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New approach for treating asthma (p 1715)
November 22, 2002Authors of a UK study in this week's issue of THE LANCET suggest that targeting the underlying cause of asthma-rather than treating symptoms of the disorder-could be more effective in reducing severe asthma attacks.
Conventional treatment for people with asthma relies on assessments of symptoms and simple measures of lung function. however, increased concentrations of microscopic cells called eosinophils cause the inflammation of airways in the lung that lead to asthma symptoms; eosinophils are also present in sputum several weeks before an asthma attack. Ian Pavord from Glenfield Hospital, Leicester, UK, and colleagues assessed whether the reduction of eosinophilic inflammation reduced asthma exacerbations compared with a conventional (British Thoracic Society[BTS]) approach.
74 patients with moderate to severe asthma were randomly allocated to management by either BTS asthma guidelines or by normalisation of the induced sputum eosinophil count; patients allocated to the sputum eosinophil group had asthma medication (inhaled or oral corticosteroids) regulated in response to changes in eosinophil concentration as the study progressed.
The sputum eosinophil count was 63% lower over 12 months among patients allocated to sputum management than those given conventional treatment. There were fewer severe asthma attacks (35) among patients in the sputum group than those given conventional treatment (105), and a reduction in hospitalisation for severe asthma (1 and 6 cases, respectively). Use of oral or inhaled corticosteroids did not differ between the two groups.
Ian Pavord comments: "Severe exacerbations of asthma needing courses of oral corticosteroids or hospital admission are the most serious manifestation of this disease. They lead to asthma deaths, illness, and a high cost to the health service in terms of doctor consultations, drug use, and hospital beds. Our results show that a strategy directed at maintenance of a normal airway eosinophilic count caused a large reduction in the number of severe exacerbations in a group of patients with moderate to severe asthma compared with traditional management based on the BTS guidelines. We believe such an effect has implications for management of asthma in that it strongly supports the view that airway inflammation should be monitored regularly for the best treatment of this group of patients."
Lancet
Asthma Current Events and Asthma News RSSStudy strengthens link between tobacco smoke and behavioral problems in boys with asthma
Boys with asthma who are exposed to environmental tobacco smoke have higher degrees of hyperactivity, aggression, depression and other behavioral problems, according to researchers at Cincinnati Children's Hospital Medical Center.
Pregnant women with asthma can be more confident about some medicines
Women can usually keep using the same asthma drugs they were using before they got pregnant. Budesonide sprays are the best studied and can be regarded as safe.
Study shows school-based program enables children and adolescents to better manage chronic disease
A new study has found that a school-based asthma education program conducted in the Oakland, California school district was shown to reduce symptoms and increase the number of days that children who suffered from asthma were able to go to school.
Pregnant women with asthma can be more confident about some medicines
Women can usually keep using the same asthma drugs they were using before they got pregnant. Budesonide sprays are the best studied and can be regarded as safe.
Fall babies: Born to wheeze?
It is said that timing is everything, and that certainly appears to be true for autumn infants. Children who are born four months before the height of cold and flu season have a greater risk of developing childhood asthma than children born at any other time of year, according to new research.
Hospital visits for respiratory illnesses spiked during Southern California wildfires
Raging wildfires that engulfed Southern California earlier this decade not only destroyed neighborhoods laying in their path, they also caused significant health problems for many who lived outside the fires' reach.
The miseries of allergies just may help prevent some cancers, study finds
There may be a silver -- and healthy -- lining to the miserable cloud of allergy symptoms: Sneezing, coughing, tearing and itching just may help prevent cancer -- particularly colon, skin, bladder, mouth, throat, uterus and cervix, lung and gastrointestinal tract cancer, according to a new Cornell study.
Is ineffective esophageal motility associated with gastropharyngeal reflux disease?
IEM is associated with an increased acid clearance times in the distal esophagus. Gastropharyngeal reflux causes supraesophageal manifestations such as globus, chronic cough, hoarseness, asthma, chronic sinusitis, or other otorhinolaryngologic diseases.
Flu vaccination rates lag for at-risk adolescents
Influenza vaccination rates for adolescents who suffer from asthma and other illnesses are still far too low, according to a recent study.
Tweens and teens double use of diabetes drugs
America's tweens and teens more than doubled their use of type 2 diabetes medications between 2002 and 2005, with girls between 10 and 14 years of age showing a 166 percent increase. One likely cause: Obesity, which is closely associated with type 2 diabetes.
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