Treating the underlying cause of asthma rather than its symptoms appears to be more effective at reducing severe asthma attacks, according to new research reported in The Lancet. Asthma is known to be associated with increased numbers of microscopic cells called eosinophils, in the airway. These can be detected by a simple sputum test and their numbers rise several weeks before an asthma attack. A study of 74 patients with moderate to severe asthma were randomly placed into two groups. One was treated conventionally, the other using the sputum test with their medication regulated in response to changes in eosinophil numbers. The results showed that the sputum test group had fewer severe attacks and hospitalisations than the conventional treatment group.From the University of Leicester :Researchers at Leicester’s Institute for Lung Health make a significant advance in treating asthma
The findings of this research published on 30th November 2002 in The Lancet suggest that targeting the underlying cause of asthma-rather than treating symptoms of the disorder-could be more effective in reducing severe asthma attacks.
Asthma affects 5.1 million people in the UK and leads to an estimated 1,500 deaths per year, however current treatment methods, based on an assessment of symptoms and a measurement of lung function may not be the most effective.
Asthma is known to be associated with increased numbers of microscopic cells called eosinophils, in the airway. These can be detected by a simple sputum test and their numbers rise several weeks before an asthma attack. A groundbreaking study undertaken by the University of Leicester and the University Hospitals NHS Trust’s Institute for Lung Health researchers Dr Ian Pavord and Dr Ruth Green assessed whether treatment which aimed to reduce the number of eosinophils reduced severe asthma attacks compared with conventional treatment.
A study of 74 patients with moderate to severe asthma were randomly placed into two groups. One was treated conventionally, the other using the sputum test with their medication regulated in response to changes in eosinophil numbers.
The results showed that the sputum test group had fewer severe attacks and hospitalisations than the conventional treatment group.
Dr Pavord, an honorary senior lecturer at the University, said: “Severe asthma attacks that require treatment with steroids or hospital admission are the most serious manifestation of the disease. They lead to asthma deaths, illness and a high cost to the health service in terms of doctor consultations, drug use and hospital beds. This approach of maintaining a normal eosinophil count resulted in a large reduction in the number of severe attacks compared with conventional management methods.”
This study which will be presented by Dr Ruth Green next week at the British Thoracic Society meeting in London as part of the National Young Investigators Award, has major implications in that it allows treatment to be targeted more precisely at those who require it most, thereby reducing demand on resources.
This study also has implications for the future of asthma research as it provides further evidence that the mechanisms that cause mild asthma symptoms are different to those that underlie a severe attack.
This is the latest in a series of important discoveries made by members of Leicester’s Institute for Lung Health. Discoveries that put the Institute at the forefront of research into adult and childhood lung disease.
NOTES TO EDITORS:
The Institute for Lung Health, part of the University of Leicester and the University Hospitals of Leicester NHS Trust, is a research based organisation that brings together members of the respiratory community involved in innovative developments in the field of respiratory medicine. The aim of the Institute is to undertake high quality research and develop it into new treatments for respiratory diseases.