Secondary Prevention Of Asthma

The foundation of wheezing and asthma is often laid very early in childhood but whether or not a harmless wheezing condition will develop into a ruthless asthma is something that cannot be predicted at that time. When wheezing first appears in childhood, and it usually does in a many a child, it should be treated then and there with the help of inhaled corticosteroids and this could really help in the prevention of this developing into a real problem. But recently it has been found out by some researchers that although such treatment could help control symptoms, you will not be able to benefit from the advantages within a few months of stopping the treatment altogether.

Here comes the concept of secondary prevention of asthma which is defined as intervention(s) for infants and children who are at high risk for the development of asthma but who have not yet developed asthma symptoms or signs; and are basically suffering from severe wheezing. Asthma is one disease which has close connection with family history and if it runs in the family, chances are that one person in every generation will be suffering from it. The allergies could be one of the these; atopic dermatitis or eczema, allergic rhinitis, food allergy, bronchial hyperreactivity, blood eosinophilia, elevated total IgE levels, elevated allergen-specific IgE, or skin-test reactivity to specific allergens. I am going to discuss about the results of two industry-sponsored, randomized, double-blind studies which will definitely increase our knowledge about the role of inhaled steroids and ß-agonists in asthma control.

In the aforementioned study, investigators compared three acute treatment strategies in more than 3300 patients (age, 12 years and older) who had moderate-to-severe asthma symptoms and who remained indicative on low-dose budesonide-formoterol. They were distributed in random groups and each group received terbutaline, formoterol alone, or additional combined budesonide-formoterol for as-needed relief therapy. At 1 year, the combination of budesonide-formoterol had considerably reduced the hazard for severe exacerbations by 27% as compared to formoterol alone and by 45% as compared to terbutaline. This great blend also reduced rates of exacerbations needing emergency- room treatment compared with the other two treatments. After randomization, increases in FEV1 were definitely a bit more in the budesonide-formoterol group. The number of asthma-free days did not differ to a great extent among all the three groups, and unpleasant events were unusual in all groups.

In another trial taken in a placebo-controlled environment, investigators studied whether early use of inhaled fluticasone (100 µg twice a day) would help in the prevention of later development of asthma in 200 young children (median age, 1.2 years) who had been suffering from wheezing previously. Compared with placebo, early use of fluticasone did not do anything to avoid future development of asthma or augment lung function as measured at age 5 years.

Scientists continue to conduct various researches for the secondary prevention of asthma. According the first study the combination of an inhaled corticosteroid and a long-acting ß2- agonist is supportive for rescue therapy in children with moderate-to-severe persistent asthma on protection therapy with low-dose, inhaled budesonide-formoterol. Unfortunately these cannot be called very effective remedies as they don't do as much to control asthma as to just rid you of the symptoms.