Updated November 21, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Personalized medicine in asthma could help you and your doctor tailor asthma treatment to your care.

Why some patients respond nicely to asthma treatments while others fail to respond at all perplexes doctor and frustrates patients. In asthma we currently have a path called a “guideline” that tells doctors what steps are best for most patients. When patients fail out of that guideline or do not respond well to treatments, you and your doctor may be on more shaky ground.

If your doctor is not an asthma specialist, a referral to an asthma specialist may be of benefit. With as many as 40% of asthmatics not responding to some part of their therapy, personalized medicine for asthma is greatly needed.

What Is Personalized Medicine?

Personalized medicine is basically customized medical treatment for your own particular genetic makeup. Your doctor may also refer to this a pharmacogenomics. By studying your genes the hope is that doctors could impact asthma at a number of different time points. Pharmacogenomics may be able to:

• Help your doctor understand your own personal risk for developing asthma.
• Diagnose asthma.
• Identify treatments that are more likely to benefit your asthma.

How Might Personalized Medicine Help In Asthma?

A 2011 study in the New England Journal of Medicine begins to push asthma treatment towards being more personal. In this study the investigators looked at the participant’s genes in comparison to how they responded to certain treatments. The study basically found that if you had two copies of a certain gene, your lung function was not likely to improve with inhaled steroid treatment.

The implications for this are significant if the research is reproducible and the test can be made widely available. Since inhaled steroids are the first line treatment for anyone who needs their therapy stepped up, a test to know whether or not you will respond to treatment could save you a significant amount of time.

Today if you fail to improve your doctor will spend a lot of time counseling you, making sure your technique is appropriate, making sure that you are avoiding triggers, and then finally increasing your dose. With a test like this, you could skip this whole process with a drug that is not likely to work. The process of finding an asthma treatment that works for you could be shortened and much less frustrating.

Is Personalized Medicine For Asthma Available Today?

The short answer is no. There are no tailor made treatments that will benefit your asthma based on your own genetic makeup.

Your doctor may be able to identify that you have one of the genes associated with a poor response to therapy. As our understanding of the genes and genetic pathways improves, it is possible that panels of tests will be developed to determine what therapies or combinations of therapies will most benefit an individual patient.

Right now we do know that there are certain groups of patients with particular risks or who might benefit from particular therapies. Menopause, for example, is associated with decreased levels of estrogen that has implications for older women with asthma. Likewise, we know that bronchial thermoplasty is beneficial for patients with significant remodeling in their lungs.

There are some examples of personalized medicine today that are very effective, mostly in cancer. For example, a small number of patients will develop severe side effects from a chemotherapy agent called Purinethol, a drug used in the treatment of leukemia. A genetic test is available to identify, before giving you the drug, if you are likely to develop this side effect. Another test in breast cancer identifies if patients over express a particular gene called HER2. While the test is associated with a worse prognosis, it is also associated with a better response to a treatment called trastuzumab.

While personalized medicine for asthma has not hit the mainstream today, it is coming as we understand more about genetics and asthma.

Sources

1. Tantisira K. Genetic variation in FCER2: implications for children with asthma. Pharmacogenomics 2011;9(7):805–807.
2. Fajt ML, Wenzel SE. Biologic therapy in asthma: entering the new age of personalized medicine. Journal of Asthma.2014;51(7):669–676.
3. Miller SM, Ortega VE. Pharmacogenetics and the development of personalized approaches for combination therapy in asthma. Curr Allergy Asthma Rep. 2013;13(5):443–452.
4. Meyer JM, McCarthy JJ. The path to personalized medicine. Current Opinion In Chemical Biology 2002.