After Years of Living with Asthma, Teacher Shares Steps She Made for Change


Posted: July 13, 2020 | Word Count: 2,308

Please see below for important safety information including patient information.

Every year, Pam, a kindergarten teacher in Wisconsin, trained her class of 4- and 5-year-olds on what to do if she had an asthma attack during class, hoping they wouldn’t have to put those plans into action. She was diagnosed with asthma and nasal polyps a decade ago, but her class hadn’t been put to the test until two years ago.

Neither her inhaler nor nebulizer helped that day. So, one student ran to the classroom next door and alerted the teacher, and another went to the principal's office. Her colleagues wanted to call an ambulance because it was an extreme emergency, but Pam’s husband was nearby and would have arrived before the ambulance, so she waited for him to take her to the emergency room safely. She still remembers the look on her students' faces.

"You look terrible when you have an asthma attack," Pam recalled one student said. Pam continued, "Their little faces were so scared. A 5-year-old should never have to see that. It still tears me up just thinking about it."

There are as many as 900,000 people in the U.S. with moderate-to-severe asthma that experience uncontrolled, persistent symptoms that can have a significant impact on their life, including disturbed sleep and restricted daily activities,[1],[2],[3],[4] Additionally, almost 50 percent of people with nasal polyps also have asthma.[5] Symptoms of nasal polyps, including breathing difficulties, nasal congestion and discharge, reduction or loss of sense of smell and taste, and facial pressure,[6] can make everyday life even more difficult. Severe asthma attacks are three times more likely to occur in patients with uncontrolled symptoms than those with better asthma control.[7] At the time, Pam was no exception to this statistic. But, that moment motivated her to keep searching for new ways to control her asthma.

Never forgetting her inhaler

In the past decade, Pam visited the emergency room three times due to asthma attacks – and each attack felt more severe than the last. What felt like allergies that never seemed to go away wasn’t that at all.

Even after her official diagnosis, she thought that the emergency room visits and frequency with which she used oral corticosteroids (OCS) was just a normal part of living with asthma. She always kept her nebulizer nearby and took her inhaler with her everywhere, even during short walks around the neighborhood – but sometimes she forgot her inhaler at home. "Not having my inhaler was scary and worrying about an attack was always in the back of my mind," Pam said. "And some days, I just didn't feel good enough to exercise because of my asthma."

A new outlook

After Pam's attack in her kindergarten class, she talked with her doctor about her asthma treatment plan, and what she could do differently to gain more control.

Type 2 inflammation is part of the body’s immune response to allergens and certain types of infections. But when the body has an overactive type 2 immune response to certain triggers, this can create excessive type 2 inflammation that can contribute to different inflammatory diseases, like atopic dermatitis, asthma and nasal polyps.[8],[9] This underlying, excessive inflammation may help explain why people with asthma can have additional airway diseases, including nasal polyps. The presence of both asthma and nasal polyps is typically seen in people with more severe diseases, who are often more difficult to treat.[8],[10],[11],[12]

Pam’s doctor introduced her to Dupixent® (dupilumab), a biologic treatment that blocks two proteins that play a major role in the inflammation that underlies specific types of asthma.[9],[13]

Dupixent is a prescription treatment approved for use with other asthma medications for the maintenance treatment of moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 12 years and older whose asthma is not controlled with their current asthma medicines. Dupixent is not used to treat sudden breathing problems. Dupixent is also indicated for use with other medicines for the maintenance treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP) in adults whose disease is not controlled. Before starting DUPIXENT, you should talk to your doctor about all the medical conditions you have or medications you are taking. You and your doctor should also discuss the potential benefits and risks of treatment with DUPIXENT including the most common side effects such as injection site reactions, and some serious side effects such as allergic reactions including anaphylaxis and inflammation of your blood vessels. To learn more about Dupixent and find tools and resources about how to have an effective conversation with your doctor, visit www.Dupixent.com.

Since changing her treatment plan to include Dupixent a year and a half ago, Pam has been breathing more comfortably. She hasn’t had an asthma attack since starting this treatment – which for Pam means she is no longer living with the constant worry about how her asthma can impact her students. A weight has been lifted off her shoulders. This is Pam's experience, and a patient's individual results with Dupixent may vary.

