Juneteenth is the annual national celebration of the end of slavery in the United States after the Civil War. In 2021, it became a federal holiday. The holiday is a time for celebration. It is also an opportunity to reflect on the health equity challenges Black people in the U.S., and Black women in particular, continue to face.

In the U.S., the burden of asthma and allergies falls disproportionately on Black, Hispanic, and American Indian and Alaska Native (AI/AN) populations. Black people are more likely to be diagnosed with asthma compared to White people. Black people are also at risk of worse asthma outcomes. They are:

• 2 times as likely to have a hospital stay due to asthma
• 3 times as likely to die from asthma
• 5 times as likely to visit the emergency department due to asthma
  
  

Black women fare the worst and have the highest rates of death due to asthma.

A Midlife Asthma Diagnosis

Sherida Miller is one of the many Black women living with asthma in the U.S. Her self-advocacy and commitment to health education are encouraging for anyone living with severe asthma.

Sherida visited a hospital emergency room in Los Angeles almost 10 years ago. She had trouble breathing and left the hospital with a new diagnosis of asthma. As an adult in her 40s, she did not expect to develop asthma, “Why am I going through this, now?” said Sherida.

Sherida, like many other women, was more likely to be diagnosed with asthma in adulthood than men. Sherida also has a strong family history of asthma, which can be an additional risk factor for a diagnosis. Sherida later discovered she has many allergies that make her asthma worse. Once she found out about and treated her allergies, her asthma control got better.

Sherida is now a confident self-advocate for her medical care.

“I didn’t always have good health care,” Sherida said. “I decided to look for better care. I’ve since found good providers that now take their time and listen to me.”

Sherida’s doctor referred her to Breathe Southern California’s (Breathe SoCal) Breathe Easier Asthma Management (BEAM) program. Breathe SoCal is one of AAFA’s Health Equity Advancement and Leadership (HEAL) program sites that works to improve health outcomes locally.

Sherida is dedicated to learning about her condition so she can stay active.

“You have to be aware and do your homework,” said Sherida.

She stays up to date on available treatments and continues to learn how to reduce her exposure to indoor and outdoor asthma and allergy triggers.

“I’ve learned that I must keep my windows closed in the early morning to reduce pollen entering my apartment,” said Sherida. “I also live in downtown [Los Angeles] near the highway, and there is a lot of dust. I stay up on my cleaning.”

Keep on Going

Sherida shares that managing asthma and her other health conditions can get overwhelming at times but they have not slowed her down. She reflects on her community and family that keep her busy. She stays active and wears a mask outside when pollen counts are high. She also exercises 5 times a week, is active in her community, and is getting her real estate and broker licenses.

Sherida’s consistency has helped. In the past year, she feels like her asthma has been more controlled. She credits this to understanding her triggers and preventing asthma attacks before they occur by using her controller medicines, reducing her triggers, eating healthy, and exercising.

Her advice to other people with asthma is to “get properly tested for asthma and allergies and do your homework. Figure out what triggers your asthma and how you can prevent it. Understanding your family history is also helpful.”

Welcome to our June research update! Getting involved with research is an important way to impact asthma and allergy treatments, education, and awareness.

This month, we are highlighting clinical trials, surveys, and news on:

• Children and adults with asthma
• Inhaler product development
• Asthma, insomnia, and depression
• Severe asthma treatments
• Chronic spontaneous urticaria (CSU)
• Chronic obstructive pulmonary disease (COPD)
  
  

Note: The links below will take you to external websites.

Surveys

Participants Needed for Mild Asthma Survey

Researchers at the University of Michigan are hoping to learn more about mild asthma. The researchers would like to better understand patients’, parents’, and physicians’ experiences with and concerns about mild asthma to direct future areas of research.

Participation will include a Qualtrics survey with demographic questions and questions about the categorization and treatment of mild asthma.

Who may qualify to participate?

• Patients >18 years old with mild/intermittent asthma
• Parents of children <18 years old with mild/intermittent asthma
  
  

Participation is voluntary and you can stop participating at any time.

