Pressure is mounting on the NHS to widen the use of a “wonder” drug that could help hundreds of thousands of severe asthma sufferers.

Currently, most of the 250,000 UK patients who suffer from severe allergic asthma are prescribed powerful oral steroids.

From Thisislondon.co.uk:

Under guidance from the NHS drugs rationing body, only about 1,000 of the worst-afflicted are offered the “revolutionary” drug omalizumab, which is proven to work but costs £12,000 a year.

Now, a new study has shown that 64 per cent of severe asthma sufferers who took omalizumab over 12 months significantly reduced their dependence on oral steroids – and half were able to stop taking them altogether.

Richard Cull, 31, a medical student at St George’s Hospital in Tooting, told the Evening Standard: “I’ve had asthma all my life and spent a good deal of my childhood in and out of hospital.

Dr Robert Niven, co-author of the University of Manchester study, said: “Omalizumab costs £12,000 a year, compared with oral steroids which are next to nothing. But the costs to the NHS of managing the side-effects have never been calculated.

They cause patients to gain significant amounts of weight and eventually develop diabetes, cataracts and glaucoma. About half go on to suffer from osteoporosis and other suffer from depression, anxiety and even growth retardation. That has to be worth reducing.”

Tags: Asthma, Oral Steroids, steroids

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A study by researchers at Washington University School of Medicine and other institutions has suggested that dose changes (steroids) and/or addition of new drugs to the asthma therapy can provide relief to patients.

Robert C. Strunk, M.D., and Leonard B. Bacharier, M.D., both Washington University pediatric asthma specialists at St. Louis Children’s Hospital were co-authors for this study.

From Sciencedaily.com:

“We used a few complicated and expensive tests we thought would help us determine which drug would be better, but they didn’t help, so we can avoid these tests,” says Strunk, the Donald Strominger Professor of Pediatrics at Washington University School of Medicine.

Although 98 percent of patients in the study showed improvement on at least one of the step-up options, there were still 120 asthma exacerbations, or attacks, among the 165 patients that required treatment with prednisone, a corticosteroid commonly used after an exacerbation that prevents the release of inflammatory substances in the body. Bacharier says that indicates none of these treatments provide perfect asthma control.

“There may not be an ideal therapy for every patient, but these step-up treatments allow for improved asthma control and outcomes over leaving them on low-dose steroids alone,” Bacharier says.

The study was published online March 2, 2010, by the New England Journal of Medicine and presented the same day at the American Academy of Allergy, Asthma and Immunology’s annual meeting in New Orleans.

Tags: Asthma, asthma therapy, corticosteroid, Prednisone, steroids

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Interferon, an immune-system protein already used for treating health complications like hepatitis C, multiple sclerosis, and a variety of cancers, could be used for granting relief to patients afflicted with asthma.

This finding was disclosed by researchers from the UT Southwestern Medical Center. It was also suggested that interferon can prove out to be a readily available and valuable therapy for treating asthmatic patients.

From Sciencedaily.com:

“This finding is incredibly important, because humans are being treated with interferon for a variety of diseases, yet no one has tried treating asthma patients with interferon,” said Dr. J. David Farrar, assistant professor of immunology and molecular biology at UT Southwestern and senior author of the study. “The current therapies for asthma are inhalers and steroids, both of which offer only temporary relief.”

Asthma results in approximately 200,000 pediatric hospitalizations each year, more than for any other childhood disease. About 20 million people have been diagnosed with asthma in the U.S.

In the current study, the researchers showed in isolated human cells that interferon blocks the development of nascent Th2 cells and inhibits cells that already have become Th2 cells by interfering with a regulatory protein called GATA3, a transcription factor Th2 cells express to regulate their function.

The study was funded by Exxon Mobil Corp and the National Institutes of Health and the findings appeared in the July 15 issue of the Journal of Immunology.

Tags: Asthma, GATA3, hepatitis C, interferon, multiple sclerosis, steroids

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Findings of a new study have indicated that patients afflicted with difficult-to-control asthma are often not taking their anti-asthma medication as prescribed by their doctor.

