An inhaler for asthma two in one hailed as a "game changer"

An international study on asthma treatment is a "game changer" for hundreds of thousands of Kiwis who live with breathing conditions, said a researcher from the University of Otago.

Inhalers for the treatment of asthma contain either a drug designed to prevent or relieve symptoms, or both at the same time.

At least 12% of New Zealanders – about 600,000 people – suffer from asthma, which causes wheezing and other breathing problems. The majority experience mild symptoms.

New Zealand's study on mild asthma in adults found that patients advised to use the drug in combination Symbicort "as needed" had half the asthma respiratory problems – called "exacerbations" – than those using a Ventolin-based medicine.

They also had 56% fewer severe exacerbations than those using only the rescue medication; and 60 percent less than those who use two inhalers – a Pulmicort prevention device twice a day plus puffs in need of a Ventolin rescue medication.

"The results of the study are exciting and could potentially change the way doctors treat mild asthma," said Professor Richard Beasley, a researcher in Wellington, at Otago University in Wellington, the first author of the Study of four countries and published in the United States today in the prestigious New England Journal of Medicine.

The trial included patients from New Zealand, Australia, Britain, and Italy whose only treatment for asthma in the previous three months was a relief inhaler. short-term action.

The researchers said the current mild asthma practice was to prescribe a preventive containing a corticosteroid twice a day, as well as a relief to dilate the respiratory tubes in order to remedy wheezing and breathing. other symptoms.

However, many physicians were reluctant to prescribe prophylaxis and it was unlikely that patients would use them regularly if their symptoms were infrequent.

Beasley said the trial showed that those who use the combined inhaler when needed "do much better" than those who follow the treatment regimen recommended by current guidelines.

"The greatest benefit has been obtained despite exposure to less than half the amount of inhaled corticosteroid prevention drug, because the inhaled corticosteroid works best when it is taken as needed in asthma." lightweight.

"This new approach simplifies treatment because patients should not take a preventive inhaler twice a day, even if they have no symptoms."

"With a combined preventive-reliever inhaler, patients have more personal and immediate control over the management of their asthma.This takes advantage of the patient's natural behavior to take a rescue medication only when he has symptoms."

Dr. Stuart Jones, a specialist in pneumology, said the Beasley study would encourage rethinking of New Zealand's guidelines for the management of mild asthma.

"For people with mild asthma, implementing the results of the study will lead to a reduction of exacerbations, which means less time for discomfort and more time doing what you love in life, while using inhaled steroids sparingly. "

He said that Symbicort is funded by the state in New Zealand, but that some people have had trouble using the device. Another, called Vannair, which contained the same drugs, was also funded but had been registered here only for regular use, and not for use as needed.

The trial has received research grants from the company that provides Symbicort and Pulmicort, AstraZeneca, and the Health Research Council of New Zealand.

An asthmatic patient

Sarah Harris, 39, a launderer and mother of two child installer from Kingseat, south of Manukau Harbor, suffers from mild asthma since she was pregnant with her son Cole, who is now 14 years old. .

"I had pneumonia when I was pregnant with my son when I was 24. I had asthma at that time and it was n? has never disappeared. "

Conan, Cole and Sarah's husband, also suffers from breathing problems.

"I do not understand it very often," said Harris. "Some days, I'm just out of breath or it's harder to get around."

Hospital treatment was never required.

She uses a drug twice daily to prevent inhaled corticosteroids from Flixotide, and sometimes also a Ventolin reliever inhaler. The Ventolin however sees a more regular use when it catches a cold. And about once a year, she needs a more powerful treatment.

"If it's really bad, I can not do anything and I usually end up with prednisone [oral steroid medicine]. "

Cole had been prescribed a Symbicort combination drug inhaler, two doses a day, and Sarah was interested in the results of the study on the use of this type of inhaler as needed to treat the drug. Mild asthma.

"It would be useful for many people," she said.