Yesterday, I posted about some AAFA research on a perpetual problem in asthma treatment, the practice of stopping inhaled maintenance steroids when flare symptoms disappear.
Recent Cochrane studies point to a possible solution, though–a combination inhaler somewhat like Advair, except it contains a short-acting beta-agonist and low-dose steroid rather than a long-acting one. The formoterol/budesonide combo would, in my daughter’s case, be like having her current Flovent and Proventil inhalers in one delivery system, rather than two.
So not only would this development keep moderate-to-severe patients from stopping their maintenance meds when they feel better (the asthma “gap”), but it would also actually increase those meds the more they use their quick-relief inhalers – exactly when asthmatics need a bump in steroids most.
And adults in this study who used the combo inhaler had fewer hospitalizations than those using single inhaler therapy (the practice of using 2 separate inhalers).
Very interesting, I hadn’t heard about this before. It certainly sounds good, and the initial results look promising. I was actually shocked to read your statistic yesterday, that 70% of asthmatics will stop their meds when feeling better. That’s not asthma control at all! I’m a very compliant patient, by necessity I suppose, but I can understand why it’s hard to keep on a med schedule sometimes.
I guess it’s sort of similar to the symbicort SMART system. Is that still being recommended or was that just a phase? I never tried it myself but heard tidbits about it.
Danielle
Wow, I had not heard of this either. What a great idea!
I’m not sure, Danielle–good question, though. I’ll have to dig around.
I do think this kind of therapy could be big–however, I wouldn’t want AG to use a combo inhaler right now. That’s because, of course, she maintained just fine w/Flovent morning and night only, and I wouldn’t want to up the dose. Plus, I wouldn’t want her to use a beta-agonist every time she took a maintenance dose–whether she needed the quick-relief or not– until I see any research on the drawbacks of that.
When she’s a teenager with a driver’s license and her inhaler use is out of MY control, though? I love the idea.
To my knowledge, Symbicort SMART therapy is still out there.
It makes sense to me in the regard that if you’re flaring up you likely need a boost in corticosteroids, but my other thought is, don’t long-acting beta-agonists take 15-30 minutes to kick in? I’d rather not wait that long for relief! Although, of course, I could be wrong on this–I don’t use a combo inhaler, either, or salmeterol/formoterol (. . . yet.)
Kerri–Long-acting beta-agonists DO take longer to kick in, but this therapy’s a little different b/c it’s a combo inhaler with a short-acting one instead.