Dr. Liam G. Heaney at Queen’s University of Belfast, Northern Ireland, and colleagues found that about 5 percent of adults with asthma remain difficult to control, with persistent symptoms and frequent flare-ups even with they were prescribed high doses of steroids.

From in.reuters.com:

To find out, Heaney’s group studied 182 patients referred to the Northern Ireland Regional Difficult Asthma Service. Nonadherence to anti-asthma therapy was not suspected as a major issue, and all patients denied not taking their medicine at their first visit to the clinic.

Nonetheless, it was found that 35 percent of these patients had filled no more than half their prescriptions for inhaled steroids, and these patients were more likely to have been hospitalized at least 3 times in the previous year.

Women were most apt to be lax in taking their asthma controller medication as prescribed, the researchers note in the latest issue of the American Journal of Respiratory and Critical Care Medicine.

Among 51 asthma patients who were supposed to be using oral prednisolone, blood tests showed that 45 percent were nonadherent.

Heaney and colleagues concluded that asthma could probably improve substantially if patients emphasize upon regular preventative therapy (as prescribed).

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According to a work published in The Cochrane Library this month, there is no evidence to suggest that increasing the dose of inhaled corticosteroids at the onset of an asthma exacerbation as part of a patient-initiated action plan minimizes the need for rescue oral corticosteroids.

Lead researcher Francine Ducharme, who works at the University of Montreal, Canada remarked that keeping to a constant dose has the potential of reinforcing the effectiveness of taking daily inhaled corticosteroids, not only during exacerbations and/or encourage the search for more effective strategies.

From Sciencedaily.com:

There are two mechanisms acting in the lungs of people with asthma. The first is called bronchoconstriction, which is when people’s airways constrict during an asthma attack, making it much harder for them to move air in and out of their lungs. The first line treatment for this sort of acute exacerbation is to try and re-open the airways by inhaling bronchodilator drugs.

The second mechanism involved in asthma is an underlying inflammation in the lungs. This is often treated by a daily dose of inhaled steroids. The amount of inflammation varies, and respiratory virus infections, allergens and other irritants all increase inflammation leading to greater obstruction of the airways. In theory, such increased inflammation could be treated with higher doses of inhaled corticosteroids. There are occasions, however, when the patient does not respond sufficiently to treatment and may need to use rescue oral corticosteroids.

Ducharme also said that more pediatric studies are needed to guide treatment of exacerbations and the best approach would be all about preventing an exacerbation by ensuring regular use of inhaled corticosteroids.

Tags: Asthma, inhaled corticosteroids, oral corticosteroids

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Asthma is one of the most prevalent diseases in today’s times with more than 5 million people being affected with the disease in the United Kingdom alone.

According to a major study in the UK that was highlighted by the researchers examining the medical records of 900,000 asthma patients across the UK, non-prescription of the most suitable inhalers is the biggest reason why asthma sufferers are dying needlessly.

From Bio-medicine.org:

Professor David Price, who led the study, said that there are a wide variety of inhaler devices available for the delivery of medication into the lungs and using the correct inhaler was crucial. He added that outcomes were consistently better in those using the breath-actuated device, with less use of rescue medication for asthma symptoms, fewer courses of steroids and less courses of antibiotics for respiratory infections prescribed to this group.

The study compared asthma control levels and the need and quantity of doctor appointments for patients making use of different devices and it was disclosed that asthma patients had far better control over their disease by making use of inhalers they would activate by breathing in, when compared with the traditional devices commonly recommended by medical practitioners.

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Sinusitis is a health complication that affects nearly 37 million people in the United States alone and a big part of this affected population also suffers from asthma that is an inflammatory disease of the lungs characterized by obstruction of reversible airway.

A study was entailed to find out the variations in sinusitis symptoms noticed by asthmatics versus non-asthmatics and the authors of “The Incidence and the Effect of Asthma on Consecutive Patients with Chronic Rhinosinusitis,” were Melanie W. Seybt MD, Kevin C. McMains MD, and Stilianos E. Kountakis MD PhD, all with the Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, GA.

