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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
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 RSSJohns Hopkins researchers track down protein responsible for chronic rhinosinusitis with polyps
A protein known to stimulate blood vessel growth has now been found to be responsible for the cell overgrowth in the development of polyps that characterize one of the most severe forms of sinusitis, a study by Johns Hopkins researchers suggests.
Ancestry attracts, but love is blind
People preferentially marry those with similar ancestry, but their decisions are not necessarily based on hair, eye or skin colour.
Common plastics chemicals linked to ADHD symptoms
Phthalates are important components of many consumer products, including toys, cleaning materials, plastics, and personal care items.
Asthma a significant risk factor for complications in children with H1N1
A new study on pediatric H1N1 influenza admissions has found that asthma is a significant risk factor for severe disease in children with pandemic H1N1 compared with the seasonal flu.
Mother's Depression a Risk Factor in Childhood Asthma Symptoms, Study Suggests
Asthma symptoms can worsen in children with depressed mothers, according to research from Johns Hopkins Children's Center published online in the Journal of Pediatric Psychology.
Sweet -- sugared polymer a new weapon against allergies and asthma
Scientists at Johns Hopkins and their colleagues have developed sugar-coated polymer strands that selectively kill off cells involved in triggering aggressive allergy and asthma attacks.
Pivotal study for PSD502 -- the first potential treatment for premature ejaculation
At the annual meeting of the Sexual Medicine Society of North America (SMSNA), Inc. in San Diego, Sciele Pharma, Inc., a Shionogi Company and Plethora Solutions Limited, a wholly owned subsidiary of Plethora Solutions Holdings PLC ("Plethora" - AIM:PLE)., today presented data from its second positive pivotal study of PSD502 for the treatment of premature ejaculation (PE).
Aileron collaborates study in Nature: Stapled peptides inhibit Notch1 transcription factor
This research validates the potential for Stapled Peptides to modulate key intracellular biological targets, such as transcription factors, that have not been addressable with current small molecule or biologic drug modalities.
Women with asthma feel worse
Women with asthma are more anxious, find it harder to sleep and are more tired during the day than their male counterparts, but nevertheless tend to be better at following their treatment.
Poll: Many parents, high-priority adults who tried to get H1N1 vaccine unable to get it
A new national poll from Harvard School of Public Health (HSPH) researchers found that a majority of adults who tried to get the H1N1 vaccine for themselves or their children have been unable to do so.
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