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For Mild Asthma, Daily Steroids May Not Be Needed, Study Says
Date:9/11/2012

TUESDAY, Sept. 11 (HealthDay News) -- Millions of people with mild to moderate asthma are routinely prescribed daily inhaled steroid medications to control the disease, but a new study suggests that may not be necessary.

The study, published Sept. 12 in the Journal of the American Medical Association, found no difference in patient outcomes whether patients took the powerful drugs each day or only when symptoms appeared.

"The discovery that these two courses of treatment do not differ significantly could eventually change the way doctors and patients manage asthma, providing an option that is easier to follow and possibly less expensive," lead author Dr. William Calhoun, professor and vice chair for research in internal medicine at the University of Texas Medical Branch at Galveston, said in a university news release. "Our findings build on a considerable foundation of research in the field and come at a time when asthma cases are rising at an alarming rate, especially in lower-income communities."

According to information in the news release, about 25 million Americans have asthma. Doctors typically assume that asthma is present even without symptoms, so it should be treated on an ongoing basis with anti-inflammatory drugs. The current accepted regimen is twice-daily use of an inhaled corticosteroid and then the use of a "rescue" medication, such as albuterol, should symptoms arise. This regimen is typically adjusted if needed every six weeks or so, according to standard treatment guidelines.

But is daily steroid use always warranted? In the new study, Calhoun's team tracked outcomes for 340 adults with mild-to-moderate, persistent asthma. The participants were randomly sent to either ongoing, physician-monitored care; continuous care based on an periodic breath tests measuring levels of nitric oxide; or care based on symptoms alone, with steroids given only as flare-ups occurred.

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