Air waves

New findings challenge asthma treatment, reports Arlene Harris.

ONE person a week dies from an asthma-related-illness in Ireland. With 470,000 people with the condition, we have the fourth highest rate of asthma in the world. Sufferers have long been told that controlled management is the answer to keeping the respiratory disease under control. But last week doctors in the US claimed that asthmatics who took a daily low-dose medication as a preventative measure did no better than those who only used their inhalers when they had symptoms.

Published in the Journal of the American Medical Association, Dr Homer A Boushey of the University of California said the findings challenge international guidelines which have been in place for 20 years. These recommendations state if a person’s asthma is mild but persistent, they should take an inhaled steroid every day to suppress airway inflammation and reduce the risk of exacerbations.

Almost 350 adults with mild to moderate, persistent asthma took part in the study. All had either reversible airflow limitation or airway hyperresponsiveness. And researchers found the frequency of flare-ups, symptom severity and pulmonary function did not differ among the treatment groups.

But Frances Guiney, director of patient services at the Asthma Society of Ireland advises sufferers not to change their treatment plan unless advised by their doctor.

“The current medical opinion is that the most effective treatment to prevent exacerbations is daily inhaled corticosteroids in conjunction with a structured asthma education programme,” she advises.

“Although there is currently no cure, if well controlled, the long-term prognosis for someone with asthma is the same as someone without.”

Dr John Ball of the Irish Association of General Practitioners (IAGP) agrees, adding that every case needs to be monitored individually.

“It would be a good idea to discuss changes with your GP,” he advises. “Some people’s asthma can become worse quite rapidly and may also be very seasonal, and therefore preparing for this may be more appropriate with the use of inhalers regularly before symptoms emerge.”

Asthma can ease over time for some people who may not require treatment for years, says Dr Ball. “It is always worth mentioning though if you had it as a child as it can return many years later.

“The majority of children with asthma will be symptom-free in adulthood. For most people with chronic asthma their symptoms can be controlled with treatment; but there is a high risk in a small number of individuals.”

¦ Visit www.asthmasociety.ie or call 1850-445464