Anne M. Ditto, MD: Therapies for Different Asthma Phenotypes

Anne M. Ditto, MD, a professor of allergy and immunology at Northwestern University's Feinberg School of Medicine, sat with MD Magazine to discuss the current state of therapies for the differing phenotypes of patients with asthma that exist. She also discussed therapies in the pipeline that could and will be used to treat these patients in the future.

Anne M. Ditto, MD, a professor of allergy and immunology at Northwestern University's Feinberg School of Medicine:

So, for asthma therapy, we have the inhaled steroids—they are the common maintenance medication for patients with persistent asthma, but there are biologics that are now available, and others that are coming onto the market for different populations of asthmatics, so it depends on what type of asthma they have. If they have what we call eosinophils, which are a certain blood cell that can be elevated with allergic diseases, [or] if they have an antibody called the IgE, which is an antibody involved with allergic diseases, depending on their asthma phenotype, as we call it, or their type of asthma, there are newer agents available by in the realm of biologics.

There are different medications coming down the pipeline. One that was recently approved, but there is another that is being investigated at this time. It has been approved for atopic dermatitis but not yet for asthma, and it looks very promising in the studies. So it's something that many of us are excited to see come to the market as we go more into the future.

Trying to determine the phenotype or the type of asthma that someone may have is important because then, as I said before, the biologics may be particular for different types of asthma. We can streamline the therapy a little more, individualize the therapy a little more, for patients [when we know the type of asthma], but I think it's also important from an allergic standpoint. With asthma, oftentimes, allergies are involved and so if we can identify the allergies and either eliminate or reduce exposure or treat those, then the asthma tends to do better for that reason as well.

So for all those reasons, I think it's important to identify what type of asthma or what may be triggers of the asthma in order to individualize the therapy. We have a lot of good treatments for asthma, but unfortunately, I think asthma is still underdiagnosed and in many circumstances for a lot of different reasons undertreated. So, unfortunately, there are still many deaths of asthma—many deaths in my city, in Chicago—and this is something that is a worldwide problem and that we would really like to avoid and stop. [We should not have] any deaths from asthma.