A combination of inhaled inflammation-reducing steroids and airway-opening drugs is far effective than a standalone low dosage of steroids when it comes to preventing severe asthma attacks, as per a recently concluded study.

The study also pointed out that higher dose of steroids alone can prove to be as effective as the combination therapy.

Muireann Ni Chroinin, M.D., of the Norfolk and Norwich University Hospital in England, and colleagues reported that patients suffering from asthma who used long acting beta-2 agonist (LABA) drugs in combination with inhaled steroids performed better than those who did not.

This study also reported that the rate of severe asthma attacks with the combination therapy helped in reducing the rate of severe asthma attacks from 27 to 22 percent.

From News-Medical.Net:

Combination therapy also improved overall lung function, increased the number of days where patients said they felt free of asthma symptoms and decreased the patients’ use of rescue inhalers, compared to inhaled steroids alone, the researchers found.

For patients who continue to have asthma symptoms while using an inhaled steroid medication, “the addition of long-acting beta-2 agonist is superior to remaining on similar doses of inhaled steroids alone,” Ni Chroinin says.

In a second review, Ilana Greenstone, M.D., of McGill University Health Center in Canada and colleagues concluded that a double dose of inhaled steroids worked just as well as combination therapy in reducing the rate of severe asthma attacks.

But the combination therapy “clearly leads to greater improvement in lung function and symptoms than a two- to two-and-a-half-fold higher dose of inhaled corticosteroids,” according to Greenstone. There was a 12 percent increase in symptom-free days among patients taking LABA and steroids, compared to those taking the higher steroid dose. Patients on the combination therapy also reduced their rescue inhaler use by as much as one less “puff” per day.

There were no significant differences in side effects between the combination therapy and higher steroid doses except for a three-fold increase in the rate of tremor, or uncontrolled muscle contractions, in the patients taking LABA medications, the researchers found.

Jerry Krishnan, M.D., an asthma researcher and assistant professor of medicine and epidemiology at the Johns Hopkins University School of Medicine, pointed out that there has been a tendency among the doctors to start the combination therapy of inhaled inflammation-reducing steroids and airway-opening drugs rather than persisting with steroid treatment alone in the initial stages and effectively combining the LABA drugs at a later stage.

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