Breaking News
February 18, 2019 - New dental adhesive prevents tooth decay around orthodontic brackets
February 18, 2019 - New eHealth tool shows potential to improve quality of asthma care
February 18, 2019 - New Australian initiative helps emergency clinicians to improve patient care
February 17, 2019 - Apellis Pharmaceuticals’ APL-2 Receives Fast Track Designation from the FDA for the Treatment of Patients with Paroxysmal Nocturnal Hemoglobinuria
February 17, 2019 - Researchers identify faulty ‘brake’ that interferes with heart muscle’s ability to contract and relax
February 17, 2019 - Support from trusted adults can reduce risk of dying in suicidal teens, finds study
February 17, 2019 - Heart attack awareness improved since 2008
February 17, 2019 - Exercise gives a better brain boost to older men than women
February 17, 2019 - New research disproves previous assumptions of how looks influence personality
February 17, 2019 - Cannabis use as a teenager linked to depression later in life
February 17, 2019 - Sinks by Toilets in ICU Patient Rooms Harbor Harmful Bacteria
February 17, 2019 - Cancer cells’ plasticity makes them harder to stop
February 17, 2019 - Young cannabis users have increased risk of depression and suicidal behavior
February 17, 2019 - Tasmanian Devils Likely to Survive Cancer Scourge
February 17, 2019 - Neoadjuvant PD-1 blockade seems effective in glioblastoma
February 17, 2019 - Personal, social factors play role in enabling sustainable return to work after ill health
February 17, 2019 - Mouse studies show ‘inhibition’ theory of autism wrong
February 17, 2019 - Study shows how neuroactive steroids inhibit activity of pro-inflammatory proteins
February 17, 2019 - Use of liver grafts from older donors decreased despite better outcomes in recipients
February 17, 2019 - MUSC researchers discover new mechanism for a class of anti-cancer drugs
February 17, 2019 - HPV misconceptions are causing women to miss smear tests
February 17, 2019 - Sanofi and Regeneron Offer Praluent (alirocumab) at a New Reduced U.S. List Price
February 17, 2019 - Researchers say auditory testing can identify children for autism screening
February 17, 2019 - New method analyzes how single biological cells react to stressful situations
February 17, 2019 - WVU gynecologic oncologist investigates novel treatment for cervical and vaginal cancers
February 17, 2019 - ADHD diagnoses poorly documented
February 17, 2019 - Majority of gender minority youth do not identify with traditional sexual identity labels
February 17, 2019 - AbbVie, Teneobio enter into strategic transaction to develop potential treatment for multiple myeloma
February 17, 2019 - Lower Birth Weight May Up Risk for Psychiatric Disorders
February 17, 2019 - Scientists identify reversible molecular defect underlying rheumatoid arthritis
February 17, 2019 - Moffitt researchers shed light on how CAR T cells function mechanistically
February 16, 2019 - Female Anatomy May Play Big Role in Sperm’s Success
February 16, 2019 - BMI may mediate inverse link between fiber intake, knee OA
February 16, 2019 - Movement impairments in autism can be reversed through behavioral training
February 16, 2019 - Studies address racial disparities in postpartum period and cardiovascular health
February 16, 2019 - Scientists implicate hidden genes in the severity of autism symptoms
February 16, 2019 - Decreased deep sleep linked to early signs of Alzheimer’s disease
February 16, 2019 - Neuroscientists show how the brain responds to texture
February 16, 2019 - Gilead Announces Topline Data From Phase 3 STELLAR-4 Study of Selonsertib in Compensated Cirrhosis (F4) Due to Nonalcoholic Steatohepatitis (NASH)
February 16, 2019 - What Can I Do About Sweating? (for Teens)
February 16, 2019 - Companies navigate dementia conversations with older workers
February 16, 2019 - Newly developed stem cell technologies show promise for treating PD patients
February 16, 2019 - Collaborative material research could advance self-assembling nanomaterials
February 16, 2019 - Researchers take major step in creating technology that mimics the human brain
February 16, 2019 - Erasing memories associated with cocaine use reduces drug seeking behavior
February 16, 2019 - Artificial intelligence can accurately predict prognosis of ovarian cancer patients
February 16, 2019 - Racial disparities in cancer deaths on the decline for America
February 16, 2019 - FDA authorizes new interoperable insulin pump for children, adults with diabetes
February 16, 2019 - Coexisting Medical Conditions, Smoking Explain PTSD-CVD Link
February 16, 2019 - Skin Cancer Screening: MedlinePlus Lab Test Information
February 16, 2019 - ‘Happiness’ exercises can boost mood in those recovering from substance use disorder
February 16, 2019 - Cell manipulation could soon halt or reverse aging
February 16, 2019 - Pumped Breast Milk Falls Short of Breastfed Version
February 16, 2019 - Men’s porn habits could fuel partners’ eating disorders, study suggests
February 16, 2019 - Rapid progression of age-related diseases may result from formation of vicious cycles
February 16, 2019 - Immune checkpoint molecule protects against future development of cancer
February 16, 2019 - New method produces hydrogels that have properties similar to cells’ environment
February 16, 2019 - $4.1 million funding for heart research on Valentine’s Day
February 16, 2019 - General anesthesia in early infancy unlikely to have lasting effects on developing brains
February 16, 2019 - New breakthroughs for muscular dystrophy research
February 16, 2019 - First Opinion: Embryo editing for higher IQ is a fantasy. Embryo profiling for it is almost here
February 16, 2019 - Vapers develop cancer-related gene deregulation as cigarette smokers
February 16, 2019 - Bringing Antimicrobial Susceptibility Testing (AST) to the Community
February 16, 2019 - Decolonization protocol after hospital discharge can prevent dangerous infections
February 16, 2019 - Children with ASD more likely to face maltreatment, study finds
February 16, 2019 - Study finds genetic vulnerability to use of menthol cigarettes
February 16, 2019 - Promising drug developed to rejuvenate muscle cells
February 16, 2019 - H-RT should be the standard of care for men with low risk prostate cancer, study shows
February 16, 2019 - New technique using patients’ own modified cells could help treat Crohn’s disease
February 16, 2019 - Therapeutic endoscopy has an expanding role in the treatment of IBD
February 16, 2019 - Blood clot discovery could lead to development of better treatments for blood diseases
February 16, 2019 - Intervention can increase exclusive breastfeeding rates
February 16, 2019 - New project explores how gaming technologies can help cancer patients communicate better
February 16, 2019 - Catalyst Biosciences Presents Updated Data from Its Phase 2/3 Trial of Subcutaneous Marzeptacog Alfa (Activated) in Individuals with Hemophilia A or B with Inhibitors at the 12th Annual EAHAD Congress
February 16, 2019 - Rerouting nerves during amputation reduces phantom limb pain before it starts
February 16, 2019 - A Hormone Produced When We Exercise Might Help Fight Alzheimer’s
February 16, 2019 - Millions of British people breathe toxic air travelling to GPs
February 16, 2019 - Conformance of genetic characteristics found to be crucial for longer preservation of kidney graft
February 16, 2019 - Researchers use optogenetic tool to control, visualize receptor signals in neural cells
February 16, 2019 - New reversible antiplatelet therapy could reduce risk of blood clots, prevent cancer metastasis
Serious asthma attacks reduced by temporary quadrupling of steroid inhaler, study finds

