Management of asthma in athletes: review article in NEJM

Athletes engaged in high-endurance sports are particularly vulnerable to various respiratory ailments, including asthma and rhinitis.

In the article “Asthma and Exercise-induced Bronchoconstriction in Athletes” in the February 12, 2015, issue of The New England Journal of Medicine, AllerGen investigators Drs Louis-Phillipe Boulet (Laval University) and Paul O’Byrne (McMaster University) review current expert opinion on the management of asthma and exercise-induced bronchoconstriction (a temporary narrowing of the airways following exercise) in athletes.

This review shows that in the athlete, asthma presents as a specific phenotype. Specific recommendations offered for high-level athletes include: early diagnosis of respiratory conditions; education on asthma self-management; pre-exercise warm-up; use of inhaled glucocorticoids according to individual need; and avoidance of exercise in conditions of very cold, dry air or during times of high levels of exposure to allergens or atmospheric pollutants.

The authors also conclude that, while these conditions can usually be well-managed in athletes at present, better data from controlled trials are needed to improve asthma-management plans for competitive athletes in the future.