Dr. Alan Khadavi, MD

Asthma Biologic Agents
The last several years have seen an influx of asthma biologic agents to hit the market. Here we will discuss the 5 that are currently FDA approved to treat type 2 inflammatory asthma. Type 2 asthma inflammation is triggered by IL-4, IL-5, and IL-13 along with other inflammatory mediators. Half of all patients with asthma have evidence of Type 2 inflammation. Sputum and blood eosinophils, exhaled nitric oxide, blood IgE levels and airway gene expression markers are frequently used biomarkers...

Best and Worst Exercises For Asthma
As asthma specialists, we are often asked which sports are the best exercises for asthma?  There are approximately 25 million Americans with asthma and exercise may cause no problems at all.  But for some, it can trigger shortness of breath and other asthma symptoms.  That doesn’t have to stop most people from exercising though, 1 in 12 Olympic athletes takes asthma medication. It is important to make sure your asthma is well controlled with proper medication and to choos...

Does Expired Albuterol work?
Does expired albuterol work?  Expiration dates of pharmaceutical products are important to know. They are based on stability studies conducted by manufacturers. Expiration dates imply that the medications no longer retain their potency and should be discarded once its reached, but in facts, the post expiration residual drug strength is usually undetermined.  In fact in a previous blog we discussed how expired Epipens still worked much past their listed expiration dates. Does an expi...

Itepekimab in Asthma and COPD
Itepekimab is an anti-Il-33 monoclonal. Il-33 is an epithelium-derived cytokine that promotes Th2 immune responses in response to cellular damage with roles in asthma and COPD (Chronic Obstructive Pulmonary Disease). Two randomized controlled clinical trials were performed assessing the efficacy of Itepekimab in asthma and COPD. After identifying the asthma associated variants in the genes encoding IL-33 or its receptor IL1RL1, also modifying the risk of COPD, the investigators performed a...

JAK inhibitors for Asthma
JAK inhibitors for asthma are currently being studied. Asthma is an inflammatory disease of the airways characterized by intermittent episodes of wheezing, chest tightness and cough. Many of the inflammatory pathways implicated in asthma involve factors that activate the Janus Kinase (JAK). The discovery of the Janus kinases activator of transcription (STAT) signaling pathway was a breakthrough in understanding of cell growth and differentiation. Janus Kinase inhibitors are under active inves...

When can you stop inhaled steroids for asthma?
Inhaled steroids for asthma is the recommended first-line treatment for patients who are uncontrolled. Inhaled steroids have led to fewer hospitalizations and deaths over the past 10-15 years. Recent Global Initiative  for Asthma guidelines, recommend in mild asthma, intermittent use of an inhaled steroid and long acting beta-2 agonist (LABA) on an as needed basis for patients in treatment step 1. Past guidelines recommended albuterol as an add needed basis for those patients. More moder...