Severe Asthma Clinic
At the Severe Asthma Clinic, children with severe and persistent uncontrolled asthma are evaluated by the clinical team and tested for appropriate allergens and other factors that may be causing their condition. They also undergo pulmonary function testing, are evaluated for social factors that may be contributing to their disease, are educated on their disease and potential therapeutic interventions, and are provided with an integrated care plan.
Our clinical team consists of pediatric allergists/immunologists (Sydney Leibel, M.D., and Bob Geng, M.D.), pediatric pulmonologist (Mateja Cernelc-Kohan, M.D.), pharmacists, social workers, a respiratory therapist and a nurse coordinator. There are several clinical studies currently underway that are available and will be offered to patients who are interested and meet appropriate criteria.
About Severe Asthma
Children with severe asthma require frequent or high doses of oral or systemic steroids to control their asthma. Many of these children still have symptoms even while on high steroid doses. Children with severe asthma tend to fall into two categories: difficult-to-treat asthma or severe therapy-resistant asthma.
Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities and poor adherence due to adverse psychological or environmental factors. Low-income patients have higher asthma severity, poorer asthma control and higher rates of asthma emergency department visits and hospitalizations. Evaluating the patient from a 360-degree view, which involves factoring in other medical conditions, addressing home exposures (mold, dust), assessing access to medication and health services, looking at tobacco exposure, and dealing with school issues, are all important and can all contribute to the clinical picture.
Incorporating a multidisciplinary model that addresses the medical and social needs of children with asthma has shown demonstrable improvement in quality of life and symptom-free days, as well as decreased hospitalizations and ER visits in children with severe uncontrolled asthma.
Typical treatment options include allergen avoidance, inhaled steroids and newer biologic therapies, including Xolair(Anti-IgE) and Mepolizomab (Anti- IL-5). Other treatments are currently under investigation.
For more information, call Maureen Ghiroli or Sonia Prakash at 858-966-1700, ext. 4214.