Advances in asthma treatment have stalled, prompting University of Newcastle researchers to seek new ways to treat the disease.
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A team of researchers from the university has been awarded $2.5 million from the National Health and Medical Research Council to investigate "personalised approaches to asthma treatment".
Professor Vanessa McDonald said the treatment of asthma had advanced significantly in recent decades before stalling.
"Thirty years ago, we didn't have the kind of treatments we have for asthma now," Professor McDonald said.
"We saw major advances in asthma management due to the introduction of new medicines and self-management education."
These advances included written asthma action plans, the development of inhaled corticosteroids and making sure inhalers were used correctly and as prescribed.
"That's been really effective in terms of helping people manage their asthma. We saw a reduction in asthma deaths and reduced hospitalisations.
"But we're not seeing as impressive gains now. In some countries, asthma death rates are actually increasing. So it's a real concern because asthma is a treatable disease."
About one in nine Australians have asthma. These people stand to benefit from the work of Professor McDonald's team at the Hunter Medical Research Institute.
The team forms part of a new centre of excellence for asthma that is focusing on "treatable traits".
"It's a new strategy that's been proposed for the management of not only asthma but other airway diseases like COPD," Professor McDonald said.
"This will allow us to take into account everything that's going on with the patient."
Professor McDonald said behaviour and lifestyle play an important role in asthma.
"Asthma is not just about the lungs," she said.
"When we treat asthma we essentially treat what's going on in the lungs. But for so many people, it's much more than that. Lots of other things impact people's ability to achieve appropriate asthma control."
Behaviour can be a difficult factor because significant change is needed from patients and clinicians.
Asthma patients already experience gaps in treatment among GPs who aren't aware of the latest treatments or don't have the time to properly discuss options. This is despite the latest science proving that a one-size-fits-all approach to asthma management is no longer valid.
Professor McDonald said the centre of excellence would examine the different types of asthma and the settings in which the disease was managed.
"There are people with fairly mild to moderate asthma, more difficult to treat asthma and severe refractory asthma," she said.
"Those different groups tend to have different needs and are treated in different settings. We want to be able to improve the outcomes for people with asthma, irrespective of the setting they're being treated in."
She said biomarkers would be used to guide treatment.
"This can actually help define what type of asthma medication someone needs for their airway inflammation," she said.
Screening tests would be done for conditions like anxiety and depression, "so those things can also be incorporated within treatment plans".
Dealing with asthma symptoms on a daily basis can lead to "psychological distress", causing or worsening anxiety and depression.
She said anxiety and depression were more prevalent in people with severe asthma than the general population.
This doesn't mean anxiety and depression are symptoms of asthma, but "there might be some overlapping symptoms that are very hard to differentiate".
"With anxiety and depression, you get chest tightness and breathlessness. They're very similar symptoms to asthma," she said.
Other traits that can be misattributed to asthma are conditions like vocal cord dysfunction and dysfunctional breathing.
"Every person with asthma is different. That's why we need this personalised approach. We need to understand what's going on in the whole individual and then focus on treating those traits," she said.
"So the treatment might be medicine, but it might also be exercise, weight loss or breathing techniques."
The team will examine a broad range of factors that "influence an individual's expression of asthma" and test tailored treatments.
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