Please click below to proceed to the survey.

PATIENT SURVEY

PARENT SURVEY

Latest Asthma and Allergy News

Asthma

The Impact of Insomnia and Depression on Asthma Control
People with asthma often report having trouble sleeping, especially if their asthma is not well-controlled. But experts have not fully understood how sleep disorders like insomnia affect asthma. It is also not clear how mood disorders like depression impact asthma control.

In this retrospective study, researchers looked at medical records from a large asthma center. They compared asthma patients with insomnia to patients without insomnia, matching them by age, sex, other health conditions, and asthma treatments. They checked for sleep apnea, mood disorders, asthma attacks, and asthma control test (ACT) scores.

The study found the patients with insomnia were more likely to also have sleep apnea (57.3% vs. 18%) and depression or anxiety (68.5% vs. 11.4%) compared to the patients without insomnia. People with insomnia had on average nearly 1 asthma flare per year, while the average for the patients without insomnia was lower (0.59 flares per year).

The authors suggest that there is significant interaction between insomnia, depression, and sleep apnea in people with asthma and are linked to more frequent asthma flares. The study suggests that sleep and mood disorders can negatively affect asthma control.

Promising Results for Rilzabrutinib, a New Medicine Under Investigation for the Treatment of Moderate to Severe Asthma
An early phase study showed that the drug rilzabrutinib can help reduce asthma attacks and improve symptoms in adults with poorly controlled moderate to severe asthma at different doses.

The results showed that high-dose rilzabrutinib reduced the loss of asthma control by 36%, and the low dose reduced it by 25%. Patients also showed major improvement in their asthma symptoms, with noticeable benefits as early as 2 weeks of treatment.

Rilzabrutinib at high and low doses was well-tolerated over 12 weeks. The most common side effect was diarrhea. No serious issues like low blood cell count, bleeding, or heart problems were reported.

Rilzabrutinib is still being studied, and regulatory authorities have not yet confirmed its safety and effectiveness.

GlaxoSmithKline (GSK) Announces Positive Results for the Treatment of Severe Asthma with a New Medicine
GSK announced positive results from a late phase clinical trialthat studied a medicine called depemokimab. The studies were done in adults and teens with severe asthma marked by high levels of eosinophils, a type of white blood cell. There are three other biologics medicines available now that reduce eosinophils in the lungs. But they have to be injected under the skin every 2 or 4 weeks. This new medicine is given every 6 months by injection.

The trials involved participants who were already on standard asthma treatments. They either received depemokimab or a placebo (non-treatment). Both trials showed that over a year, participants who took depemokimab had fewer asthma flares compared to participants who did not take the treatment. Both depemokimab and placebo has similar rates and severity of adverse events.

Depemokimab is still being tested and is not yet approved. It is also being studied for other inflammatory diseases. GSK plans to use these results to seek approval from health authorities.

Chronic Obstructive Pulmonary Disease (COPD)

New Data Show TEZSPIRE Impact on Moderate to Severe COPD
A recent early phase study on chronic obstructive pulmonary disease (COPD) looked at how well TEZSPIRE® (tezepelumab), approved for asthma, works for people with moderate to very severeCOPD. The study looked at people with COPD who had different levels of blood eosinophils. Blood eosinophils are a type of white blood cell which are found more often in people with asthma.

In the studay, TEZSPIRE reduced COPD flare-ups by 17% over a year compared to no treatment, regardless of blood eosinophil count, but was not statistically significant.

But, for patients with an eosinophil count of 150 cells/µL or more, TEZSPIRE reduced flare-ups by 37%, which was a major improvement. People with even higher blood eosinophils counts (300 cells/µL or more), saw a reduction in flare ups of 46%.

Along with the reduction in flares, the TEZSPIRE groups had improved lung function and quality of life. The drug was generally safe. The most common side effects were worsening of the underlying COPD and COVID-19 infections. Otherwise, there were no differences in side effects from previous asthma studies. TEZSPIRE was approved by the Food and Drug Administration (FDA) for asthma in 2021. It  continues to be studied for COPD but is not yet approved.

