Asthma is a chronic respiratory disease that affects millions of people worldwide. Although for many patients asthma is effectively controlled with standard therapy, some patients may experience a complicated course of the disease that requires a more advanced approach to treatment. In this article, we will discuss a case study of complicated asthma.

   Case description

  The patient, a 45-year-old woman, presented for consultation due to worsening shortness of breath and cough. Despite regular use of a corticosteroid inhaler and a long-acting β2-agonist, the symptoms persisted, causing significant deterioration in the patient's quality of life. Spirometry testing showed a reduced FEV1 (forced expiratory volume in one second) and a good response to bronchodilators.

   Diagnosis

  Based on clinical symptoms, medical history and spirometry results, the patient was diagnosed with severe, unstable asthma.

   Treatment

  Treatment was started by increasing the dose of an inhaled corticosteroid and adding an oral antihistamine to treat concurrent allergic rhinitis. The patient was also referred to a pulmonary rehabilitation program.

  After two months, despite initial improvement, the patient's symptoms worsened again, prompting consideration of further therapeutic steps. It was decided to start biologic therapy - omalizumab, a drug directed against IgE antibodies, which play a key role in the development of allergic asthma.

   Effects of treatment

  After several months of treatment with omalizumab, the patient reported a significant improvement in her symptoms - cough and shortness of breath were less frequent, and her quality of life significantly improved. A follow-up spirometry test showed an improvement in respiratory parameters.

  In conclusion, this case shows how complicated the course of asthma can be in some patients and the importance of individualized treatment. For patients in whom standard treatment is unsuccessful, another therapeutic strategy, including biologic therapy, should be considered. As always, the key to success is close cooperation between doctor and patient, and monitoring and regular evaluation of treatment effects.