€18 test ‘to improve asthma care in children’
Scientists in Britain have found a simple saliva test costing £15 (€18.40) helps work out the best treatment for children with asthma.
A popular drug called salmeterol, used for long-term control of asthma, works poorly in children with a particular genetic variant carried by one-in-seven sufferers. Scientists say new advice should be given to GPs and parents on what to do if a child fails to respond well to the drug.
They found children with the Arg16 genotype fared better using montelukast instead of salmeterol.
Lead researcher, Somnath Mukhopadhyay from the Brighton and Sussex Medical School, said that when symptoms did not improve in children, doctors often blamed the mother for not giving salmeterol properly rather than concluding that the drug was not working.
About one-in-five children in Ireland have asthma and those diagnosed with the condition are usually given a blue Ventolin inhaler to provide instant relief from attacks.
Some need to use the inhaler so frequently that doctors also prescribe a steroid inhaler, or where this is ineffective, salmeterol for longer-acting treatment.
The researchers, whose work is published in Clinical Science, studied 62 children with the genetic variant.
All of the children continued to use their reliever inhaler but half were randomly chosen to get salmeterol while the others were given a different drug, montelukast. It was found that the children taking montelukast were not wheezing and coughing as much, were less reliant on their inhalers, and missed school less often.
At the start of the study, 36% of the children were using their reliever inhaler every day but by the end of the year-long study, those using it daily had halved in the montelukast group, but not in the salmeterol group.
The scientists in the study believe that if larger trials showed the same effect, the genetic test should be made available to doctors.
It is unlikely the findings apply to adults because child asthma is very different to that experienced later in life.
GlaxoSmithKline, that makes salmeterol under the trade name Serevent, said the medicine had been extensively studied since licensing in 1990. A spokesperson said it supported ongoing research into genetics that could help to more effectively tailor asthma treatments.
“The results of this small study raise interesting questions around how different patients can gain the most benefit from their medicines and it warrants further research,” said the spokesman.
Frances Guiney, a respiratory nurse specialist with the Asthma Society of Ireland, said while it was a small study, it identified another less common possibility for poor control. However, further research was needed.
She said there were many reasons for poor asthma control, including inadequate inhaler technique, non-compliance with controller medication regime and exposure to triggers.
*www.asthmasociety.ie
