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Study: Inhaled steroid crucial in treating asthma

From Christy Feig
CNN Medical Unit

WASHINGTON (CNN) -- Laura Caulfield has had asthma for about 12 years.

"It's a feeling of anxiety and heat, and a feeling that you can't breathe," she said of the disease, a chronic inflammation of the lungs' airways often brought on by allergies, infections or exercise. "And it's not that you can't get air in, it's that you can't get air out."

A new study confirms that taking two types of medicine instead of just one gives patients the best chance to control it.

The medicines commonly used to treat asthma are an inhaled corticosteroid -- which prevents inflammation that can trigger an attack -- and a broncodialator that widens the airways.

It's the inhaled steroid, the one that prevents the disease, that many patients don't take as they should.

"It probably takes a minimum of a few days and maybe as much as one to two weeks to begin to feel the effects of inhaled steroids, so patients don't recognize a benefit and they often stop taking them," said Dr. Stephen Lazarus of the University of California San Francisco.

Because patients often don't take the inhaled steroid, Lazarus and his colleagues decided to study whether just using the broncodialator alone would control asthma.

His results, published in the Journal of the American Medical Association, found the broncodialator alone doesn't work.

"They had an incidence of asthma attacks that required additional medication that was about three to four times higher than the people on the inhaled corticosteroid," Lazarus said.

Researchers also found that once asthma is under control with both medicines, the steroid dose can be reduced up to 50 percent.

A new device called Advair may also help. It's the first device to combine both drugs, making compliance easier.

"Compliance is a critical problem," said Dr. Peter Creticos of the Johns Hopkins Bloomberg School of Public Health, "and now you have a therapeutic entity that allows two medications to be delivered simultaneously, that's going to improve compliance. And if people are compliant, of course they will then begin to see improvement."

• American Academy of Allergy, Asthma & Immunology Online
• Asthma and Allergy Foundation of America (AAFA)
• Bloomberg School of Public Health
• University of California San Francisco

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