The role of long acting bronchodilators in asthma management

The role of long acting bronchodilators in asthma management

A study released June 5, 2006 adds to the ongoing debate and controversy among researchers about the benefits of long acting beta-agonist bronchodilators. Although some studies have shown them to be safe and effective, other studies have raised questions about increased death rates.

An editorial released concurrently with the study suggests the most important action is to follow current guidelines for asthma management. The Lung Association agrees.

Asthma is a chronic lung condition characterized by one or more breathing problems such as cough, wheeze, shortness of breath, or chest tightness. In Canada, 16 - 21% of school age children and 7.5% of the adult population are affected by asthma. Asthma deaths in Canada have decreased from 454 in 1998 to 287 in 2003. It is likely that more than 80% of these deaths might have been prevented with proper asthma education and appropriate treatment in compliance with the Canadian asthma guidelines.

The Canadian Thoracic Society developed the first set of guidelines for asthma management in the world. Asthma management is not simply about medications. The guidelines start with education of patients to understand their asthma and to avoid the things that trigger their asthma. The next step is the proper use of medications with a written asthma management plan. The management plan is personalized for each patient regarding how to prevent asthma episodes, when to take which medications, when to make changes and when to seek help.

The two main actions of asthma medications are to relieve the symptoms of asthma and to control the underlying inflammation in the airways. The most common mistake that is made is an over-reliance on medications which only relieve the symptoms of asthma without treating the underlying disease. This can result in severe episodes of asthma that lead to emergency room visits or, in some cases, death.

Any medication can carry a risk of side effects, but the risk is always greater if the medication is used inappropriately. The Canadian asthma guidelines provide a consensus among asthma experts regarding the optimal use of medications to optimize asthma control and minimize side effects. Thankfully, the number of asthma deaths and hospitalizations has declined in the 16 years since adoption of the Canadian asthma guidelines.

What should patients with asthma who are concerned about their medications do?

The Lung Association says, firstly, asthma patients should make sure that they are taking all of their asthma medications as prescribed by their physician and should only make changes to their use of medications as outlined in their written asthma management plan. Secondly, they can confirm with their physician or their Certified Asthma Educator that their treatment is consistent with the Canadian asthma guidelines.

Canadian Thoracic Society Asthma Committee continually reviews all new research and publications and updates the asthma guidelines as the body of scientific knowledge grows and new treatments become available.

Information on asthma and its treatment is available from the Lung Association website or by calling The Lung Association at 1-888-566-LUNG (5864).

References:
Study: Meta-Analysis: Effect of Long-Acting B-Agonists on Severe Asthma Exacerbations and Asthma-Related Deaths

Editorial: The Role of Long-Acting B-Agonists in the Management of Asthma: Analysis, Meta-Analysis, and More Analysis