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A large international study led by a Hamilton researcher has found a patient-centric treatment that works for people with mild asthma. People with mild asthma are often prescribed a daily treatment regimen, but some do not follow the routine, using inhalers only when they have an asthma attack. Researchers have found an as-needed combined-drug inhaler is a viable treatment option.
According to Paul O’Byrne , the principal investigator on the study suggests an inhaler with a combination of budesonide, a steroid that controls inflammation, and formoterol, a beta2-agonist that helps to open airways and make breathing easier, may be an alternative to conventional treatment strategies.
Short-acting beta-agonists- rescue inhalers, work quickly but they do not treat the underlying problem of inflammation, the secret in this new approach is that it not only relieves symptoms but at the same time delivers steroids required for overall control of asthma.
Symptoms may not always be burdensome, airway inflammation is usually present, and mild asthma patients are at risk of severe exacerbations, commonly called asthma attacks, which can result in emergency care or even asthma-related death.
In clinical practice, poor adherence to asthma medications, particularly inhaled steroids as maintenance therapy, is a major problem across all severities of asthma. Patients were randomly assigned one of three regimens and were closely monitored. One group took a twice-daily placebo plus as-needed terbutaline, a relief beta agonist used to prevent and treat wheezing; a second group was on a twice-daily placebo plus budesonide-formoterol used as needed, while a third group was on twice-daily maintenance budesonide plus terbutaline used as needed.
All patients received an electronic reminder to take their maintenance treatment twice daily. The trial results showed budesonide-formoterol used as needed was superior to terbutaline alone as needed for improving asthma symptom control, as well as reducing the risk of an asthma attacks by more than 60 per cent, but was inferior to the twice-daily budesonide maintenance therapy for symptom control.
Taking maintenance budesonide treatment and following it carefully, they would get the best day-to-day symptom control, but the risk of exacerbation was the same as if they used the combined budesonide and formoterol as needed. The amount of steroids used was much less when the combined inhaler was used, because the patient did not need to take it every day.
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