The prevalence of severe asthma in women is twice that of men

The severe asthma is not a common phenomenon, but those who struggle with this form require special attention and treatment. It affects only a small fraction of asthma sufferers; however, a significant portion of treatment costs arises from these severe cases. Severe asthma not only impacts the health of patients but also their quality of life, as frequent exacerbations and complications of the disease can even lead to fatal outcomes.

Respiratory professional organizations, such as the European Respiratory Society and the American Thoracic Society, have provided a precise definition regarding the treatment of severe asthma. According to this, severe asthma is a condition that requires high doses of inhaled corticosteroids or systemic corticosteroids, or it needs to be treated with other asthma medications. Based on the latest guidelines from the Global Initiative for Asthma, difficult-to-treat asthma falls under the subgroup of severe asthma, where the disease remains uncontrolled despite appropriate treatment. Various factors may contribute to this, such as improper inhalation technique or non-adherence to medication.

To gain a precise understanding of the prevalence of severe asthma, Hungarian researchers have created a database that collects information on patients treated in lung clinics. The 156 institutions operating within the national lung clinic network provide annual data on the prevalence of various lung diseases, including the situation of asthma. As a result, it was found that the prevalence of severe asthma in the Hungarian asthmatic population is 0.89%. The average age of the examined patients is 56.4 years, and surprisingly, the proportion of female patients is nearly twice that of males.

The research also examined the prevalence of salicylate intolerance and rhinosinusitis. Among those living with salicylate intolerance, systemic corticosteroid treatment was used more frequently, and the rate of salicylate intolerance was significantly higher among women. Additionally, respiratory limitation affected 72.1% of those suffering from severe asthma, while severe airway obstruction was observed in 37.9% of the patients. Interestingly, allergic reactions were much more common among those who developed asthma in childhood compared to those with adult-onset asthma.

The causes and characteristics of severe asthma

There are several underlying causes of severe asthma, some of which directly influence the course of the disease. Primary factors include genetic predisposition, environmental effects, and the presence of comorbidities. Genetic predisposition means that certain individuals may be more susceptible to developing the disease, while environmental factors such as polluted air, smoking, or allergens can exacerbate symptoms.

Comorbidities, such as rhinosinusitis, also play a significant role in the development of severe asthma. In middle-aged women, salicylate intolerance occurs more frequently, which can worsen asthma symptoms and the effectiveness of treatment. Additionally, improper inhalation technique or neglecting medication therapy can also contribute to the worsening of the disease.

A characteristic of severe asthma is that it is not easily treatable, and symptoms often worsen, particularly due to respiratory limitation. As a result of airway inflammation and narrowing, patients experience difficulty breathing, which significantly impacts their quality of life. Consequently, those suffering from severe asthma often experience severe exacerbations that may require hospitalization.

Treatment of severe asthma

The treatment of severe asthma is a complex task that requires professional guidance. The first step is to establish an accurate diagnosis, which involves a thorough review of the patient’s medical history and symptoms. Treatment options include medication therapy, breathing exercises, and educating the patient on proper inhalation techniques.

In medication treatment, inhaled corticosteroids are generally the first choice, as they help reduce inflammation in the airways. However, in severe cases, systemic corticosteroids may also be necessary. It is crucial for patients to adhere to the medication regimen prescribed by their doctor, as neglecting therapy can lead to severe complications.

Furthermore, patient education is essential, as improper inhalation technique can significantly affect the effectiveness of treatment. Minimizing environmental factors, such as polluted air and avoiding allergens, is also part of asthma management, so patients are advised to create an asthma-friendly environment.

Breathing exercises, such as diaphragmatic breathing, can also help alleviate breathing difficulties. Mastering these techniques can contribute to patients’ independence and improve their quality of life. Therefore, the treatment of severe asthma requires a multidisciplinary approach, which also necessitates the active participation of patients.