Patients with asthma could benefit as much from inhaling steroid medication when they show symptoms of the condition rather than having to inhale cortisteroids twice daily.
Current guidelines suggest inhaled steroids taken morning and evening, along with the use of a bronchodilator such as albuterol to open up inflamed airways, are needed to control asthma.
However, many people with mild or moderate asthma admit to skipping the twice-daily steroids and only using them when they feel they need them. A recent study, sponsored by the National Heart, Lung and Blood Institute in the US, set out to examine any risks or benefits to not taking the steroids on a regular, daily basis and involved more than 340 adults with mild to moderate asthma who use inhaled steroids to control their symptoms.
Over nine months, patients were split into three groups – the first took the prescribed inhaled steroids twice a day; the second took the steroids but had the daily dose adjusted every six weeks after their lungs were checked for levels of nitric oxide; and the third took two puffs of albuterol along with two puffs of a steroid when they wanted to relieve asthma symptoms.
The study concluded that the condition of patients who only used the steroids for symptom relief was no worse than those in the other two groups.
Importantly, those patients used half as much steroids as those in the other groups, which could have major implications for health care costs as a reduction in the use of the drugs could save the NHS millions of pounds a year. A reduction in the use of steroids would also minimise the risk of side effects for patients.
The researchers say their findings could give asthma patients more control over how they deal with their condition by encouraging them to follow a symptoms-based strategy.
However, they reiterated that this approach is only feasible in those with mild to moderate asthma and asthma experts insist that those with the most severe form of the condition must continue to follow medical advice and take the inhaled steroids when prescribed.
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