Study Shows Dupixent Impact on Uncontrolled COPD
A later phase study in adults looked at Dupixent® (dupilumab) as an add-on treatment for uncontrolled COPD despite being on maximum standard treatment. The group on Dupixent were compared to people on the maximum standard of care for COPD and a placebo (non-treatment). The study focused on patients with high levels of eosinophils, a type of white blood cell. Dupixent has been FDA approved for asthma and other allergic diseases like eczema, eosinophilic esophagitis, and chronic nasal and sinus symptoms from nasal polyps.

The results show that after a year Dupixent reduced moderate to severe COPD flare-ups by 34%. Compared to participants who did not take the treatment, participants on Dupixent had improved lung function, better quality of life, and reduced respiratory symptoms.

Safety results were consistent with known side effects of Dupixent. Common side effects included COVID-19, inflammation of the nasal passages, and headaches. Fewer COPD-related adverse events happened with Dupixent compared to placebo.

The results confirmed earlier positive findings from another study that showed major benefits. The use of Dupixent for COPD is still being studied and has not yet been fully approved. Dupixent is currently being reviewed by the FDA and other regulatory bodies worldwide. The FDA’s decision is expected by June 27, 2024.

Medical Review: June 2024 by Jerry Shier, MD

AAFA is pushing to lower the costs of asthma and allergy medicines, including inhalers. We know the high cost of medicine can be a barrier to treatment.

Some major asthma inhaler manufacturers have announced $35 a month caps on out-of-pocket costs. The price cap will apply to people with commercial/private insurance or no insurance. The inhalers that will be price capped include:

AstraZeneca (effective June 1, 2024):

• AIRSUPRA® (albuterol and budesonide) inhalation aerosol
• BEVESPI AEROSPHERE® (glycopyrrolate and formoterol fumarate) inhalation aerosol
• BREZTRI AEROSPHERE® (budesonide, glycopyrrolate, and formoterol fumarate) inhalation aerosol
• SYMBICORT® (budesonide and formoterol fumarate dihydrate) inhalation aerosol

How it works:

• Commercially insured and covered: You can pay as little as $0 for AIRSUPRA and BREZTRI and pay no more than $35 for SYMBICORT and BEVESPI using the savings cards provided on brand websites. 
  • Here are the website links to access the savings cards: AIRSUPRA, BEVESPI, BREZTRI, and SYMBICORT
• Commercially insured but AstraZeneca inhaler is not covered in your plan: You or your health care providers can request a prior authorization or ask your doctor about a therapeutic alternative. 
• Uninsured: if eligible, you can use the $35 uninsured savings card accessible on the US Patient Support site. 
• Government insured (Medicare/Medicaid):  Federal law prohibits people on government programs from using a savings card, which is why they may be directed to AZ&Me. Qualifications for AZ&Me are based on where you live, insurance status, and income.
• For additional questions or more information, visit AstraZeneca’s patient support site or call: 1-800-236-9933

Boehringer Ingelheim (effective June 1, 2024):

• Atrovent® HFA (ipratropium bromide HFA) inhalation aerosol
• Combivent® Respimat® (ipratropium bromide and albuterol) inhalation spray
• Spiriva® HandiHaler® (tiotropium bromide) inhalation powder
• Spiriva® Respimat® 1.25 mcg (tiotropium bromide) inhalation spray
• Spiriva® Respimat® 2.5 mcg (tiotropium bromide) inhalation spray
• Stiolto® Respimat® (tiotropium bromide and olodaterol) inhalation spray
• Striverdi® Respimat® (olodaterol) inhalation spray

How it works:

• If you have commercial insurance and are eligible, the reduced out-of-pocket cost will be automatically applied at participating retail pharmacies. More than 90% of pharmacies across the country are participating in the program, making the change seamless and automatic for most people. There are no forms to fill out or websites to go to – the discount happens electronically with no action required.
• All other eligible people, including those whose pharmacies do not participate and people without insurance, can visit www.InhalerOffer.com to enroll for a savings card to present at pharmacies to receive the same $35 cap of out-of-pocket costs.
• Federal law prevents people on government insurance programs (Medicare/Medicaid/TriCare) from being eligible for this price cap program.

