Varying treatment of asthma

Asthma symptoms vary greatly among individuals and vary at times with each individual.

In this comprehensive study in the April issue of Mayo Clinic Proceedings, researchers address the prevalence and process of step-down therapy as symptoms subside. Of the 397 adults and children studied, 64 percent had at least one change in medication dose during the two years of the study. Most changes were step-up in doses during an asthma flare. Step-down changes were far less common.

Lead author Barbara Yawn., M.D., from the Department of Research at Olmsted Medical Center in Rochester, Minn., comments that “patients indicate it is important to them to take the lowest possible dose of medication to maintain asthma control, suggesting we need to step down therapy when feasible.”

This is one of the first studies to address the frequency, type and context of step-up and step-down changes in asthma therapy for children and young adults. The study asserts that asthma care continues to be episodic, with most physician visits occurring at a flare-up. Additional research will help determine the best course of long-term treatment for patients with asthma.

Other study authors are Peter Wollan, Ph.D., and Susan Bertram, also from the Department of Research at Olmsted Medical Center; David Lowe, M.D., and Denise Bonde, M.D., from the Department of Allergy and Asthma at Olmsted Medical Center; and Joseph Butterfield, M.D., and James Li, M.D., Ph.D., from the Division of Allergic Diseases at Mayo Clinic in Rochester.

This study was funded by a grant from Integrated Therapeutics and the National Institutes of Health.

A peer-review journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 nationally and internationally. Articles are available online at www.mayoclinicproceedings.com