According to new research, for some people suffering from mild asthma which is controlled with twice-daily use of inhaled steroids, once a day may be enough.
Asthma is an inflammation of the airways that makes breathing difficult; symptoms can include wheezing, shortness or breath, coughing and chest tightness.
Researchers at Wake Forest University Baptist Medical Center and 20 other centers took part in a study involving people with mild asthma.
The study, involved 500 children and adults with mild asthma and was conducted by the American Lung Association’s Asthma Clinical Research Centers.
The aim was to find out if patients whose symptoms were well controlled on twice daily inhaled corticosteroid could scale down their medication.
The participants' asthma was treated with twice-daily inhaled fluticasone propionate, a commonly prescribed synthetic steroid designed to suppress inflammation within the airways that can cause narrowing.
Asthma is considered mild, but persistent, when symptoms occur more than two times a week or cause the patient to awaken during the night more than twice a month.
The standard treatment for mild-persistent asthma is twice-daily use of an inhaled steroid to prevent symptoms and sufferers can also take additional drugs such as the inhaler albuterol, known as "rescue" therapy, to treat symptoms.
According to Dr. Stephen P. Peters, the lead author, who is a professor of pediatrics and associate director of the Center for Human Genomics, the majority of people with asthma have mild disease.
The study group were randomly divided into three groups; one group continued to take Flovent twice a day for 16 weeks, while the two other groups took alternative therapies: either a combination of fluticasone propionate and salmeterol in a single inhaler once daily or the oral medication montelukast that blocks chemicals produced by the body that cause inflammation, which was also taken once daily.
Salmeterol, used in the combination therapy, is a long-acting bronchodilator, or a drug that relaxes and opens the airways.
Treatment failure rates were measured among the three groups and included hospitalization or urgent medical care, the need for additional medications for asthma, a decline in lung function, or the need to take more than 10 puffs a day of a "rescue" inhaler for two consecutive days.
The researchers found that the groups taking twice-daily fluticasone and once-daily fluticasone/salmeterol both had a treatment failure rate of 20 percent, while the group taking montelukast, had a 30 percent failure rate.
Dr. Peters says the study suggests that patients whose asthma is well controlled on twice-daily fluticasone can be switched to once-daily flucitasone/salmeterol without increased rates of treatment failure.