Specialized phenotypic biomarker profiling, Fractional Exhaled Nitric Oxide (FeNO) assessment, and next-generation targeted biologic therapies for patients with severe, uncontrolled, brittle, or oral-steroid-dependent asthma at KIMS Super Speciality Hospital, Electronic City, Bangalore.
High-precision diagnostics, cutting-edge medical technologies, and evidence-based treatment pathways tailored for individual patient outcomes.
While mild to moderate asthma is typically well controlled with standard inhaled corticosteroids and bronchodilators, severe asthma affects approximately 5-10% of asthma sufferers and remains refractory to high-dose inhalers. Patients endure chronic breathlessness, sleep-disrupting nocturnal cough, frequent emergency hospitalizations, and severe adverse effects from repeated courses of oral steroid tablets.
Modern respiratory protocols classify severe asthma across distinct biological endotypes (Type-2 High eosinophilic/allergic asthma vs. Type-2 Low non-eosinophilic asthma). The Severe Asthma Clinic utilizes precision airway biomarkers (FeNO, blood eosinophil counts, total and allergen-specific IgE) to identify molecular drivers and guide targeted monoclonal antibody biologic therapies.
Recognizing clinical signs and diagnostic triggers that indicate the need for specialized pulmonary review.
Waking multiple nights per week with severe chest tightness, choking cough, or loud wheezing despite taking maximum-dose daily inhaler medication.
Requiring two or more courses of oral corticosteroid tablets (prednisolone) in the past 12 months, or needing hospital emergency nebulization and injections.
Inability to climb one flight of stairs, walk briskly, or engage in physical exercise without immediate breathlessness and rescue inhaler reliance.
Relying on short-acting rescue puffs (salbutamol/levosalbutamol) several times per day or going through more than 2 rescue canisters every year.
Developing high blood pressure, diabetes, rapid weight gain, cataracts, facial swelling, or osteopenia/osteoporosis from chronic oral steroid use.
Severe loss of smell (anosmia), recurrent chronic rhinosinusitis with nasal polyps, or severe atopic dermatitis coexisting with chronic chest tightness.
Advanced medical and surgical equipment providing high-yield diagnostic precision and life-saving therapeutic interventions.
A rapid, non-invasive breath test measuring parts-per-billion of nitric oxide exhaled from airway epithelial cells, providing direct objective quantification of eosinophilic (Type-2) bronchial inflammation.
High-precision computerized spirometry measuring FEV1, FVC, and mid-expiratory flow rates (FEF 25-75%), followed by post-bronchodilator reversibility testing to document fixed vs reversible obstruction.
Multidisciplinary laboratory profiling including absolute blood eosinophil count (AEC), total serum IgE, specific allergen serology panels, and sputum cytology to classify the patient's biological asthma endotype.
Subcutaneous injectable biologic medications administered every 2 to 4 weeks that specifically bind and neutralize key inflammatory cytokines, dramatically reducing flare-ups and eliminating oral steroid need.
Rigorous assessment of patient inhalation technique across metered dose inhalers (MDI), dry powder inhalers (DPI), and soft mist inhalers, prescribing specialized valved holding chambers (spacers) to ensure drug reaches distal bronchioles.
Bronchoscopic catheter procedure delivering controlled thermal radiofrequency energy to the airway walls, permanently reducing excess bronchial smooth muscle mass in refractory non-T2 asthma candidates.
How we guide every patient from initial assessment to definitive treatment and long-term functional recovery.
Confirmation of asthma diagnosis (excluding vocal cord dysfunction, COPD overlap, cardiac failure, or foreign body) and verification of inhaler adherence.
Same-day FeNO breath test, full spirometry with reversibility, absolute eosinophil count, and total IgE testing to map the immunological profile.
Selection of the optimal biologic agent (Omalizumab, Mepolizumab, Benralizumab, or Dupilumab) with first dose administered under monitored clinical supervision.
Structured, gradual tapering of oral steroids under close supervision, serial FeNO tracking, and comprehensive quality of life assessment.
Clear, clinically accurate answers to common patient questions regarding this pulmonary specialty.
No. Biologics are completely different from steroids. They are laboratory-engineered monoclonal antibodies that pinpoint and neutralize specific inflammatory proteins (such as IgE, IL-4, IL-5, or IL-13). They do not cause steroid side effects like weight gain, osteoporosis, cataracts, diabetes, or thinning of the skin.
Biologics are given as gentle subcutaneous injections (just under the skin of the arm, thigh, or abdomen) once every 2 weeks or once every 4 weeks, depending on the specific medicine. After the initial monitored clinic visits, many patients can comfortably self-administer at home using pre-filled autopen injectors.
Many patients report noticeable reductions in wheezing, nocturnal coughing, and rescue inhaler reliance within 2 to 4 weeks. Major clinical trial endpoints and our clinical experience demonstrate that exacerbations and hospital admissions are reduced by over 50-70% within 16 weeks of therapy.
A Fractional Exhaled Nitric Oxide (FeNO) test is a quick, completely painless breath test where you breathe into a handheld sensor for 10 seconds. High levels indicate active allergic/eosinophilic inflammation in your airways. It helps Dr. Yadav determine exactly which medications will work best for your lungs.
While asthma cannot be "cured" in the traditional sense because airway hyperreactivity is an inherent biological trait, severe asthma can achieve complete clinical remission with modern targeted biologics—meaning zero asthma attacks, zero need for oral steroids, normal lung function, and an entirely normal active life.
Consultation Specialty: Severe Asthma Management
