therapy — your care team can advise on timing and whether any vaccines, including live vaccines, should be avoided or prioritized before or during treatment.

Strategies to Achieve Treatment Goals

• Stay on your therapy.
• Keep appointments and follow up with your physician.
• Report side effects or unmanaged symptoms to your pharmacist or healthcare team right away.
• Report any new or changed medications, including OTC products and supplements, to your pharmacist and healthcare team.
• Avoid known triggers, such as cigarette smoke, drinking lots of alcohol, and food sensitivities.
• Practice stress management and relaxation techniques.
• Exercise on a regular basis and engage in physical activity programs.
• Eat a healthy diet and stay at a healthy weight.
• Talk about your vaccination status with your care team, especially before starting or changing therapy.

Sources

• • https://www.cdc.gov/arthritis/rheumatoid-arthritis/
  • https://www.niams.nih.gov/health-topics/rheumatoid-arthritis
  • https://www.niams.nih.gov/health-topics/ankylosing-spondylitis
  • https://www.hopkinsmedicine.org/health/conditions-and-diseases/ankylosing-spondylitis
  • https://www.niams.nih.gov/health-topics/psoriatic-arthritis
  • https://www.niams.nih.gov/health-topics/juvenile-arthritis
  • https://www.cdc.gov/lupus/about/index.html