Asthma Treatment

Study of patients with mild persistent asthma find that inhaled steroids long consider the gold standard for asthma treatment were no more effective than placebo in nearly three fourths of the study patients, all over age 12. Inhale steroids were better than placebo for a subset of the patients who had high levels of a particular type of inflammatory cells; which called eosinophils, in their sputum, but they represent about a fourth of patients enroll in the trial.

The study was fund by the National Heart, Lung, and Blood Institute (NHLBI); so part of the National Institutes of Health, and appear online on May 19 in the New England Journal of Medicine (NEJM). The publication coincides with the study’s presentation at the international conference of the American Thoracic Society, which takes place in Dallas.

More effective treatments

The research highlights the need for developing more effective treatments for asthma; also suggests that it may be possible to target particular therapies to subsets of patients; so such as those with high or low eosinophils. New approaches to treating the “low eosinophil” group be especially helpful for improving the overall effectiveness of treatments for mild asthma, the most common type of this respiratory condition.

They’re intrigue by the results of this study and believe it raises questions; which about the way doctors manage mild persistent asthma, said Stephen Lazarus, M.D., lead study author and a professor of medicine at the University of California, San Francisco. They’re not saying that steroids are unimportant for mild asthma; but our study does suggest that treatment guidelines should be re evaluate for patients ; so with mild persistent asthma who have low sputum eosinophils.

Asthma affects nearly 25 million Americans; so according to the Centers for Disease Control and Prevention. Despite significant research strides; so increasing numbers of people continue to have poorly control asthma. However, daily steroid use can have adverse side effects over time; so including weight gain and diabetes, and, at $200 to $400 per inhaler, can be expensive.  A growing number of studies suggest that it may be possible; hence to manage mild persistent asthma safely without daily steroid use.

Treatments for asthma

In the quest to improve treatments for this type of asthma; so researchers in the current study focus on sputum eosinophils; so white blood cells find in the lung that can serve as bio markers of airway inflammation. Biomarkers are generally use to guide treatment only in the most severe forms of asthma. But laboratory tests to measure sputum eosinophils are relatively complex and not routinely use in most clinics.

The researchers were surprise to find that nearly 73% of the participants, or 221 people; so were classify as having low sputum eosinophils, a much higher frequency than expect. Among those participants who were classify as “Eos-low,” the number who respond better to active treatment with steroids was no different than the number who respond better to placebo.  By contrast, those who were classify as “Eos-high” were nearly three times as likely to respond to inhale steroids than placebo.

Among those who were ‘Eos-low’ and had a better response to one of the treatments, 60% had superior results on LAMA, versus 40% who had better symptom control on placebo. The researchers emphasize that for now people with asthma should continue to follow their doctor’s recommendations regarding their treatments.