"I don't have to stress about carrying my nebulizer everywhere, and this is the first year I feel I don’t have to train my class on how to help if I have an attack in class," Pam said. "I have a new lease on life. I hope that everyone who has uncontrolled asthma knows that they don't have to accept living in constant fear. I hope they keep searching for ways to better control their asthma because it’s been absolutely life changing for me."

Do you have persistent asthma symptoms? Click here to learn more about the signs of inadequate disease control.

Now that Pam has learned more about her own asthma, she wants to help others to become more educated and empowered. She is collaborating with Regeneron and Sanofi to share her own personal experiences with Dupixent. If you are living with persistent asthma, click here to learn more about the signs of inadequate disease control.

IMPORTANT SAFETY INFORMATION & INDICATIONS

Do not use if you are allergic to dupilumab or to any of the ingredients in DUPIXENT®.

Before using DUPIXENT, tell your healthcare provider about all your medical conditions, including if you:

  • have eye problems
  • have a parasitic (helminth) infection
  • are scheduled to receive any vaccinations. You should not receive a “live vaccine” if you are treated with DUPIXENT.
  • are pregnant or plan to become pregnant. It is not known whether DUPIXENT will harm your unborn baby.
    • There is a pregnancy exposure registry for women who take DUPIXENT during pregnancy to collect information about the health of you and your baby. Your healthcare provider can enroll you or you may enroll yourself. To get more information about the registry call 1-877-311-8972 or go to https://mothertobaby.org/ongoing-study/dupixent/.
  • are breastfeeding or plan to breastfeed. It is not known whether DUPIXENT passes into your breast milk.

Tell your healthcare provider about all the medicines you take, including prescription and over-the- counter medicines, vitamins and herbal supplements.

Especially tell your healthcare provider if you are taking oral, topical, or inhaled corticosteroid medicines; have asthma and use an asthma medicine; or have atopic dermatitis or CRSwNP, and also have asthma. Do not change or stop your corticosteroid medicine or other asthma medicine without talking to your healthcare provider. This may cause other symptoms that were controlled by the corticosteroid medicine or other asthma medicine to come back.

DUPIXENT can cause serious side effects, including:

  • Allergic reactions (hypersensitivity), including a severe reaction known as anaphylaxis. Stop using DUPIXENT and tell your healthcare provider or get emergency help right away if you get any of the following symptoms: breathing problems, fever, general ill feeling, swollen lymph nodes, swelling of the face, mouth and tongue, hives, itching, fainting, dizziness, feeling lightheaded (low blood pressure), joint pain, or skin rash.
  • Eye problems. Tell your healthcare provider if you have any new or worsening eye problems, including eye pain or changes in vision.
  • Inflammation of your blood vessels. Rarely, this can happen in people with asthma who receive DUPIXENT. This may happen in people who also take a steroid medicine by mouth that is being stopped or the dose is being lowered. It is not known whether this is caused by DUPIXENT. Tell your healthcare provider right away if you have: rash, shortness of breath, persistent fever, chest pain, or a feeling of pins and needles or numbness of your arms or legs.

The most common side effects include:

  • Atopic dermatitis: injection site reactions, eye and eyelid inflammation, including redness, swelling, and itching, and cold sores in your mouth or on your lips.
  • Asthma: injection site reactions, pain in the throat (oropharyngeal pain), and high count of a certain white blood cell (eosinophilia).
  • Chronic rhinosinusitis with nasal polyposis: injection site reactions, eye and eyelid inflammation, including redness, swelling, and itching, high count of a certain white blood cell (eosinophilia), trouble sleeping (insomnia), toothache, gastritis, and joint pain (arthralgia).

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of DUPIXENT. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Use DUPIXENT exactly as prescribed. Your healthcare provider will tell you how much DUPIXENT to inject and how often to inject it. DUPIXENT is an injection given under the skin (subcutaneous injection). If your healthcare provider decides that you or a caregiver can give DUPIXENT injections, you or your caregiver should receive training on the right way to prepare and inject DUPIXENT. Do not try to inject DUPIXENT until you have been shown the right way by your healthcare provider. In children 12 years of age and older, it is recommended that DUPIXENT be administered by or under supervision of an adult. In children younger than 12 years of age, DUPIXENT should be given by a caregiver.

