in a study comparing pills for asthma against steroids inhaled commonly prescribed, British researchers found that oral medicines have been as effective as the inhaled medications.
Oral drugs, known as leukotriene receptor antagonists, "showed similar efficacy and cost and better compliance and should be regarded as for any patient, not as a last option, but as an option for any patient."," said study co-author Dr. Stanley Musgrove, a senior research associate at the University of East Anglia in Norwich.
"Each different patient will have their own issues that are important for their care: their compliance with the different drugs, how although they feel that different drugs work for them, their concerns about drugs, any possible minor side effects."", etc., and all those who are to be considered when the clinician and the patient are taken a decision on the best drugs," he noted.
Results of the study are published in the May 5 of the New England Journal of Medicine issue.
The study was designed to be what researchers call a "pragmatic" trial, which more closely mimics the way people use drugs in real life as opposed to strict rules of a clinical trial, according to Musgrove.
Researchers recruitment 650 people with mild to moderate asthma. Study volunteers were between the ages of 12 to 80 and insufficient control of asthma or an alteration of the quality of life due to asthma symptoms.
Volunteers were assigned randomly to a group. An arm of the comparative study of antagonists of leukotriene receptor (Singulair and Accolate) to corticosteroids as a treatment of first line for asthma. The other branch of the study compared people who were already inhaled steroids then added either on a long duration of action of rescue medication (known as a LABA) or leukotriene receptor antagonists (LTRAs).
Patients were allowed to comply they wanted and change drugs that they had, said Musgrove.
Results two months suggest that the LTRAs are similarly effective corticosteroids when it is used as first line treatment LABAs when used as a supplementary treatment. After two years, the effectiveness of these two treatments was similar, but the researchers noted that "equivalence was not proven."
The main measure of the effectiveness of the drugs was the quality of life for asthma Mini Questionnaire. This 15-item quiz has total scores ranging from 15 to 105, higher scores indicating less affect asthma. Scores increased an average of 0.8 to 1 point in the two arms of the trial. Asthma control and exacerbations of asthma incidence was similar between groups.
Musgrove said there is no significant side effects to drugs. However, in 2009, the U.S. Food and Drug Administration requested that drug LTRA manufacturers add a warning to their labels because of behavioral side effects serious medication, including suicidal thoughts and depression in some people.
The risks of inhaled asthma steroids include hoarse voice, thrush, of sore throat and possibly reduced bone density.
In terms of costs, a United Kingdom of 2010 study that compares the costs of two therapies for initial asthma control revealed that the price of LTRAs was "significantly higher" than that of inhaled steroids.
An expert said the most recent study comparing the effectiveness of the LTRAs and inhaled steroids has stressed the need for individualized treatment.
"These study results not me to change my mind." "It confirms that there are various options, and there is not a single response for everyone," said Dr. Jennifer Appleyard, head of Allergy and Immunology at St. John Hospital Medical Center in Detroit.
"The National Institutes of Health has issued guidelines on asthma management, and much of the literature review is entered in the implementation of these guidelines that recommend trying first inhaled corticosteroids.". "And this has been my experience that I get a good control with more patients using steroids," she said.
"But if someone is difficult to use an inhaler properly or they experience side effects, then I think on the modification of their medication," she added. "But there is no drug that will help the world and no medicine is without risk.".
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