Can Asthma Be Cured?

Asthma is a chronic lung disease that affects the airways of the lungs. Over 25 million people in the U.S. have asthma, leading to nearly 1 million emergency department visits each year. Unfortunately, there’s no cure for asthma. While some children with asthma seem to outgrow it as they get older, it’s a lifelong condition for most people. Thankfully, there are many effective medications that can help control asthma symptoms and let people live active and fulfilling lives. 

Part of the reason there’s no cure for asthma is that researchers don’t understand exactly what causes it. It’s clear that a person gets asthma when their genetics combine with certain factors in that person’s environment to cause inflammation in the airways. And asthma symptoms are triggered by certain factors — like cold weather, viruses, or allergies. 

But researchers are still studying the causes and treatments for different types of asthma. In the future, medications may be able to cure the airway inflammation that causes asthma — but we’re not quite there yet.

Types of asthma

To understand the best asthma treatments, let’s first review the different types of asthma. Asthma types differ in severity, triggers, and symptoms. Scientists have developed targeted asthma treatments by studying how different types of asthma respond to different medications. Let’s review some of the more common types of asthma. 

Allergic asthma

This is the most common type of asthma. In allergic asthma, triggers like dust, pollen, or pet dander causes the immune system in the lungs to react. The result is airway swelling and difficulty breathing. Skin testing can help to identify triggers for this type of asthma.

Nonallergic asthma

This type of asthma is linked to nonallergic triggers, like smoke, pollution, stress, and weather changes. Nonallergic asthma tends to be more severe and difficult to treat. Skin testing for triggers isn’t usually helpful.  

Aspirin-exacerbated respiratory disease (AERD)

About 7% of people with asthma have aspirin-exacerbated respiratory disease (AERD). Symptoms of AERD are triggered by taking aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen (Advil, Motrin). 

Sinus problems and nasal polyps are also common with this type of asthma. For unknown reasons, AERD is more common in adults than children.

Asthma with obesity

Scientists used to think that obesity was a risk factor for adult-onset asthma. Now experts know that it’s actually a separate type of asthma. The link between weight and asthma is not yet fully understood.

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Exercise-induced asthma

Exercise-induced asthma is when exercise triggers chest tightness and cough. For some people, this occurs as part of a known asthma diagnosis. For others, asthma symptoms only occur with exercise. Using an inhaler before exercise can be very helpful for preventing symptoms.

Asthma symptoms

Asthma symptoms vary. What asthma feels like can be different from person to person. For most people, asthma symptoms are often worse at night or first thing in the morning. Certain triggers often worsen symptoms, but they completely go away at other times. 

The most common symptoms of asthma are: 

• Breathlessness

• Wheezing (noisy breathing)

• Chest tightness

• Cough 

Asthma symptoms can be intermittent, which means they only happen occasionally. Or they can be persistent, which means they happen more frequently. For people with persistent asthma, symptoms can be mild, moderate, or severe. The severity of a person’s asthma determines which treatment plan is best for them. 

Symptoms can sometimes come on suddenly. An asthma attack is when the airways in the lungs become tight and swollen. Although rare, asthma attacks can be deadly. During an asthma attack you may feel like you can’t breathe and have chest tightness, wheezing, and coughing.

With an understanding of the common types of asthma and their symptoms, let’s now cover the best asthma treatments. 

The 6 best asthma treatments

There’s no cure for asthma. But there are excellent treatments for asthma that can help you control your symptoms and lower your chances of having an asthma attack. Here are some of the most commonly used asthma treatments that work best.

1. First-choice asthma inhalers 

Inhalers are devices that let you breathe medications into your lungs through your mouth. Asthma inhalers are the backbone of asthma treatment. The main types of inhalers include:

• Inhaled bronchodilators open up the airways and let more air pass through them. Short-acting bronchodilators help provide immediate relief during an asthma attack. Long-acting bronchodilators help prevent asthma attacks.  

• Inhaled corticosteroids reduce airway inflammation (swelling) and keep the airways calm. These are used as daily treatment to help prevent asthma flare-ups. 

• Combination inhalers combine inhaled corticosteroids with one or two long-acting inhaled bronchodilators. Combination inhalers can be a convenient and effective way to maximize asthma treatment without having to take multiple medications.

2. Tiotropium

Tiotropium (Spiriva) is a type of inhaled bronchodilator called a LAMA (long-acting muscarinic antagonist). It works by relaxing the muscles around the airways. Tiotropium has been around for years and is a common treatment for COPD (chronic obstructive pulmonary disease). 

Multiple studies have shown that tiotropium is safe and effective as an add-on treatment after inhaled steroids for people 6 years of age and older who have uncontrolled asthma symptoms. 

3. Montelukast

Montelukast (Singulair) can be an add-on oral asthma medication for some people. It works by blocking certain chemicals that cause inflammation and swollen airways in asthma. 

Singulair is usually an option for people with allergies and asthma who are already taking an antihistamine. But it’s less effective for asthma than inhaled steroids. There’s also a serious risk of mental health problems for people taking montelukast, among other side effects.