Please see accompanying full Prescribing Information including Patient Information.

INDICATIONS

DUPIXENT is a prescription medicine used:

  • to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. DUPIXENT can be used with or without topical corticosteroids. It is not known if DUPIXENT is safe and effective in children with atopic dermatitis under 6 years of age.
  • with other asthma medicines for the maintenance treatment of moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 12 years and older whose asthma is not controlled with their current asthma medicines. DUPIXENT helps prevent severe asthma attacks (exacerbations) and can improve your breathing. DUPIXENT may also help reduce the amount of oral corticosteroids you need while preventing severe asthma attacks and improving your breathing. DUPIXENT is not used to treat sudden breathing problems. It is not known if DUPIXENT is safe and effective in children with asthma under 12 years of age.
  • with other medicines for the maintenance treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP) in adults whose disease is not controlled. It is not known if DUPIXENT is safe and effective in children with chronic rhinosinusitis with nasal polyposis under 18 years of age.


[1] U.S. Census Bureau, Population Division. “Monthly Population Estimates for the United States: April 1, 2010 to December 1, 2018: 2017 Population Estimates.” United States Census Bureau. (2017): 1-8.

[2] Centers for Disease Control and Prevention. National Health Interview Survey 2016. Sample Child and Sample Adult file available at: https://www.cdc.gov/nchs/nhis/nhis_2016_data_release.htm.

[3] Dean BB, BM Calimlim, SL Kindermann, et al. The Impact of Uncontrolled Asthma on Absenteeism and Health-Related Quality of Life. J Asthma. 2009;46(9):861-6.

[4] GINA 2020 Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. 2020. Available at: https://ginasthma.org/gina-reports/. Last accessed April 2020.

[5] Stevens, Whitney W., et al. "Clinical characteristics of patients with chronic rhinosinusitis with nasal polyps, asthma, and aspirin-exacerbated respiratory disease." The Journal of Allergy and Clinical Immunology: In Practice. 5.4 (2017): 1061-1070.

[6] Newton JR, Ah-See KW. A review of nasal polyposis. Ther Clin Risk Manag. 2008;4(2):507-12.

[7] Haselkorn T, Fish JE, Zeiger RS, et al; TENOR Study Group. Consistently very poorly controlled asthma, as defined by the impairment domain of the Expert Panel Report 3 guidelines, increases risk for future severe asthma exacerbations in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. J Allergy Clin Immunol. 2009;124(5):895-902.

[8] Gandhi NA, BL Bennett, NM Graham, et al. Targeting key proximal drivers of type 2 inflammation in disease. Nat Rev Drug Discov. 2016;15(1):35-50.

[9] Gandhi, Namita A., Gianluca Pirozzi, and Neil MH Graham. "Commonality of the IL-4/IL-13 Pathway in Atopic Diseases." Expert Review of Clinical Immunology. 13.5 (2017): 425-437.

[10] Staikuniene J, et al. Association of chronic rhinosinusitis with nasal polyps and asthma: clinical and radiological features, allergy and inflammation markers. Medicina (Kaunas). 2008; 44(4):257-265.

[11] Amelink M, de Groot JC, de Nijs SB, Lutter R, Zwinderman AH, Sterk PJ, ten Brinke A, Bel EH. Severe adult-onset asthma: a distinct phenotype. Journal of allergy and clinical immunology. 2013 Aug 1;132(2):336-41.

[12] Tay, T. R., Radhakrishna, N., Hore-Lacy, F., Smith, C., Hoy, R., Dabscheck, E., & Hew, M. (2016). Comorbidities in difficult asthma are independent risk factors for frequent exacerbations, poor control and diminished quality of life. Respirology. 21(8), 1384-1390.

[13] Simpson, Eric L., etal. "Two phase 3 trials of dupilumab versus placebo in atopicdermatitis." New England Journal of Medicine. 375.24(2016): 2335-2348.

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