Hail inhaler

Doubts concerning the reliability of inhalers in controlling mild asthma have been put to rest as a recent study in the US has given beta-agonists the clean chit

Published: Thursday 31 October 1996

it is a common sight to see asthma patients puff at their inhalers. But the safety and effectiveness of the device has been debated for quite some time. A study conducted by researchers with the us -based National Heart, Lung and Blood Institute (nhlbi), published recently in the New England Journal of Medicine puts an end to this debate by suggesting that inhaled drugs are safe and effective for people with mild asthma ( National Institutes of Health release , September 18, 1996).

Mild asthma is a condition in which a patient has few clinical signs of asthma. For these occasional episodes of coughing and wheezing, the patient relies on beta-agonists, a class of drugs that relaxes the muscles in the windpipe. Beta-agonists are taken as inhalers. Albuterol is the most commonly prescribed and used beta-agonist. However, the drugs do not treat the underlying inflammation that causes the disease. So, if patients begin experiencing the symptoms of asthma more frequently or if the beta-agonist no longer proves effective, they normally contact their physician.

Prior to 1990, most asthma experts believed that prescribing beta-agonists improved overall control over the symptoms of asthma. But several studies conducted after 1990 have suggested that it is the regular use of a beta-agonist that might induce tolerance (the ability of enduring or being less responsive to the influence of a drug; particularly through its continuous use), leading to a diminished control over asthma in some patients. Some scientists even hypothesised that it was the inhalation of beta-agonists that was causing an increased incidence of asthma, hospitalisation and death rates, worldwide.

Investigating the effectiveness of inhalers, researchers working for the Asthma Clinical Research Network at the nhlbi arrived at some significant conclusions. Conducted at five medical centres nationally, the study focussed on 255 patients with mild asthma between the age groups of 12 and 55, for six months. The patients were divided into two groups on a random basis: one was put on albuterol and the other on a placebo inhaler (which does not contain a beta-agonist) for 16 weeks.

The study showed that there were no significant differences between the two groups in measures of lung function, asthma symptoms or quality of life. Based on these observations researchers have recommended that for patients showing only occasional symptoms of asthma, there is no need for using beta-agonists regularly. As for patients with more frequent symptoms, it is suggested that they contact their physicians and not use their inhaler more frequently, which is the common practice.

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