Once-daily treatment OK for mild asthma-study

CHICAGO, May 17 (Reuters) People whose mild asthma is under control may be able to safely step down to a daily treatment, researchers said.

Current treatment guidelines call for patients with persistent mild asthma to use inhaled corticosteroids twice a day.

''Even though people can be well controlled on the gold standard, some people want alternatives,'' said Dr Stephen Peters of Wake Forest University in North Carolina, who participated in the study yesterday.

''We looked at two different alternatives,'' said Peters, whose work appeared in the New England Journal of Medicine.

Asthma is an inflammation of the airways that makes breathing difficult. Symptoms can include wheezing, shortness or breath, coughing and chest tightness.

The researchers studied 500 patients with asthma that was well controlled by inhaled fluticasone propionate, or Flovent, used twice a day. These patients were divided into three groups.

About a third continued on the twice-daily treatment, another third took a once-daily combination of fluticasone plus salmeterol, sold as Advair by GlaxoSmithKline Plc .

A third group took a once-daily pill known as montelukast sodium, or Singulair, sold by Merck&Co. Inc. Singulair works by blocking the protein leukotriene and is also approved to treat allergies.

After 16 weeks, people were evaluated for treatment failure, which included a host of problems from an asthma attack that sent them to the hospital to a significant drop in lung function.

What they found is that most people were able to switch to a less frequent treatment without too many problems.

The study found no difference in asthma control between the patients who took Flovent once a day or those who switched to Advair. About 20 per cent of both of those groups experienced treatment failure.

Patients who switched to the Singulair had more frequent problems, with about 30 per cent of those experiencing treatment failure.

But the researchers said there was no difference in the percentage of symptom-free days among the three groups.

Peters said patients who are doing well on their current treatment don't need to do anything, but the study shows that less frequent alternatives may also be effective.

''This is all about choices. Not every medication and every way of doing things is best for every patient,'' he said.

In a separate asthma study appearing in the same issue of the journal, patients with mild asthma who took inhaled steroids on an as-needed basis fared about as well as patients who took the drug on a regular basis.

''We're taking baby steps away from the guideline therapy,'' Peters said.

REUTERS DS HS0934