Symptoms
Common symptoms are wheeze, cough, breathlessness and chest tightness. They may be worse at night, with exercise or after exposure to triggers. Similar symptoms can occur with other conditions, so symptoms alone do not confirm asthma.
How is it diagnosed?
Diagnosis combines a clinical history with objective testing. Tests may include blood eosinophils, a breath test for airway inflammation called FeNO, spirometry or full lung function tests before and after an airway-opening medicine, or peak-flow measurements over time. Further tests may be needed if results are inconclusive. Tell the clinician which inhalers you use, as treatment can affect results; only change medicines on their advice.
How is it treated?
Treatment should address airway inflammation as well as symptoms. Current guidance includes inhaled corticosteroid/formoterol used as an anti-inflammatory reliever (AIR), or as regular maintenance and reliever therapy (MART), depending on your needs. Not every combination inhaler is suitable for these regimens. Your clinician will explain exactly which inhaler to use and how.
A written asthma action plan, good inhaler technique and regular reviews are important. If control remains poor, your team will review the diagnosis, triggers, inhaler use and other conditions before considering additional treatment or specialist severe-asthma assessment.
Biologic treatments for severe asthma
Biologics are targeted antibody medicines, usually given by injection every few weeks, for selected adults with severe asthma that remains uncontrolled despite optimised treatment. They act on specific inflammatory pathways, such as IgE, interleukin-5, IL-4/IL-13 or TSLP. They can reduce asthma attacks and, for some people, the need for steroid tablets. They are added to inhaled treatment, not used instead of it, and are not a rescue treatment for an attack.
Before a biologic is considered, the diagnosis is confirmed and inhaler technique, adherence, triggers and other conditions are reviewed. Blood eosinophils, FeNO, IgE and allergy tests help identify the inflammatory pattern and the most suitable medicine. Response is reviewed regularly against agreed goals.
Dr Knight regularly manages patients receiving biologics for both asthma and COPD, including assessment for treatment, choosing a medicine and reviewing response. Depending on your insurance, funding and eligibility, treatment may be provided privately or through an NHS specialist service.
Read our detailed guide to biologics in asthma, including the clinical trial evidence.
When to get urgent help
Follow your prescribed asthma action plan. Call 999 for severe breathing difficulty, inability to speak normally, or a rapidly worsening attack. Do not wait for a routine clinic appointment.
Sources and further information
This guide gives general information for adults and does not replace individual medical advice.