Symptoms of mild, persistent asthma are wheezing, coughing, or chest tightness two to six days of the week, or awakening due to asthma two or three times a month. Conventional treatment usually requires two prescribed drugs: a "beta agonist" for immediate relief, and daily use of inhaled corticosteroids to reduce airway inflammation and minimize risk of severe asthma attacks and airway scarring that might permanently reduce lung capacity.
But the year-long controlled study shows that adult asthma sufferers fare about as well whether they take a steroid drug every day or only during asthma attacks. Changes in lung function, overall frequency of symptoms and the number of severe attacks were about the same, whichever regimen was followed.
According to one of the study's authors, if the estimated four million people with mild persistent asthma took inhaled steroids only when symptoms flared, the annual medication costs would be about $2 billion lower -- or up to $150 a month per patient less -- than if they took the steroids every day as current NIH guidelines recommend.
The multi-center study, known as the Improving Asthma Control Trial (IMPACT), was funded by the National Heart, Lung and Blood Institute, and led by scientists at UCSF and Harvard Medical School.
The results are being published in the April 14 issue of The New England Journal of Medicine. The issue also includes an editorial on the study and its likely impact on treatment for asthma.
"There is no question that use of inhaled corticosteroids or other anti-inflammatory drugs known as anti-leukotrienes are effective -- and necessary -- for patients with moderate or severe asthma, but our findin
Contact: Wallace Ravven
University of California - San Francisco