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Inhaled Steroids Lead to Big Drop in Asthma Deaths at Texas Hospital: Study

Posted 12 days ago by Drugs.com

TUESDAY, May 15 – Patient education and medication compliance contributed to a 74 percent drop in the number of patients with life-threatening asthma admitted to the intensive care unit at University Hospital in San Antonio, Texas, researchers report. Their review of 30 years of hospital data focused on patients with severe asthma who didn't respond to standard inhalers. They found that there were 227 patients admitted to the intensive care unit (ICU) with 280 episodes of life-threatening asthma between 1980 and 2010. One patient died, but the death was from a different cause after the patient's asthma improved, according to the team at the University of Texas Health Science Center at San Antonio. "The main reason for the decline in cases is that more of our patients are taking their controller medications, such as inhaled corticosteroids, which reduce the amount of inflammation in the ... Read more

Seniors Undertreated for Asthma, and Many Skip Inhalers: Study

Posted 1 May 2012 by Drugs.com

TUESDAY, May 1 – Asthma often is misdiagnosed and undertreated in older people, with only 53 percent of those with asthma using prescribed inhalers, a small new study suggests. The study included 77 people, including people both with and without asthma, who were over age 60. Of those with asthma, 89 percent also had allergies to mold, animals or dust mites. The asthma patients were more likely than those without asthma to have hay fever, arthritis, diabetes, higher levels of pain and poor general health than those without asthma. The study appears in the May issue of the journal Annals of Allergy, Asthma & Immunology. "Those with asthma reported more infections, physician visits and impact on health, yet only half are regularly treating the disease," lead author and allergist Dr. Andrew Smith said in a journal news release. "Patients should regularly carry and take prescribed asthma ... Read more

Rapid Asthma Treatment in ER May Prevent Admission

Posted 6 Apr 2012 by Drugs.com

FRIDAY, April 6 – Rapid treatment with asthma medications seems to help reduce hospitalizations among children with asthma, a new study finds. Canadian researchers analyzed data from 406 children and found that those with moderate or severe asthma attacks who received systemic corticosteroids within 75 minutes of arriving at a hospital emergency department were 16 percent less likely to be admitted to the hospital. Corticosteroids reduce inflammation. The findings illustrate the importance of rapidly identifying and treating children with asthma when they arrive at an emergency department, the researchers said. The study was recently published online in the journal Annals of Emergency Medicine. "We knew that corticosteroids could help avoid hospital admissions and relapses. However, just how delays between emergency department admission and administration of the treatment impacted ... Read more

Heavy Kids May Not Respond as Well to Asthma Meds

Posted 4 Mar 2012 by Drugs.com

SUNDAY, March 4 – Overweight children may not respond as well to common asthma medicines known as inhaled corticosteroids, new research finds. As a result, they may need more of the long-term control medication, said researcher Dr. Pia Hauk, an assistant professor of pediatrics at National Jewish Health, in Denver. "In our patient population, and we see a lot of severe asthmatics, the overweight and obese children have about twice as high an inhaled corticosteroid requirement than those of a healthy weight," Hauk said. The study was small, including just 61 children with asthma, aged 2 to 18, so the results should not be considered conclusive. Thirty-four children were at healthy weights, 13 were overweight and 14 obese. Most of the kids, 56, used inhaled corticosteroids. The researchers noted each child's weight and body-mass index (BMI) – a measurement based on height and weight – ... Read more

Asthma Meds Likely Safe During Pregnancy: Study

Posted 20 Jan 2012 by Drugs.com

FRIDAY, Jan. 20 – A new study found no statistically significant link between asthma medication use during pregnancy and common birth defects. However, the study did find a positive association between some rare birth defects and mothers with asthma, and potentially with their medication use. But, the researchers couldn't tease out whether the problem was a loss of oxygen from less than well-controlled asthma or an effect of medications. "Worsening asthma is a risk to the mom and the fetus. Hypoxia (a lack of oxygen) we know is a problem for a developing fetus. And, the potential risk they found here is very small. Even if it turns out to be a true increase, the risk is so small. This study raises more questions than it answers," said Dr. Natalie Meirowitz, chief of the division of maternal fetal medicine at Long Island Jewish Medical Center in New Hyde Park, N.Y. What's most ... Read more

