A potential new treatment approach has been identified for treating severe asthma, as per a small study. The approach is focused up on blocking of a powerful immune system, which is present in large amounts in patients with the severe form of asthma.

It is believed that one out of every ten asthmatics suffers from severe asthma that frequently requires progressively higher doses of steroids for controlling symptoms.

From News-Medical.Net:

Included in the study were 26 healthy people, 67 mild asthmatics, and 51 severe asthmatics. Bronchial fluid and lung tissue samples were taken from the participants to discover their levels of TNF alpha.

Levels were significantly higher in those with severe disease and concentrated in one particular type of immune cell (mast cells) which are recognised components of the inflammatory reaction in asthma.

TNF alpha levels were low and similar in those with no asthma or who only had mild symptoms.

This suggests that the high levels of TNF alpha in severe disease are characteristic of more chronic disease that is resistant to steroid treatment, rather than a feature of the disease itself, say the authors.

The authors caution that that more research is required in this field before the approach can be recommended at any stage but also said that this approach is a potentially new avenue of treatment for severe asthma.

Tags:  asthma, severe asthma, Steroids

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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.

Tags:  airway opening drugs, asthma attacks, inhaled inflammation reducing steroids, LABA drugs, severe asthma, Steroids

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