Some adults with mild persistent asthma may be able to control their asthma by taking corticosteroids only when needed, according to a new study supported by NIH. Those who took corticosteroids when their symptoms arose had about the same number of severe asthma flare-ups as those taking daily, long-term control medications. This finding needs to be confirmed in a larger study, but it suggests that some patients may be able to safely avoid the expense and inconvenience of daily medication.
More than 20 million Americans have asthma. Mild persistent asthma brings symptoms like wheezing, coughing, or chest tightness more than twice a week but not daily, or wakes you up more than two nights a month. National treatment guidelines recommend daily long-term control medication to prevent symptoms, along with quick-relief medication (inhaled bronchodilator) as needed to treat acute symptoms.
For this study, the researchers put 255 adult patients into three treatment groups. Two groups took asthma control medication twice a day—either an inhaled corticosteroid or another type of asthma medication in pill form. The third received a placebo (inactive) medication. All were given additional medicines with clear instructions on how to use them to treat symptoms if they appeared.
After one year, the three groups were similar in measurements of lung air flow, the number of severe asthma attacks, and quality-of-life tests. Those in the daily inhaled steroid group, however, did have significantly more symptom-free days than those in the other two treatment groups.
An expert panel will soon consider whether to change treatment recommendations for adults with mild persistent asthma. For those with more frequent symptoms or more severe asthma, these new findings don’t apply. If you have asthma, however severe, work with your health care provider to develop and follow an asthma treatment plan.