Study Offers Clues to Why Some Don't Benefit From Asthma Drugs

Posted 6 Jan 2012 by Drugs.com

FRIDAY, Jan. 6 – Almost half of patients with mild or moderate asthma may have a different type of disease than those with more severe symptoms, perhaps explaining why common treatments don't work well for them, new research suggests. "We are beginning to understand that different 'flavors' of asthma probably have different molecular mechanisms," said Dr. John Fahy, director of the Airway Clinical Research Center at the University of California, San Francisco. He is the senior author of the new study, published online Friday in the American Journal of Respiratory and Critical Care Medicine. Asthma is a chronic disease involving inflamed airways. As the airways become more swollen, the muscles around them can tighten when something triggers symptoms such as coughing, wheezing and shortness of breath. Current anti-inflammatory treatments target a condition called eosinophilic airway ... Read more

Asthma Drugs in Pregnancy Might Pose Risk for Kids

Posted 16 Dec 2011 by Drugs.com

FRIDAY, Dec. 16 – Infants born to mothers who use inhaled glucocorticoids – a class of steroids – to treat asthma during pregnancy may be at risk for endocrine and metabolic disorders, a new study indicates. Researchers looked at more than 65,000 mother-child pairs from the Danish National Birth Cohort who were followed from early pregnancy into childhood. Of the women in the study, about 61,000 (94 percent) had no asthma during pregnancy while almost 4,100 (6 percent) did have asthma during pregnancy. At the end of follow-up, the median age for the children was about 6, with an age range of about 3.5 to 9. For mothers who used the asthma inhalers, budesonide (Pulmicort) was the most common glucocorticoid. The use of inhaled glucocorticoids during pregnancy was not associated with an increased risk of most diseases in children, with the exception of endocrine and metabolic disorders. ... Read more

Intermittent Steroid Use Called OK for Wheezing Preschoolers

Posted 23 Nov 2011 by Drugs.com

WEDNESDAY, Nov. 23 – Preschoolers who have recurrent wheezing episodes but not an asthma diagnosis are often prescribed inhaled steroid medication, and new research suggests it's OK to take those medications on an as-needed basis instead of every day. Respiratory illnesses frequently trigger severe wheezing in young children, and the treatment for some of these kids – using inhaled steroid medications such as budesonide (Pulmicort) on a daily basis – might expose them to more of the drugs than necessary, the researchers said. "We learned that the daily, low-dose treatment regimen of inhaled budesonide was no better than a high-dose regimen used for seven days during a specific respiratory illness," said the study's lead author, Dr. Robert Zeiger, a clinical professor of pediatrics at the University of California, San Diego, and director of allergy research at Kaiser Permanente in San ... Read more

Use of Asthma Controller Meds on the Rise Among U.S. Kids

Posted 13 Oct 2011 by Drugs.com

THURSDAY, Oct. 13 – The percentage of children with asthma in the United States who use a prescription "controller" medicine has nearly doubled since the late 1990s, a new federal government report finds. The analysis of data from the Medical Expenditure Panel Survey showed that the use of controller drugs by these children increased from 29 percent in 1997-1998 to 58 percent in 2007-2008, according to the latest News and Numbers from the U.S. Agency for Healthcare Research and Quality. Asthma controller drugs include: corticosteroids, which control inflammation and reduce the risk of airway spasms; beta-2-agonists, which make breathing easier; and leukotrienes, which help prevent asthma symptoms from occurring. Use of inhaled corticosteroids among American children with asthma increased from 15.5 percent to 40 percent, use of leukotrienes rose from 3 percent to 34 percent, and use of ... Read more

Gene Variant Linked to Failure of Asthma Drug

Posted 28 Sep 2011 by Drugs.com

WEDNESDAY, Sept. 28 – About one in six asthma sufferers carries a genetic variant that's associated with a poor response to commonly prescribed inhaled asthma medications called corticosteroids, according to a new study. Researchers found that people with asthma carrying two copies of a specific gene variant were more than twice as likely not to respond to inhaled steroids as those without the variant. Those who responded poorly showed only about one-third the improvement in lung function in response to steroid inhalers used for the long-term control of asthma than those without the variant. Researchers said the variant probably works alongside other genetic and environmental factors to affect response to the medication. "This finding helps to explain the genetic basis for the long-standing observation that some people do not respond well to what is a common asthma treatment," said Dr. ... Read more

