Can You Answer These 6 Questions About Severe, Uncontrolled Asthma?

Learn more about the condition that affects millions

Adult woman using inhaler

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Most people know someone—maybe a friend or family member—who lives with asthma, a chronic disease marked by inflammation of the airway that makes it hard to breathe. At the heart of it all, asthma is not the same for everyone. It can have different triggers, attack in different forms, and may sometimes require specialized treatment.

May is Asthma and Allergy Awareness Month, a peak season for the millions of Americans living with asthma and allergies. Here are the six most important questions you need to know about severe, uncontrolled asthma.

1. What is severe, uncontrolled asthma?

Asthma is an inflammatory disease that causes the airways in the lungs to become swollen or inflamed and over-reactive to triggers like pollen, dust, or smoke. An asthma attack can make it hard to breathe, and in many cases, people don’t recognize their asthma as severe.

Severe asthma requires medium- to high-dose inhaled corticosteroids plus another asthma controller medication and may require the addition of oral corticosteroids. However, despite using high-dose medicines, reducing risks, and following a treatment plan, many times asthma remains uncontrolled.

According to the American Lung Association, people with uncontrolled asthma experience at least three of the following:

  • Daytime symptoms like shortness of breath, chest tightness, and cough more than twice a week
  • Waking up with nighttime asthma symptoms more than twice a month
  • Using a rescue medicine, such as an inhaler, more than twice a week
  • The need to limit exercise or other daily activities because of asthma symptoms

2. How many people live with severe, uncontrolled asthma?

Around 5 percent to 10 percent of asthma cases are diagnosed as severe. About 20 percent to 50 percent of those are considered to have severe, uncontrolled asthma, which means they are unable to effectively control their condition with currently available medications. It’s estimated that about 1 million people in the U.S. and about 2.5 million people globally live with severe, uncontrolled asthma.

3. Why are asthma cases rising?

The total number of asthma cases is on the rise—the American Thoracic Society estimates the number of Americans with asthma will grow 10 percent by 2039. That means asthma is also a serious public health issue. One study projects that uncontrolled asthma could cost the U.S. health system around $300 billion in that timeframe.

Scientists don’t know for sure why asthma rates are increasing, but it’s thought that increased urbanization, lifestyle changes, and even growing rates of obesity could play a role.

4. What is it like to live with severe, uncontrolled asthma?

Life with severe, uncontrolled asthma can be a frustrating, and sometimes frightening, experience. Individuals often refer to asthma attacks as “an elephant sitting on your chest,” or like “breathing through a straw.” And it’s not just asthma attacks themselves that pose challenges. Many people who live with severe, uncontrolled asthma require daily management and significant changes in their lives to avoid potential triggers.  

"Every day, we hear from people living with severe asthma who feel like prisoners in their own body—unable to work, exercise, or do household chores without breathlessness," says Tonya A. Winders, President and CEO of the Allergy & Asthma Network. "We now have a more comprehensive understanding of different types of severe asthma and targeted treatment options. It is an exciting time of innovation and hope!

Given this, it’s more important than ever for those with severe, uncontrolled asthma to work closely with their healthcare providers to find management solutions and strategies that contribute to better quality of life.

5. Are there racial disparities among asthma patients?

Asthma, including severe, uncontrolled asthma, disproportionately affects Black, Hispanic, and Indigenous Americans. Black Americans not only have higher rates of asthma, but also significantly worse outcomes, being five times more likely to seek emergency care for asthma than white Americans, according to the Asthma and Allergy Foundation of America.

Experts have long been researching the causes of and potential solutions to this important issue.

While reducing disparities among asthma patients is incredibly complex, there are a few ideas on the table, including increasing access to preventive asthma care, improving treatment education, creating community support, and developing public health initiatives that address asthma-related environmental issues.

6. How many people with severe asthma have seen a specialist?

In the United States, only 38 percent of patients with severe asthma have seen a specialist—such as a pulmonologist, allergist, or immunologist—over the past two years. That means that more than 6 out of 10 Americans living with severe asthma are not getting specialized care that could help them find the right combination of medications and lifestyle changes to better manage their condition.

"Often times, people living with asthma need to see a specialist to determine the specific type of asthma they have and to access the most innovative, personalized treatment plan. If you are tired of living with limited daily activities, now is the time to seek a higher level of care,” says Winders. “I remain enthusiastic about the future as science continues to drive innovation for patients living with severe, uncontrolled asthma.

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Article Sources
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  2. American Lung Association. Severe Asthma. November 23, 2020.

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  5. American Thoracic Society. Uncontrolled Asthma Over Next 20 Years Likely to Add $300 Billion to U.S. Health Care Bill. July 1, 2019.

  6. Asthma and Allergy Foundation of America. Asthma Disparities in America. 2021.

  7. Asthma and Allergy Foundation of America. Asthma Facts. 2021.

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