Mario Castro, MD, MPH: The Future of Asthma-Modifying Therapy


Dr. Castro considers it to be a fruitful and exciting time in the study of asthma-modifying therapy, with some biologic therapies achieving control in patients with severe asthma.

In the September 2021 episode of Lungcast, Al Rizzo, MD, Chief Medical Officer of the American Lung Association (ALA), touched on the future of asthma-modifying therapy with Mario Castro, MD, MPH.

Castro is the Chief of Pulmonary, Critical Care and Sleep Medicine; Vice-Chair for Clinical and Translational Research; and Director of Rainbow Clinical and Translational Science Unit, Frontiers at the University of Kansas School of Medicine.

He noted that it was an “exciting time” for the future of asthma therapy, as clinicians continue to find agents that will modify the disease process for affected patients.

We have some good drugs now, so I think that what we're really studying now (is) whether or not they're truly disease modifying,” Castro said. “None of these therapies have that indication approved by the FDA, but we might have some candidates; these biologic therapies, as I mentioned, they're achieving control, they're improving lung function, and we think that they might have a chance of disease modification.”

For Castro, disease modification would entail improving a patient’s lung function and normalizing their disease to the extent that they do not have progressive disability.

“My goal is not to take away (or) cure the disease, I think that's an unrealistic expectation at this point with the current therapies that we have available,” Castro said. “But, if I can modify that disease to the point that their lung function is preserved, they don't ever reach the point of disability from reduced lung function then that, to me, is a disease modifier.”

He added that he is often asked of early introductions of disease modification in children, with an example being the change of progression of chronic obstructive lung disease from childhood to adulthood.

Though he is optimistic about those possibilities, Castro mentioned that the best way to aim for those results is through increased, safe studies on biologics and the pediatric population.

Rizzo and Castro briefly discussed the implications of the COVID-19 virus on asthmatic patients.

Though recent CDC data suggested the virus posed no increased risk to patients with asthma, Castro mentioned that patients who received the vaccine experienced very mild disease in comparison to unvaccinated people.

“I truly believe that the vaccine is effective and my patients with asthma, and certainly encourage them (to get vaccinated),” Castro said.

Lungcast is a monthly respiratory health podcast series from the ALA, produced by HCPLive.

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