Asthma Watch

Improved Meds Better Control Severe Asthma

New asthma medications and tools have greatly improved the management of this lung disease in children over the past 10 years, according to findings presented recently at the American Academy of Allergy, Asthma&Immunology annual meeting. The study found that from 2004 to 2007 the participants were less likely to need oral steroids and rescue inhalers, and their lung function scores were better, compared with children with the same form of asthma in the 1990s.

The medications assessed in the study included new inhaled steroids, combinations of inhaled steroids and long-acting bronchodilators, and leukotriene receptor antagonists. The researchers found that just over three quarters of the 65 children in the present-day group were on a leukotriene receptor antagonist, and two thirds were on combination medication. None of the 164 children from the 1990s group took any of these medications.

The present-day children were 28% less likely to need oral steroids, compared with 51% of the older group. The new group also used their rescue inhalers about half as often.

Broccoli Cuts InflammationBroccoli and other cruciferous consumption may help protect against respiratory inflammation associated with asthma, allergic rhinitis, and chronic obstructive pulmonary disease, found a study published in the March 2009 issue of Clinical Immunology.

The compound sulforaphane found in these vegetables increased the production of antioxidant enzymes in the airway that prevent large amounts of tissue-damaging free radicals humans breathe daily in polluted air, pollen, and tobacco smoke. For the study, 65 participants received varying doses of either broccoli or alfalfa sprout preparations for 3 days. Alfalfa sprouts do not contain sulforaphane.

“We found a 2- to 3-fold increase in antioxidant enzymes in the nasal airway cells of study participants who had eaten a preparation of broccoli sprouts,” said lead researcher Marc Riedl, MD. “This strategy may offer protection against inflammatory processes and could lead to potential treatments for a variety of respiratory conditions.”

Home Visits for Asthma

A study reported in the Archives of Pediatrics&Adolescent Medicine (March 2009) found that community health workers acting as asthma coaches are able to keep kids from being rehospitalized for asthma episodes.

The study included 191 black children covered by Medicaid who were hospitalized for asthma. The children were randomly assigned to usual care or to work for 2 years with an asthma coach.

The coaches reinforced basic asthma education and positive behaviors to manage the disease during home visits and with phone calls. During the intervention, there was an average of 21.2 contacts per parent over the first 24 months. Parents (89.6%) had at least 1 contact with the coach during the first 3 months. The proportion of children rehospitalized was 35 of 96 (36.5%) in the asthma coach group, compared with 55 of 93 (59.1%) in the usual care group.

Birth Control May Up Asthma Risk

Oral contraceptive use may increase the risk for asthma in some women, according to a Scandinavian study. From 1999 to 2001, the researchers sent questionnaires to women aged 25 to 44 years old in Denmark, Estonia, Iceland, Norway, and Sweden. The participants included 4728 women who did not use birth control and 961 who did.

The findings showed that women who took oral contraceptives were 42% more prone to have asthma. The risk was higher when body mass index was factored in, however. The odds for asthma with birth control were 45% higher for normal weight women and 91% higher for overweight women, but 69% lower for thinner women.

The study was reported recently in the Journal of Allergy and Clinical Immunology.

Statins Cut Back Asthma ER Visits Researchers from Medco Health Solutions Inc and Brigham and Women’s Hospital presented their findings on statin use among patients with asthma during the recent annual meeting of the American Academy of Allergy, Asthma & Immunology. Among patients on inhaled corticosteroids in the study of 6574 patients, those also taking statins lowered their chances of asthmarelated hospitalization or emergency department visits by 33%.

“The implications of this study are exciting, because they point to the potential role statins could play in helping prevent the most serious asthma attacks that land patients in the hospital,” said Robert Epstein, MD, Medco’s chief medical officer. He cautioned that the findings are preliminary and warrant more clinical studies.

FAST FACT: Every day in America 30,000 people have an asthma attack.