New Approach to Treating Asthma in Pregnancy

Posted 9 Sep 2011 by Drugs.com

FRIDAY, Sept. 9 – Researchers in Australia have developed a new treatment plan to reduce asthma flare-ups in pregnancy while minimizing drug exposure to developing fetuses. This therapy tracks airway inflammation directly by measuring something known as "the fraction of exhaled nitric oxide" – a marker of inflammation abbreviated as FENO – in an exhaled breath. By doing so, researchers can identify asthma in pregnant women who have airway inflammation but no symptoms and tailor drug therapy accordingly. In this study, researchers examined 220 non-smoking women with asthma who were less than 22 weeks pregnant. Half the women were treated based on their clinical symptoms during monthly visits (the control group) and compared to the women in the FENO group, who were tested for airway inflammation. The researchers found the flare-up rate among the women in the FENO group was roughly half ... Read more

New Guidelines for Spotting, Treating COPD Released

Posted 1 Aug 2011 by Drugs.com

MONDAY, Aug. 1 – Four of the world's leading pulmonary associations have issued new guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease, one of the world's leading killers. While the recommendations are based on more recent studies of the disorder, they differ little from previous guidelines and are meant largely to emphasize how critical it is to manage the disease to reduce hospitalizations, exacerbations and deaths, said lead author Dr. Amir Qaseem, director of clinical policy in the medical education division of the American College of Physicians, one of the four sponsoring organizations. "We're repeating the message. Chronic obstructive pulmonary disease is the third leading cause of death and . . . the number keeps going up. In 2007, it was the fifth leading cause of death," said Qaseem. "Many patients are still not getting the appropriate care." ... Read more

Asthma Pills Work as Well as Inhaled Steroids: Study

Posted 4 May 2011 by Drugs.com

WEDNESDAY, May 4 – In a study that compared asthma pills against commonly prescribed inhaled steroids, British researchers found that the oral medications were as effective as the inhaled drugs. The oral medications, known as leukotriene-receptor antagonists, "have shown similar efficacy and cost and better compliance, and should be considered for any patient, not as a last option but as an option for any patient," said study co-author Dr. Stanley Musgrove, a senior research associate at the University of East Anglia in Norwich. "Every different patient will have their own issues that are important to their care: their compliance to different medications, how well they feel that different medications work for them, their concerns about different medications, any possible minor side effects, etcetera, and all of those should be considered when the clinician and the patient are making a ... Read more

Inhaled Meds May Save COPD/Pneumonia Patients' Lives

Posted 23 Apr 2011 by Drugs.com

WEDNESDAY, April 20 – Inhaled corticosteroids can actually reduce the risk of death in patients with chronic obstructive pulmonary disease, or COPD, who are hospitalized with pneumonia, a new study has found. U.S. researchers examined the medical records of 15,768 COPD patients older than 65 who were admitted to VA hospitals for pneumonia between 2002 and 2007. Of those patients, 52.5 percent were treated with inhaled corticosteroids. The all-cause death rate after 30 days was 10.2 percent for inhaled corticosteroid users and 13.6 percent for those who weren't treated with inhaled corticosteroids. After 90 days, the death rate was 17.3 percent among inhaled corticosteroid users and 22.8 percent for those who didn't receive inhaled corticosteroids, the investigators found. Overall, patients not treated with inhaled corticosteroids were about 25 percent more likely to die than those who ... Read more

Inhalers Linked to Higher Odds of Diabetes in Asthma, COPD Patients

Posted 16 Dec 2010 by Drugs.com

THURSDAY, Dec. 16 – Asthma and chronic obstructive pulmonary disease (COPD) patients who are treated with inhaled corticosteroids may face a significantly higher relative risk for both the development and progression of diabetes, new Canadian research suggests. The warning stems from an analysis of data involving more than 380,000 respiratory patients in Quebec. Inhaler use was associated with a 34 percent increase in the rate of new diabetes diagnoses and diabetes progression, the researchers found. What's more, asthma and COPD patients treated with the highest dose inhalers appear to face even higher diabetes-related risks: a 64 percent jump in the onset of diabetes and a 54 percent rise in diabetes progression. "High doses of inhaled corticosteroids commonly used in patients with COPD are associated with an increase in the risk of requiring treatment for diabetes and of having to ... Read more