GSK (with price change going into effect no later than Jan. 1, 2025):

• Advair Diskus (fluticasone propionate and salmeterol inhalation powder)
• Advair HFA (fluticasone propionate and salmeterol inhalation aerosol)
• Anoro Ellipta (umeclidinium and vilanterol inhalation powder)
• Arnuity Ellipta (fluticasone furoate inhalation powder)
• Breo Ellipta (fluticasone furoate and vilanterol inhalation powder)
• Incruse Ellipta (umeclidinium inhalation powder)
• Serevent Diskus (salmeterol xinafoate inhalation powder)
• Trelegy Ellipta (fluticasone furoate, umeclidinium, and vilanterol inhalation powder)
• Ventolin HFA (albuterol sulfate inhalation aerosol)

AAFA is leading the way to reduce health care costs for people with asthma

"On behalf of the 27 million people in the United States with asthma, we appreciate the leadership of President Biden and Senator Sanders to bring down costs for asthma treatments. Pricing announcements made in March by some manufacturers of inhalers will mean lower costs and improved access to asthma medicine for many people with asthma starting this June,” said AAFA President and CEO Kenneth Mendez. “As President Biden indicated, more can and should be done. It’s not just drug companies, others need to step forward. We welcome continued efforts to improve affordability and accessibility of these essential medicines so all patients can get the treatment they need.”

AAFA continues to raise the voice of the patient community and draw attention to the ways America’s complex drug pricing ecosystem makes asthma medications more expensive for people who need them most. Drug manufacturers, pharmacy benefit managers, insurers, employers, and the government must work together to improve affordability and access.

Access to affordable drugs is a critical component of reducing racial disparities in asthma. Black and Hispanic individuals not only experience higher rates of asthma but also are more likely to be uninsured or underinsured. Deaths due to asthma – although decreasing overall – occur at a much higher rate in the Black and Puerto Rican populations than in the White population. Black individuals are nearly three times as likely to die from asthma than White individuals.

Last fall, AAFA shared patient stories and its Asthma Disparities in America report with the Senate Health, Education, Labor, and Pensions (HELP) Committee which then launched an investigation into the high price of asthma inhalers early this year.

AAFA’s research indicates that when the cost of medicine becomes a barrier to treatment, people with asthma resort to rationing or simply discontinue use.

Access to asthma medications can save lives, reduce hospitalizations, and lower the more than $82 billion in annual costs to the U.S. economy from this chronic disease. But the U.S. health care system is complex, and often leaves patients with few affordable options.

Tobacco smoke and e-cigarette aerosol hurts everyone. It can affect you even if you aren’t around someone who is actively smoking or vaping. The effects of smoking and vaping reach much farther than many people realize.

Tobacco smoke and e-cigarette aerosol can be especially harmful to people who have asthma, children, and older adults. If you smoke or vape or are around someone who does, you need to know about the effects to help you manage your asthma and prevent asthma symptoms.

How Does Smoking and Vaping Affect Asthma?

Asthma is a chronic disease that causes your airways to become inflamed, making it hard to breathe. Asthma triggers cause this inflammation. Triggers are things that bother people with asthma but may not bother other people. Tobacco smoke is one of the most common triggers of asthma symptoms.

When you think of the bad ingredients in tobacco, nicotine usually comes to mind. But tobacco smoke is full of many other toxic substances, like arsenic, cyanide, and many more.

The aerosol from e-cigarettes is harmful too. E-cigarettes are sometimes called e-cigs, electronic nicotine delivery systems (ENDS), vape pens, or vapes. Vaping is the act of breathing e-cigarette aerosol in and out. E-cigarette aerosol often contains nicotine and other toxic chemicals.

The chemicals in tobacco smoke and e-cigarette aerosol can irritate your lungs and the lungs of people around you.

What Is Secondhand and Thirdhand Smoke and Aerosol?

