New Thinking on Longstanding Asthma Treatments

Study data published the NEJM challenge the longstanding belief of treating asthma using only a daily steroid inhaler to reduce inflammation in addition to an as-needed rescue inhaler needs to be updated, The Wall Street Journal reported.

"As specialists we don't just settle for one size fits all," remarked Michael Wein, chief of allergy at Cleveland Clinic Indian River Hospital, adding "other treatments may be more effective for a minority of asthmatics."

In the study, the investigators randomised patients with asthma and high or low eosinophil counts to treatment with the inhaled steroid mometasone, the long-acting muscarinic antagonist tiotropium or placebo.

The research team found that most patients with high eosinophil counts did better when taking a mometasone versus placebo, while similar outcomes were not observed in patients with low eosinophil counts.

Meanwhile, patients with low eosinophil counts who received tiotropium did better than those who received placebo, although the difference did not reach significance.

"If you have patients who have been prescribed steroids and they don't seem to be responding, the solution is not to escalate the dose and give them more and more, the solution is to think of alternative ways of managing the asthma," commented study author Stephen Lazarus.