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YOUR HEALTH: The asthma-allergy double whammy

Asthma is the most common chronic condition among kids, but what happens when you add allergies to the mix?

PHILADELPHIA — Asthma is the third-leading cause of hospitalization among those under the age of 15. If a child with asthma also has allergies, it's a double whammy.

Tayonni "Onni" Westbrooks had problems doing the physical activities she loves because of her lifetime reactions to asthma and allergies. From the time Onni was one month old, she had trouble breathing.

"It was terrifying. I thought my baby was gonna die," her mother LaToya said.

LaToya took her to countless doctors and tried every medication available.

"As she got older, they were trying different injections, different medications," Latoya said. "She was on five inhalers."

Onni was also allergic to dust, grass, pollen, dander and pets.

"You name it, she was allergic to it," LaToya said.

The combination of asthma and allergies would trigger life-threatening reactions. Onni used to be hospitalized almost once a month.

In 2021, the Westbrookses were referred to PAPA: the Pulmonary and Allergy Personalized Asthma Clinic. There, pediatric pulmonologists and allergists worked together to wean Onni off a high volume of steroids.

"We came up with a strategy where we were using a combination inhaler that we used several times a day initially to get her under control," Pediatric Pulmonologist Dr. Jeffrey Ewig said.

"When we did our most recent virtual visit with her, she was actually on a bouncy ball hopping up and down on the bouncy ball throughout the visit," Allergist Dr. Priya Patel said.

Onni's doctors also teach behavioral changes to help her with the steps she can take first before grabbing her inhaler. 

"I take deep breaths," she said. "I do that a couple times, and it helps."

Her mom sees the difference.

"She can be a child, you know," LaToya said, "... and live a normal life."  

Onni's doctors also worked with the family on lifestyle changes and have helped her recognize her allergy triggers to reduce the frequency of attacks.

Latoya said at one time her daughter was prescribed steroids at such a high level that the medication impacted her blood sugar and she was considered pre-diabetic.

With her new personalized treatment, that is no longer the case.

Future trends in asthma treatments

Asthma treatments may be changed by novel monoclonal antibodies targeting cytokines, new asthma guidelines emphasizing precision medicine and real-world evidence on the efficacy of newer asthma drugs.

Research showed promising results on the monoclonal antibodies tezepelumab and astegolimab, both of which showed impressive efficacy in reducing asthma exacerbation rates. 

"The most interesting thing about these drugs is that they are focused on a different aspect, the cytokines, released from the respiratory epithelium, and they did show effectiveness in all comers with severe asthma regardless of their T2 status," said Dr. Jon Romeo, chair of the American College of Allergy, Asthma and Immunology Asthma Committee and pulmonology advisor in Raleigh, North Carolina. 

The FDA's approval of Tezspire could also change asthma care soon. Tezspire is a monoclonal antibody used as an add-on maintenance treatment for patients 12 years of age and older with severe asthma.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

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