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Pulmonary Medicine

On the Leading Edge of Treatments for Asthma

“I’ve had terrible allergies my whole life, and asthma since I was 18,” says Karen. The last few years it’s gotten worse, and I’ve needed up to three inhalers a day along with taking more and more prednisone just to keep my asthma under control. I felt like I was out of ideas for options, and there was no hope. But after receiving a new form of biologic treatment for my asthma, I feel much, much better. It’s been a lifesaver for me. Dr. Wyckoff fights for his patients and never gives up trying to find the right treatment. He really cares about and listens to them. He puts so much effort into taking care of his patients.” — Karen King, a Certified Nurse Midwife at Virginia Hospital Center.

“We’re taking a more personalized approach to asthma treatment with monoclonal antibody therapy. Just like treating cancer, where we can check for mutations in cancer cells, with asthma we can individualize and target our treatment, too. NUCALA® is just one of a number of new biologic therapies that are available to treat severe, persistent asthma. XOLAIR® is an additional therapy that is available but, unlike NUCALA®, which is approved for both allergic and non-allergic asthma, it is only approved for allergic asthma. None of these therapies cure asthma, but they have been shown to decrease asthma attacks, improve quality of life, and reduce the need for oral steroids. Patients are achieving better control of their asthma while lowering their need for maintenance medications. Patients I used to see monthly or even weekly for asthma attacks, I’m now seeing much less frequently with these newer treatments.” — Christopher Wyckoff, MD, pulmonologist.

For Karen, Dr. Wyckoff began a series of monthly injections of the new biologic NUCALA®. An ongoing treatment, NUCALA® reduces the number of eosinophils in the blood, which are a type of white blood cell that is a normal part of the body’s immune system. However, an elevated level of eosinophils may lead to inflammation in the lungs that can cause severe asthma attacks. A simple blood test is done to test the eosinophil count to identify patients whose asthma may be more likely to respond to NUCALA® treatment.

Virginia Hospital Center is on the forefront of a new wave of treatment options for patients who have severe asthma, like Karen. These new treatments include immunomodulators—monoclonal antibodies, also known as biological medication. They act by directly changing the behavior of the immune system.

Not all asthma is the same. While the majority of people with asthma can find relief with standard inhalers and oral medications, those with severe asthma require more powerful treatments. Physicians at Virginia Hospital Center are working with these patients to find the right advanced therapy.

Bronchial Thermoplasty (BT)

Another advanced asthma treatment physicians are using at Virginia Hospital Center is Bronchial Thermoplasty (BT). Smooth muscle mass in the bronchial airways can become thicker, restricting airflow and the ability to breathe during an asthma attack. BT uses radio-frequency energy to heat these lower airways, reducing the smooth muscle mass.

“We treat patients during three separate outpatient sessions, scheduled a few weeks apart. No incision is required, and the bronchoscopy procedure has been clinically proven to reduce asthma attacks for at least five years.”
Jeff B. Hales, MD, Chief of the Division of Pulmonary, Critical Care & Sleep Medicine.

BT can be an effective complement to current treatment options to significantly improve quality of life for people with severe, persistent asthma. Read more



Bronchial Thermoplasty Success Story

photo of the patient
“Asthma felt like a knife jabbing in my chest. After the first procedure, I felt fantastic right away. I wasn’t tired, sick, or wheezing. So I started running and got faster and faster. I lost 40-50 pounds, and then started placing at the top in local races. I haven’t missed a day of work in five years. I love Dr. Duhamel and Dr. Hales, my pulmonologists, and all their staff, and everyone at Virginia Hospital Center. They are all just the best people in the world, and I owe them my life. Every morning I get up and pray that they have the greatest day." — Tony

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