Secondhand smoke is tobacco smoke inhaled by someone who doesn’t smoke. This includes e-cigarette aerosol too. Thirdhand smoke is residue from tobacco smoke. It sticks to surfaces and dust for months after a cigarette has been smoked.

Secondhand and thirdhand smoke can cause many of the same problems smoking can cause. Children are the most affected by secondhand and thirdhand smoke.

Scientists are still learning about thirdhand e-cigarette aerosol. But they do know that the substances found in e-cigarette aerosol can stick to surfaces and it is very hard to clean.

The only way we can decrease asthma attacks from tobacco and vaping is to reduce exposure to it. If you smoke or vape, do your best to quit. Ask others not to smoke in or near your home or car. Support laws that ban smoking in public places.

Learn more about the effects of tobacco smoke and vaping and get resources to help you quit at: aafa.org/tobacco

Medical Review: adapted from the webpage “Tobacco Smoke, Vaping, and Asthma” reviewed May 2024 by Maureen George, PhD, RN, AEC, FAAN

If you have asthma, major weather events or disasters could affect your lung health in different ways. It’s important to be prepared to treat and control your asthma during emergencies.

Asthma flare-ups during a weather event, disaster, or another emergency can happen because of:

• Allergens in the air (pollen, mold, etc.)
• Irritants in the air (dust, smoke, fumes)
• Strong emotions (stress, fear, anxiety)
• Temperature (extreme cold or heat)
• Losing access to your treatments

Create an Emergency Kit

Now is a good time to create an emergency kit with your asthma in mind. Hopefully, you never have to use it.

Keep your kit in a safe spot in your home. Make sure it is easy to find in case you need to leave in a hurry or if you have to shelter-in-place for a few days.

What should you put in an emergency kit? That depends on your specific needs. This list is a starting point:

1. Medicine, medical supplies, and equipment
The American Red Cross recommends including a 7-day supply of medicine in your emergency kit. Keep track of the expiration dates of the medicines inside the kit, starting with the medicine that expires first. You can do this by listing the contents of the kit on an index card. Ask your pharmacist for extra labels and vials so all medicines are labeled correctly.

Here are some asthma-related items you may need in your emergency kit:

• Medicines prescribed by your doctor
  • Quick-relief asthma medicines
  • Controller asthma medicines
  • Biologic medicines (may need to be kept cool*)
  • Allergy medicines, such as antihistamines and nasal sprays
  • Other emergency medicines, such as epinephrine in case of severe allergic reaction or anaphylaxis
  • Eczema lotions and medicines
  • Other medicines that have been prescribed to you
• Spacers or valved holding chambers to be used with inhalers
• Nebulizer* (portable, battery powered options may be helpful)
• Extra tubing and nebulizer parts
• N95 masks to shield your mouth and nose from blowing dust, dirt, smoke, or other airborne asthma triggers
• First aid supplies, such as bandages, antibiotic cream, pain medicine, etc. If someone in your household is allergic to latex, make sure your kit is latex free.
  
  

2. Important paperwork
Keep printed copies of important documents with your emergency kit. You won’t have access to digital documents if phone and internet networks are down.

• Asthma Action Plans
• Lists of medicines you take and doses
• Insurance cards
• Phone numbers of family and friends in case your phone runs out of power
• Names and numbers of your doctors and pharmacies
  
  

3. Food and water

If someone in your family has food allergies, they may not be able to eat food provided by shelters. Even if the ingredients are safe, there may be the potential for cross-contact with their food allergens.

Keep at least a 3-day supply of food and water on hand for each person in your household. Have it packed and ready to go in an evacuation kit so you don’t have to find it during an emergency.