From News-Medical.Net:

A retrospective chart review of 145 adult patients diagnosed with sinusitis at the Medical College of Georgia Rhinology Clinic between January of 2003 and September of 2003 was performed. Data included patient age, gender, presence or absence of asthma, presence of signs and symptoms including allergic rhinitis, nasal polyposis, nasal congestion, headache/facial pain, anosmia/hyposmia, rhinorrhea, and postnasal drip. Other variables evaluated included failure of medical management (prescription drugs) and need for surgical treatment. Patients were designated as asthmatic or non-asthmatic by patient history, use of asthma medications or prior pulmonary function tests.

All patients underwent medical therapy including intranasal steroids, saline nasal spray and irrigations, high-dose guaifenesin and appropriate antibiotic therapy when indicated, before being considered for surgery.

The findings were presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting & OTO EXPO, at the Jacob K. Javits Convention Center, New York City, NY.

Tags: Asthma, intranasal steroids, sinusitis, steroids

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Being overweight or obese does not make asthma worse in patients with mild and moderate forms of the health complication, as per researchers from National Jewish Health. It was, however, noted by the researchers that it could minimize the response to medications.

Lead author E. Rand Sutherland, Associate Professor of Medicine at National Jewish Health said that the findings suggest that asthma improvement may not necessarily result from loss of weight.

From News-medical.net:

“The findings also suggest that patients and physicians should be aware that obese asthma patients may not respond well to corticosteroids, the most successful controller medication for asthma, which can affect dosing decisions and choices of possible alternatives to steroids.”

Previous studies have suggested that obesity predisposes people to developing asthma, to suffer more severe asthma symptoms, and to respond less to medications. However, the exact mechanism for these links has been unclear, and the studies have generally relied upon patients’ reports of their diagnosis and symptoms rather than using more precise tools to characterize patients.

Dr. Sutherland said the data suggest that obese and overweight people respond less well to asthma controller medications when compared to their leaner counterparts.

Tags: Asthma, corticosteroids, obesity, steroids

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Cells that could possibly play an important role in some forms of steroid-resistant asthma, a complication of the condition that makes treatment even more challenging, have been identified by researchers at Children’s Hospital of Pittsburgh of UPMC.

Study’s senior author, Jay K. Kolls, MD, chief of the Division of Pediatric Pulmonary Medicine, Allergy and Immunology at Children’s Hospital, remarked that the identification of a lineage of cells called as T Helper Type 17 (Th17) could assist scientists in developing new treatments for exercising a better control on the disease.

From Sciencedaily.com:

More than 22 million Americans (including 9 million children) are diagnosed with asthma, according to the U.S. Centers for Disease Control and Prevention (CDC). As many as 50 percent of them have asthma that can be resistant to steroids, which are intended to reduce lung inflammation during an asthma attack, Dr. Kolls said.

“Asthma is a challenging condition to treat. For many patients, if they take preventive medications regularly, the condition can be controlled and they can lead relatively normal lives,” Dr. Kolls said. “Inhaled steroids are an important treatment for patients to prevent asthma attacks. Unfortunately, some patients have attacks despite the use of inhaled steroids, meaning they don’t respond to steroids or they need such high doses that side effects are experienced.”

The study was published in an issue of the Journal of Immunology.

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New study results have suggested that some children suffering with asthma may respond differently to steroids when compared to other asthmatic children, according to a new study presented at the American Thoracic Society.

It was remarked by Gregory Sawicki, M.D. of Children’s Hospital in Boston that young children tend to demonstrate the same negative response to high doses of steroids as adult asthmatic patients.

From News-Medical.Net:

“The majority of children with mild asthma are less likely to have symptoms as they get older and may not need to be on daily steroids,” Dr. Sawicki said. “The flip side is that if a child has poor asthma control, the parents and doctor need to make sure the child is adhering to their inhaled steroid treatment. But variation in response to inhaled steroids, as other medications, is well described.”

The data comes from the Child Asthma Management Program Continuation Study (CAMPCS), one of the largest groups of children with mild to moderate asthma in the nation who have been followed over 10 years. “This study gives us a good sense of real-world practice in asthma management,” Dr. Sawicki says. “The children’s care is not directed by anyone in the study; it’s an observation of what goes on when the children’s care is directed by their own physicians.”

Sawicki further said that results of this study suggest that not every child afflicted with asthma shows same response to treatment based on steroids.

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