Interesting article re NOT always keeping up with inhaled steroids if your asthma is mild

Has anyone seen this? Some interesting points, though I hope it wouldn't mean people who do need inhaled steroids daily not getting enough of them. Always thought it took time to build up as well - I know I saw no positive effects from Symbicort for just over 3 weeks, so how would it work just taking when you get symptoms, if it needs time to build up? Slightly confused by some of this, but an interesting read anyway.

What does anyone else think?

9 Replies

  • It might just be me, but I can't get the link to work...

  • I think the site was having issues as I couldn't load other articles in my RSS feed - try again now, as I'm not having those issues anymore.

  • Thanks, got it to work now.

    It's a very interesting article, it's a shame that the sample size is small though since that stops if from being completely reliable. Surely though it's better to prevent the symptoms in the first place rather than just to treat them when they occur.

    Maybe some kind of psychological effect going on?

    I agree with you Philomela, I hope it doesn't stop people having access to the treament they need.

  • I could imagine this would be good for people who have mild asthma but it is interpreting mild.

    My close friend has mild asthma and already does this, she can go between 3 steps, using reliever rarely if at all, then adding Qvar and just one period she added serevent for a year. But being mild she responds quickly to adding on Qvar and everything calms down completely. She then goes months and months with no symptoms and using no inhalers. The trick then of course is to add on treatment promptly when they need it.

  • Very true re interpreting mild. I think it's fine if there's good communication and they do take symptoms into account. I've been told I'm 'mild' according to LF tests, and while I'm aware that there are many who are much worse off than me including quite a few users on here, I'd dispute mild esp. in relation to this article; would have said moderate, at least partly because of the effect of medication and how much it takes to work (less than some but more than 'standard' for mild.)

    I've had mild asthma before - where I might very well have benefited from this approach - and I do know the difference between that and now, where I really struggle with things if I don't keep up with my Symbicort/montelukast (and even sometimes then - but they certainly help and I know I'd be a lot worse if I only took them sometimes, plus they take a while to work for me and if I stopped I'd have to build up again.) So would be interesting to see how they'd implement it.

  • i heard something about this a little while ago, i will admit i haven't fully read the article.

    As JF says it's how you interpret mild - i would've said i was mild but i have a friend who also has an asthmatic sister and he says mine is far worse than hers, though i am exercise-induced and often when he has seen my asthma it's because we've been doing something energetic.

    What's the definition of mild - using reliever about once or twice a week (like me when i go running, or needing a reliever less than once a week. Generally my asthma IS mild (as far as i'm concerned) but when it hits i can have extended periods of excesssive coughing.

    Edit: cross-posted with philomela

  • I think it could work for people with mild occaisional symptoms.

    I also thought this article was interesting Internet Monitoring Strategy for Severe Asthma Patients Sown to Be Effective

  • Jinglfairy, think your post isn't saying exactly the same thing though...unless it did before you edited!

    There is a difference I think between mild and well controlled which the approach in the article would obviously need to consider - there are some people who really are mild and therefore don't need reliever much, but some people who don't use much reliever most of the time but are on several or strong preventers/add-ons might have worse asthma that just responds very well to medication and happen to be on the right meds/dose combo - obviously they would be the ones who need to keep taking it all the time.

    I also think being up and down too much is a sign of not being controlled - I'm sure control means not being thrown off course too easily! Presumably if someone on this plan kept needing short bursts of preventer it might be a sign they should just keep taking it all the time.

  • I think also if you fit into the 'difficult to control' category this wouldn't work at all.

    I am sure there are loads of people out there whose asthma rarely has an impact on their lives who could benefit from this sort of regime but it is when somebody's asthma changes from easily controlled to difficult that this regime would have to be scrapped.

    My concern too whilst reading the article is how many children die from asthma when they previously had 'mild' asthma. Would those numbers increase?

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