4. Biologics

Monoclonal antibodies, or biologics, are a newer class of medications that show promise for treating asthma. They’re lab-made synthetic proteins (antibodies) that are designed to target some of the cells and chemicals that cause airway inflammation. They’re recommended to add when other treatment options haven’t worked well enough.

Five biologics have been approved so far: 

• Omalizumab (Xolair): This injection is given under the skin to help treat asthma symptoms in people 6 years and older with moderate to severe allergic asthma. It can also improve lung function for people with nonallergic asthma.

• Dupixent (dupilumab): This is also an injection under the skin. It reduces asthma attacks by almost half and also improves lung function. It’s approved for people 6 years old and up.

• Anti-IL-5 therapies: These include Nucala (mepolizumab) for ages 6 and up, Fasenra (benralizumab) for ages 12 and up), and Cinqair (reslizumab) for ages 18 and up. These medications are given by IV (intravenous) infusion or an injection under the skin. 

5. Bronchial thermoplasty

Bronchial thermoplasty is a procedure (not a medication) that shows promise as an asthma treatment. Heat is applied to the airways to reduce the amount of muscle around them. The FDA approved it for adults with asthma who still have symptoms after taking inhaled steroids and bronchodilators. 

Studies show that bronchial thermoplasty reduces attacks and emergency department visits. Because it’s a newer procedure, researchers don’t know anything about the long-term effects. Experts also still aren’t sure when to use it or who will respond well.

6. Desensitization

Desensitization is an effective procedure for people with AERD. People are slowly given higher and higher doses of aspirin or an NSAID as they’re monitored for potential allergy symptoms. For safety reasons, desensitization must be performed by an allergy specialist in a medical facility. 

Desensitization can make it safe for people with AERD to take aspirin again, after which aspirin can actually become part of asthma treatment. It can improve symptoms in about 6 in 10 people with AERD.

Why is asthma so hard to cure?

One reason there’s no asthma cure is that the body’s own immune system causes asthma attacks. The immune system is very complex. It involves many chemical signals released during an allergic response. Scientists are still learning about what these chemical signals do during an asthma attack and why this happens. These chemical signals are critical for a healthy immune system, so we can’t just wipe them out when they cause problems.

But they can be targeted with medications, such as with the biologics mentioned above. Biologics are a big development in asthma treatments, but they’re likely just the beginning. There are still many more chemical pathways to discover and study in the immune system and body.

Another reason asthma is so hard to cure is that scientists still don’t understand the whole picture about how it is inherited. While scientists are quickly identifying genes that are responsible, there’s still much work to be done.

Can you grow out of asthma?

It’s possible for some people with asthma to achieve remission. Here’s what this means:

• They no longer have asthma symptoms or asthma attacks.

• Their lung function has gone back to normal.

Some people achieve remission with medications, and others don’t need medications. Children are much more likely than adults to stop having asthma symptoms without using medications. This is what people describe as “growing out of asthma”. 

About half of children seem to grow out of their asthma. But studies suggest that only 1 in 6 adults will become free of symptoms. 

Nevertheless, this picture is more complex than it seems: About half of children and adults who become free of symptoms still have abnormal lung function. So even though they don’t have symptoms, they’re not considered to be in full remission and may be prone to relapse when they get older.   

Overall, a person with asthma is more likely to develop remission if they:

• Were younger at diagnosis

• Had milder asthma symptoms to begin with

• Never smoked or quit smoking

• Have better lung function 

• Have fewer chronic medical conditions

• Have had asthma symptoms for fewer years

Another way of achieving remission is through the use of biologic medications. This is called treatment-induced remission. One reason that the biologic class of medications is such an exciting development is that, unlike traditional medications, biologics sometimes induce remission. 

One study showed that after at least 12 months of treatment with biologic medication, remission rates ranged from 21% to 36% in people who had severe asthma before treatment. 

Researchers are still trying to understand if biologic medications can be stopped after a person goes into remission. If so, this would be the closest thing to a cure for asthma so far. More research is needed to understand what factors can affect whether a person could remain in remission even after stopping treatment. 

Asthma prevention

You may not be able to get rid of your asthma, but there are ways to help prevent asthma attacks. The following tips can help you keep your asthma symptoms at bay.  

Avoid triggers

If you know what triggers your asthma, it’s important to avoid those things as much as possible. For example, most people need to avoid smoke — both active smoking and secondhand smoke. Check out our full review of asthma triggers.

Use inhalers as prescribed

Your healthcare provider will talk with you about inhalers that help to prevent attacks and others that treat attacks. Be sure to use your preventive medications every day as prescribed.

Have an action plan

An asthma action plan can help you decide what to do if you start having symptoms. The plan should be unique to you and your asthma. If you don’t have an action plan, ask your healthcare provider about making one together.

Stay healthy

It’s important for everyone to stay active, eat a healthy diet, and maintain a healthy weight. This is very true for people with asthma. Getting a flu vaccine every year will lower your risk of severe disease during flu season.

Why trust our experts?

Written by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician in a variety of clinical settings. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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