Serious asthma attacks reduced by temporary quadrupling of steroid inhaler, study finds

image_pdfDownload PDFimage_print
Serious asthma attacks reduced by temporary quadrupling of steroid inhaler, study finds
Credit: University of Nottingham

Serious asthma attacks in adults can be reduced by a temporary but significant increase in the dose of inhaled steroids during severe episodes of asthma, according to a new UK-wide study led by experts at the University of Nottingham.

Previous research at the University has found that doubling the dose of inhaled steroids during worsening asthma did not prevent the frequency of serious attacks, so this new NIHR-funded clinical trial was set up to see if quadrupling the dose had a more beneficial effect.

Asthma is one of the most common chronic diseases and affects around 300 million people worldwide. Acute episodes are frightening for patients, cause significant ill health, unnecessary deaths and also account for a large proportion of the overall costs of asthma to health services.

During serious asthma attacks patients may have to be admitted to hospital for treatment including oxygen, nebulised bronchodilators and high dose steroids that can sometimes have adverse side effects.

Three people die from asthma in the UK every day and, according to the National Review of Asthma Deaths, two thirds of these deaths could have been prevented with basic asthma care, which includes patients getting a written asthma action plan from their doctor which, among other advice, outlines the medicine they should use.

The Fourfold Asthma Study (FAST) – published in the New England Journal of Medicine – compared two asthma self-management plans in a large trial involving nearly 2000 patient volunteers in England and Scotland. Around half the patients were randomly assigned to the plan that prescribed a quadrupling of inhaled steroid during periods of worsening asthma and the other half followed the current standard self-care plan over a period of 12 months.

The study showed that the participants in the quadrupling group had a 20% reduction in severe asthma attacks compared with the usual care group and they also had fewer asthma-related hospital admissions as only 3 patients in the quadrupling group were admitted to hospital compared with 18 in the usual care group.

Professor of Asthma and Respiratory Medicine, Tim Harrison, from the University’s School of Medicine, and the NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust said: “Our study shows that patients can reduce the risk of a severe asthma attack by following a self-management plan which includes a temporary four-fold increase in their preventer medication when their asthma is deteriorating. This means less need for oral steroids such as prednisolone, less admissions to hospital with severe asthma and hopefully fewer deaths from asthma”.

Long-term asthma patient, Richard Harris, 68, from Stamford, Lincs, who took part in the trial, said: “The study has made a real difference to my quality of life and my asthma is under much better control as a result. At the completion of the study I continued to follow the quadrupling self-management plan with the agreement of my GP. I could not praise the team at Nottingham highly enough. They manage to combine high levels of professionalism with a friendly approach that makes the patient feel part of the team, with valued opinions and information.”

Dr. Samantha Walker, Director of Research and Policy at Asthma UK, and co- author of the study said: “This groundbreaking research could make a real difference to the 5.4 million people in the UK with asthma. This study showed that increasing the steroids in someone’s preventer inhaler could prevent them having severe asthma attacks and needing to go to hospital.

“We’d urge any healthcare professionals who want to increase their patient’s asthma medication to fully explain what it means, let them know about potential side effects and include it in their written asthma action plan. People with asthma who would like to increase their medication should talk to their healthcare professional and should not delay getting help or support even if they do have an asthma attack.”

The FAST trial was managed by the Nottingham Clinical Trials Unit and funded by National Institute for Health Research (NIHR). Professor Hywel Williams, Director of the NIHR’s Health Technology Assessment (HTA) Programme, said: “We are proud to have funded this original researcher-led study. The research shows that quadrupling inhaled steroids during periods of worsening asthma reduces severe asthma attacks by a substantial amount, resulting in a reduced need for oral steroids and fewer hospital admissions. The study is good news for asthma sufferers all over the world as it shows how patients can better manage their condition and ultimately improve their quality of life.”


Explore further:
Short-term increases in inhaled steroid doses do not prevent asthma flare-ups in children

More information:
Tricia McKeever et al. Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations, New England Journal of Medicine (2018). DOI: 10.1056/NEJMoa1714257

Journal reference:
New England Journal of Medicine

Provided by:
University of Nottingham

Tagged with:

About author

Related Articles