Best Asthma Medications?

Ever had the sensation you can't breathe?  No, not just short of breath but really unable to draw air into your lungs.  It's a pretty scary feeling, speaking as someone with allergies that sometimes compromise my breathing, but for folks with asthma, such sensations are common, debilitating, may result in hospitalization or even death.  And the number of people with asthma is growing.

The American Academy of Allergy, Asthma and Immunology cites 300 million as the number of people with asthma worldwide, with an estimate that by 2025 there will be another 100 million of them.  The best way to treat asthma is therefore a huge public health issue, and this week's NEJM provides some answers. 

Leukotriene receptor antagonists (listening to that with Rick's Texas twang is a real treat on this week's podcast) or LTRAs are examined in two parallel studies: one where the drugs are used as first line treatment and the other where they're used as add-on medications to an existing regimen.  One of the really interesting aspects to these studies is one I'm betting we'll be hearing much more about.  They're so-called 'pragmatic' studies.  AKA, real world. 

Researchers recruited everyone who had a physician's diagnosis of asthma and was willing to participate.  This is in contrast to many study participants who are carefully selected, often intensively managed, and are likely not representative of the folks who will ultimately receive a drug or treatment under study. 

These study subjects ranged in age from 18 to 80.  About half of the 300 people who enrolled for the first line trial received LTRAs, with the other half receiving the guideline recommended treatment with inhaled steroid medication.  As a add-on treatment, 350 patients were enrolled, about half of whom took LTRAs while the other half took another class of asthma medications known as long acting beta agonists (LABA).  At two months, LTRAs were shown to be equivalent to the comparators for both studies.  After two years of follow-up this equivalence could not be shown, but the authors speculate this may be due to crossover among the treatment groups and the lack of a placebo treated group.

There are significant advantages to LTRAs, as Rick points out in the podcast.  They are once a day, oral medications, and people are much more likely to remember to take medications such as these rather than inhaled steroids that must be administered twice a day.  And they'll soon come off patent, so generics will be available at presumably decreased cost.    Clearly, getting a handle on how best to treat asthma in the real world is deserving of more studies such as this one.

Other topics this week include another in NEJM on , whether salt is really Darth Vader in JAMA, and a high rate of use of botanical supplements in infants in Pediatrics.  Until next week, y'all live well.

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Asthma Medications
June 26, 2011 at 8:43 pm

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Madeline November 11, 2012 at 10:44 am

I'm impressed, I have to admit. Seldom do I encounter a blog that's
equally educative and interesting, and let me tell you,
you've hit the nail on the head. The problem is something which not enough people are speaking intelligently about. I am very happy that I found this in my hunt for something regarding this.


Medications for asthma June 27, 2012 at 7:38 am

It is necessary to increase the awareness about the problem of asthma because many people are affected by this disease. Information provided by this blog is to know about the medications for asthma to reduce this problem.After reading this blog,i come to know which types of medications can be effective to treat asthma.


Adam March 21, 2012 at 10:32 am

the best way to stay healthy and to live healthy life is to take care of your health at micro level: to charge your body, to stay away from stress, to look after your Telomeres.
you can


Frank Tsu May 31, 2011 at 10:57 am

There was a recent study out from University of Aberdeen that drew a comparison between Leukotriene receptor antaonists (LTRAs) and steroid inhalers here
It cites the learning curve associated with inhaler use as well.


Rodrigues Ellegies May 9, 2011 at 1:02 am

Asthma is the thing with which every generation people is connected. Asthma can be happen to anyone in the age range of 15 to 85. The effects of Asthma rises in accordance with the human body. Asthma symptoms include wheezing, coughing, chest tightness, and shortness of breath. Researchers also said that Asthma can be the one reason of your Erectile Dysfunction. Some really good points are given in this blog saying that How Asthma affect your body.


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