For most children with asthma, a pediatrician can manage their condition with routine care. But for kids with severe asthma, every breath can be a daily struggle. Rady Children’s Hospital San Diego’s Severe Asthma Clinic is dedicated to treating children from across Southern California whose symptoms exceed standard treatment, offering specialized care designed to uncover underlying triggers, reduce hospitalizations and let kids go back to doing what they’re best at—just being kids.
The clinic’s multidisciplinary staff combine advanced diagnostics, personalized treatment plans and ongoing family education to reimagine what’s possible for kids living with severe asthma.
Roughly 10% of kids have asthma at some point (and most outgrow it). Of that 10%, somewhere between 1% and 5% have severe asthma.
“Most kids who have asthma have mild asthma, but even those kids can have severe asthma attacks,” says Sydney Leibel, a pediatric allergist/immunologist at Rady Children’s and an assistant professor of pediatrics at UC San Diego School of Medicine. “Our goal is to change the paradigm in how we treat asthma in general so that we are a little bit more aggressive and step up treatment to prevent a serious episode that could send them to the hospital.”
Typically, patients are referred to the Severe Asthma Clinic because despite being treated by their pediatrician or even an allergist or pulmonologist, they’re still having issues controlling their asthma, or they’ve had an attack that landed them in the emergency department or intensive care unit. Clinic staff complete a comprehensive evaluation and breathing test on each patient to find the issue’s underlying causes, which could be as simple as incorrect inhaler usage or a socioeconomic barrier to care to as complex as a genetic condition or specific allergen in their home environment.
“Asthma is considered a multifactorial disease,” explains Dr. Leibel. “There’s a genetic component, and kids who have allergies also are at increased risk for asthma. Then there is an environmental component. Asthma attacks can also be triggered by viral infections. Individual triggers are different for each person, but they all cause inflammation in the airway and constrict the muscles around the lungs. That’s why, in part, the Severe Asthma Clinic is trying to identify particular triggers that our patients have.”
In addition to identifying the root causes of a child’s asthma attacks, doctors also have game-changing treatment options that weren’t available only a decade ago. Unlike traditional inhalers that broadly manage symptoms, a newer class of injectable medications called biologics target specific immune pathways that cause inflammation, safely and with fewer side effects.
Rady Children’s is working toward the future of asthma treatment, participating in several clinical trials for promising new biologics. The Hospital has also recently become a part of a severe asthma consortium with 15 sites across the country. Rady Children’s is currently the only site on the West Coast. The goal is to standardize care and collect data to improve treatment recommendations.
The clinic’s results speak for themself. In patients of the Severe Asthma Clinic, asthma-related hospitalizations have fallen by 75% to 80%.
“We have a lot of patients who tell us that they’re grateful that they’re able to live a more ‘normal’ life. They’re not missing school as much. They’re not in the hospital all the time,” says Dr. Leibel. “For us, it’s an incredibly rewarding clinic because we are able to kinda see that sort of improvement in our patients.”