Here are some possible foods, depending on your family’s food allergy or dietary needs:

• Special medical foods and formulas
• Proteins: beef jerky, sunflower/soy/pea/peanut/other no-nut spread, tuna pouches, Spam™, canned beans, canned chicken, canned ham
• Grains: cereal, oatmeal, crackers, trail mix, cereal bars
• Produce: canned fruit, canned vegetables, applesauce
• Snacks: fruit snacks/leathers, chips, pretzels, cookies, candy, non-perishable fruit pouches or fruit cups
• Drinks: juice pouches, bottled water
• Other supplies: disposable plates, cups, utensils, manual can opener
• Pets: supply of safe food, their medicines, and bowls
  
  

Kids with Food Allergies, a division of the Asthma and Allergy Foundation of America, has more tips on preparing for emergencies when your family has food allergies.

4. Other supplies that may be helpful

• Extra chargers and portable battery packs for your phone
• Batteries
• Extension cords
• Hand wipes and hand sanitizer
• Flashlights
• Medical alert contact information, if you use such a service
• Plastic bags for trash, contaminated clothing, and supplies
• Change of clothing for each member of the family
• A deck of cards, small non-electronic games, or toys
• Hand warmers or cooling towels, depending on the weather
  
  

The Federal Emergency Management Agency (FEMA) includes 18 natural hazards to be aware of:

• Avalanche
• Coastal flooding
• Cold wave
• Drought
• Earthquake
• Hail
• Heat wave
• Hurricane
• Ice storm
• Landslide
• Lightning
• River flooding
• Strong wind
• Tornado
• Tsunami
• Volcanic activity
• Wildfire
• Winter weather
  
  

Many of these are common in various parts of the U.S. and don’t always cause major issues. But some of them may introduce asthma triggers that can cause symptoms. More serious events may have a more long-term impact. You may need to tailor your emergency kit based on potential hazards specific to your location.

Resources for Preparing for Emergencies

For more help preparing for an emergency in your area, visit these sites:

• The American Red Cross
• FEMA
• USDA Food Safety Tips
  
• EPA Fire and Smoke Map
• CDC Heath and Health Index
  
  

Advocacy Action Day marks the last day of National Asthma and Allergy Awareness Month, May 31. On this day, we're rallying support for some of our top priorities at the federal and state levels. Click on the links below to learn about the bills and how to take action.

• Ask Congress to expand care for people with asthma under the Elijah E. Cummings Family Asthma Act.
• Ask Congress to support expanded access to epinephrine under Dillon’s Law.
• Ask Congress to cap the cost of epinephrine under the EPIPEN Act.

Better yet, you can ask Congress to support all three bills!

As a bonus, if you live in California, Kansas, Michigan, Missouri, or Pennsylvania, you can also ask your state representatives to protect children with food allergies in child care settings under Elijah’s Law.

We hope you have been empowered by our National Asthma and Allergy Awareness Month activities and encourage you to join our Advocacy Action Network to stay in touch year-round!

This year, on World Asthma Day, the Asthma and Allergy Foundation of America (AAFA) celebrated the 25^th anniversary of the National Asthma Control Program (NACP) on Capitol Hill.

AAFA co-hosted a congressional briefing with the American Lung Association (ALA), the Allergy and Asthma Network (AAN), the American Thoracic Society (ATS), the American Academy of Allergy, Asthma and Immunology (AAAAI), and the American College of Allergy, Asthma and Immunology (ACAAI).

Speakers at the briefing included Asthma and Allergy Caucus co-chair, Rep. David Valadao (R-CA); Michigan Asthma Prevention and Control Program Manager, John Dowling; and Director for the National Center of Environmental Health of the Centers for Disease Control and Prevention (CDC), Dr. Aaron Bernstein.

The briefing highlighted the many successes of the program over 25 years. By working with state health departments on community-based care since 1999, the NACP has helped reduce the number of asthma-related:

• Deaths
• Hospital stays
• Emergency department visits
• Missed school and workdays
• Other limits on activity
  
  

The briefing also highlighted the need for more resources to expand the program. The NACP only has enough funding to work with 25 states, territories, and communities. You can help change that.

Join AAFA today in asking your House representative to support the Elijah E. Cummings Family Asthma Act (H.R. 5749). This is a bill that would allow NACP to serve all 50 states, the District of Columbia, and Puerto Rico.

Use our tool below to send a message to your representative. Just follow the steps: