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East of England Respiratory Programme

NEJM paper shows success of asthma tablets in 'real-world' situation

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NEJM paper shows success of asthma tablets in 'real-world' situation

A UK study published in the New England Journal of Medicine has shown that LTRA tablets are as effective as inhalers in the 'real-world' management of asthma patients - partly due to the high levels of poor inhaler technique.

The study by the University of East Anglia (UEA) and Aberdeen University, followed 650 patients with chronic asthma for two years. It aimed to look at 'real-world' management of asthma - ie taking into account how patients took and used their medication.

The studey found that Leukotriene Receptor Antagonists (LTRAs) managed the disease equally successfully as steroid inhalers for patients with mild asthma and in a parallel sample of patients with moderate asthma, The studey also found that LTRAs managed the disease equally successfully as other "preventer" inhalers when used in addition to steroid inhalers.

Under UK guidelines LTRAs are currently recommended as third or fourth steps in asthma management. As a result, LTRAs are far less frequently prescribed than inhalers.

The results indicate that LTRAs could provide an effective alternative to steroid inhalers and other 'preventer' inhalers when used in addition to steroid inhalers, which could be useful for the more than 80 per cent of patients who have problems using inhalers, are unable to use them due to side effects, or do not want to take steroids.

 Lead author Prof David Price of the University of Aberdeen and UEA."We hope these findings will increase the options for healthcare professionals when prescribing for this common but disruptive disease," said

"We found that adherence to treatment was vastly improved - by as much as 60 per cent - when patients were given the once-a-day LTRA tablets and patients did not have to worry about using appropriate inhaler technique."

Co-author Dr Stanley Musgrave of Norwich Medical School at UEA added: "LTRAs are easy to use and can help patients control their asthma effectively and improve their quality of life."

Known as ELEVATE, the randomised controlled trial was designed by the UEA and University of Aberdeen team to examine asthma therapies in a real-world setting. The volunteer patients were recruited from 53 doctors' surgeries in NorfolkSuffolk,EssexCambridgeshireHampshire and Dorset. All were unpaid. The trial was sponsored by the NHS's Health Technology Assessment programme.

 

Read the abstract free on the NEJM Website (full paper available to subscribers only)

Primary source: New England Journal of Medicine

Source reference:
Price D, et al "Leukotriene antagonists as first-line or add-on asthma-controller therapy" N Engl J Med 2011; 364(18): 1695-1707. 

Additional source: New England Journal of Medicine
Source reference:
Dahlen SE, et al "Asthma treatment guidelines meet the real world" N Engl J Med 2011; 364(18): 1769-1770.