Daily use of maintenance inhalers results in better asthma control.

Simply treating asthma attacks when they happen is not always enough to manage patient condition.* I know that for a fact, as I have asthma and come from a family of "asthmatics". 

However, the reality is that asthma patients often underestimate their diagnosis and therefore fail to get the proper, persistent treatment that they need. Research shows that 6 out of 10 asthmatic individuals consider their condition to be controlled, despite 41.3% reporting shortness of breath at least three times a week, and 57.8% having to use their reliever inhalers at least twice a week.**

As a result, the chances of complications may rise. Those with under-treated asthma can suffer from sleep disturbance, fatigue, poor concentration***, or airway inflammation****. There's also the risk of needing emergency care or hospitalization for treatment. And in the most severe cases, asthma can lead to death.*****

Being a chronic condition, asthma requires medication that not only relieves current symptoms but also provides sufficient control to improve the patient’s quality of life. Here’s a rundown of the usual medication for asthma patients, as well as new evidence which cites daily treatments as a more effective way of managing asthma both in the short-term and long-term.

Asthma Relievers versus Controllers

The first medication type that asthma patients typically take is called a reliever. A staple in our home, and a must-have everywhere I go, these fast-acting medications relax tightened airway muscles and open them up, alleviating acute signs of asthma. Relievers help when a patient suffers an asthma attack, but may also be used as a preventive measure in some instances. For example, a reliever may be used prior to physical exercise to prevent asthma attacks.^

On the other hand, controllers are medications meant to reduce the inflammation in the lungs, therefore preventing asthma symptoms over time. These usually contain steroids. Unlike relievers which are used as needed for short-term symptom relief,^^  controllers are usually taken on a daily basis - even when patients are not experiencing any acute asthma symptoms.^^^

The Effectivity of Daily Asthma Treatments

A recent study by Professor Dave Singh looked into the efficacy of proactive treatments via inhaled corticosteroids (ICS) or maintenance inhalers. Singh’s study revealed that higher doses of ICS treatment and higher adherence to treatment schedule generally provided the best protection for most forms of asthma.^^^^

Supporting this is a post-hoc analysis of data from a GSK-sponsored AUSTRI study which finds that in patients with a one-year history of exacerbations, ~92% of those treated with a daily regimen of ICS/LABA did not exacerbate during the treatment period.

Additionally, this same study also showed that this specific approach to daily treatment was able to reduce asthma attacks by 21.8%.^^^^^ Patients treated with daily usage of ICS-LABA witnessed fewer asthma exacerbations compared to those treated with ICS alone.

"These new pieces of evidence simply tell us that the daily usage of ICS treatments can in fact treat both the immediate symptoms of asthma, while also providing long-term control for the condition," explains Dr. Gyneth Lourdes Bibera, Country Medical Director of GSK Philippines. “Asthma shouldn’t just be treated as a condition that happens occasionally. It's better to follow a consistent plan that involves daily asthma treatment, to address evident and underlying symptoms and ultimately decrease the number and severity of asthma attacks over time,” she says.

 
*Medication for people with asthma. (2017, November 30). National National Center for Biotechnology Information. Retrieved September 23, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK279519/

**Price D, et al. npj Prim Care Respir Med 2014; 24:14009; 2. Chapman KR, et al. Respir Med 2021;186:106524.

***Asthma. (2022, May 11). Retrieved September 23, 2022, from https://www.who.int/news-room/fact-sheets/detail/asthma

****Asthma: Treatments for Inflammation. (n.d.). Cleveland Clinic. Retrieved September 13, 2022, from https://my.clevelandclinic.org/health/drugs/11871-treating-the-inflammation-of-asthma

*****Asthma. (2022, May 11). Retrieved September 23, 2022, from https://www.who.int/news-room/fact-sheets/detail/asthma

^Medication for people with asthma. (2017, November 30). National National Center for Biotechnology Information. Retrieved September 23, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK279519/

^^Asthma medications: Know your options. (2022, August 19). Mayo Clinic. Retrieved September 23, 2022, from https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-medications/art-20045557

^^^Medication for people with asthma. (2017, November 30). National National Center for Biotechnology Information. Retrieved September 23, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK279519/

^^^^Singh, D. (2022, March). New Versus Old: The Impact of Changing Patterns of Inhaled Corticosteroid Prescribing and Dosing Regimens in Asthma Management. Springer Open Choice, 39(5). https://doi.org/10.1007/s12325-022-02092-7. Accessed 13 Sept 2022.

^^^^^USTRI post hoc analyses - Busse W, et al. J Allergy Clin Immunol Pract. 2022;S2213-2198(22)00341-5.