Monday, September 23, 2013

Asthma Pills Work as Well as Inhaled Steroids


Asthma Pills Work as Well as Inhaled Steroids
In a study pill asthma compared with commonly prescribed inhaled steroids, British researchers found that oral drugs as effective as inhaled drugs.

Oral drug, known as leukotriene-receptor antagonist, “has shown similar efficacy and cost and better compliance, and should be considered for all patients, not as a last resort, but as an option for patients,” said study co-author Dr Stanley Musgrove., senior research fellow at the University of East Anglia in Norwich.


“Every different patients will have their own problems that are important to care for them: their adherence to different medications, how well they feel that different drugs work for them, their concerns about different drugs, side effects may be small, and so forth, and all these should be considered when doctors and patients make decisions about the best medicine, “he said.


The results published in the May 5 edition of the New England Journal of Medicine.


This study was designed to be what the researchers call a “pragmatic” trial, which more closely mimic the way people are using drugs in real life as opposed to the strict rules of clinical trials, according to Musgrove.


The researchers recruited 650 people with mild to moderate asthma. The study volunteers were between the ages of 12 and 80, and have inadequate asthma control or quality of life disruption due to asthma symptoms.


Volunteers were randomly assigned to groups. One research group compared with leukotriene-receptor antagonist (Accolate and Singulair) for inhaled corticosteroids as first-line treatment for asthma. Another group of studies compared people who are already taking inhaled steroids are then added to both long-acting rescue medication (known as NET) or leukotriene-receptor antagonist (LTRAs).


Patients were allowed to comply as they wish and change drugs they need, Musgrove said.


Results in two months show that LTRAs also equally effective for inhaled corticosteroids when used as first-line treatment and for consumed when used as an additional treatment. After two years, the effectiveness of these two similar treatment but the researchers noted that “equality has not been proven.”


Primary measure of effectiveness of the drug ‘is the Mini Asthma Quality of Life Questionnaire. This quiz has a 15-item total score between 15 to 105, with higher scores showed less decline in asthma. Increased by an average score of 0.8 to 1 point in the trial arms. Asthma control and frequency of asthma exacerbations were similar between the groups.


Musgrove said there was no significant side effects were reported for each drug. However, in 2009, the U.S. Food and Drug Administration asked drug makers to add warnings to labels LTRA their medication because of serious side effects behavior, including thoughts of suicide and depression in some people taking the drug.


Risk inhaled steroids for asthma include hoarseness, thrush, sore throat, and bone density may be reduced.


In terms of cost, in 2010 British study that compares the cost of the two therapies
to control asthma LTRAs initial finding that the price is “higher” than the inhaled steroid.


One expert says the latest study comparing the effectiveness of inhaled steroids LTRAs and underlines the need for individual therapy.


“The findings of the study does not make me change my mind. It is asserted that there are various options, and no one answer for everyone,” said Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Hospital and Medical Center in Detroit.


“The National Institutes of Health has issued guidelines for the management of asthma, and many a literature review to go into setting those guidelines which recommend inhaled corticosteroids are tried first. And, it is my experience that I get good control with more patients using inhaled corticosteroids,” he said.


“But if someone is having difficulty using the inhaler on a regular basis or they experience side effects, then I’ll think about changing their medication,” he added. “But, there is no medicine that will help everyone, and no treatment without risk.”







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