Most patients with asthma feel that their disease manifestations are the same as others with this complicated disease.  Many doctors who do not deal with asthma on a regular and high volume basis have the same idea.  We are learning more each day about this disease that has affected both the rich and the poor for centuries.Recently, a large study has found that age is a factor in how patients respond to therapy and how this leads to “treatment failures”. 

To summarize the finding, it appears that patients older than 30 years old have an increased risk of treatment failures.One of the reasons proposed for these findings is that the type of inflammation in the airways either changes, or was different from the beginning in some patients. 

This can quickly become a very complicated discussion, but remember that airways of asthma patients have a chronic inflammatory process going on and it is this inflammation which leads to the symptoms.  The primary treatment for asthma is reducing the airways inflammation.  What we are learning is the type of inflammation may vary from one asthmatic to the next. 

This means that the treatment for one asthmatic may be different from another.  Unfortunately, we do not have good and reliable tests to separate one from another.To do the best job we can for asthmatic patients, it may require testing for certain so-called biomarkers in the blood and in many situations having to use multiple therapies to gain control of disease symptoms and progression.