Inhaled corticosteroids have been the mainstay of treatment for persistent asthma for decades. A new trial suggests that for the ~50% of asthma patients with low sputum eosinophils, inhaled steroids are no better than placebo, and neither was tiotropium.
Treatment with the inhaled glucocorticoid mometasone or the long-acting muscarinic antagonist tiotropium resulted in similar outcomes among the majority of patients with mild asthma who had low (less than 2%) sputum eosinophil levels. Results from the SIENA trial were published in the New England Journal of Medicine and presented at a society conference.
Very interesting thanks 2greys. I wonder if this will lead to a more detailed study or trial. It can seem like doctors just throw tiotropium and inhaled corticosteroids at various conditions in spite of the side effects from long term use, regardless of whether these work or not. Also, many people have more than one distinct lung condition. To just be told that a certain inhaler works for 'everyone' isn't much help or very supportive. Clearly not every inhaler works for everyone, otherwise there would only be one inhaler out there as there would be no need for more than that. It would be fantastic to have a trial that focuses on individual cases and maybe prescribers (is that a word?) won't just throw inhaled corticosteroids at everyone and send them on their way.
If you have been prescribed a steroid preventer for asthma.....please don’t just stop taking it . Get advice from a health professional about any medication..
My now adult daughters were relied on Ventolin only for their asthma, before preventers became common, with dire results. This was about thirty years ago.
The advice is if you need to take more than three puffs of Ventolin a week, a preventer is needed.
Many people here cope with a combined inhaler, but after trial and error they don’t seem to suit me. I take a single preventer. We are all different.
A few folks would jump at the chance to ditch the (lifesaving) drugs. As an asmatic, mother and grandmother to asthmatics I cannot imagine what life would be like without a preventive and reliever. No life I suspect and an unnecessary & unpleasant death.
NB I do realise you're just passing on research 2G x
The thing is, there are inhalers out there that are neither tiotropium or inhaled corticosteroids. For many years I had such an inhaler which worked fantastically well for me. But it was taken away and replaced by various inhaled corticosteroids plus tiotropium, which really don’t work well for me at all, the side effects are varying degrees of lousy, and I don’t like the idea of the long term effects either. The response was, This is what everyone has now. A study like this could show that we are not all Everyone.
I am one of those asthma patients who can't take inhaled steroids - they do no good at all and make my breathing worse for literally hours after taking them. I have been tried on a really expensive, finer powder brand (can't recall it's name) but my rescue inhaler use trebled while I was on it. I've just tried Pulmicort again for a 6 week period but I've had to stop it, as my breathing was getting worse and worse. My problem is an asthma nurse who refuses to believe that it doesn't work, and keeps saying that if I need my rescue inhaler more than 3 times a week, I should be on a steroid. I have had asthma for 55 years and used to take my steroid inhaler and rescue inhaler together, every morning and night (the instructions were different back then), and I was plagued with constant asthma attacks, and severe infections and pneumonias. In the last 10years, after stopping my Pulmicort, I have been so much better! I can walk up the hills of Devon without disintegrating into a breathless heap every 20 steps. I also have only had one pneumonia (not caused by flu (tested in A & E), in the 11 years I've lived in Devon and not been on the steroids.
I certainly wouldn't advise anyone to drop any medication on the strength of my experience, but I just thought I'd add my story, because it outlines very well that we are all different, and no NICE advice can possibly fit all persons. I just wish I could persuade my asthma nurse (who has never had asthma) that I can't tolerate it. I feel guilty every time I use my Bricanyl inhaler.
In 30+ years as a mental health specialist social worker I saw too many people with serious psychiatric side effects from steroid treatment. I've refused any steroids treatment since. For COPD I use a Seebri inhaler for prevention. In 2010 I refused a 'nerve block' for a trapped lumbar nerve when I found out it was actually a steroid injection. Apart from the pathological weight gain from steroid treatment it can lead to serious intractable depression, sometimes with psychotic features and I had already suffered for years from unipolar episodic depression.
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