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Severe asthma 'less responsive to steroid preventer treatment'

By
WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
woman using astma inhaler

9th September 2013 - People with severe asthma are less likely to respond to the treatment they depend on compared to those who have a milder form of the disease, says a new study.

Although asthma is a fairly common condition, affecting 5.4 million people in the UK, experts do not fully understand why some people have a more serious form of the disease than others.

The U-BIOPRED project - which stands for Unbiased BIOmarkers in PREDiction of respiratory disease outcomes - is using samples from adults and children to learn more about these different types of asthma in order to categorise them into sub-groups.

Personalised treatment

The aim is for researchers to develop more personalised medicine, which treats the specific disease in each specific individual.

The project is running for 5 years and is due to end in 2014.

A key component of treating asthma is the 'preventer inhaler' which contain low doses of steroid medicine designed to control swelling and inflammation in the airways.

The results of initial findings being presented at the European Respiratory Society Annual Congress in Barcelona, Spain has found that those with severe forms of the condition - sometimes referred to as ‘steroid dependent' - are less likely to respond to their treatment.

In adults:

  • 55% with severe asthma took regular oral corticosteroids and yet showed greater airway obstruction than those whose asthma was classed as mild or moderate
  • Patients with severe asthma still experienced asthma attacks and severe symptoms despite taking high doses of the corticosteroids.

In children:

  • The level of airway obstruction in severe and mild or moderate asthma was similar
  • The severe asthma group had higher FeNO levels (fraction exhaled nitric oxide), which is a measurement used to diagnose asthma.

Corticosteroids

David Gibeon, lead author of the study from Imperial College, London, says in a statement: "We would like to understand why people with more severe asthma are less responsive to the effects of corticosteroids.

"Our parallel work on the ways in which patients with asthma respond to corticosteroid treatment, which is a commonly-used treatment for asthma, show that asthmatics may become less responsive to this treatment in many different molecular ways.

"This initial analysis will provide an overview of the groups which exist within asthma, which will help us develop a more personalised approach to treating the individual patient with asthma."

Commenting on the findings, Malayka Rahman, research analyst at Asthma UK, says in a statement: "The U-BIOPRED project is an important initiative that aims to improve the lives of people with severe asthma. In the UK people with severe asthma are some of the most marginalised in society, missing out on vital life opportunities and often experiencing isolation.

"Asthma manifests itself differently in each individual, and as this research shows, people’s responses to treatments vary hugely.

"This initial analysis has already started to unravel some of the mysteries of what drives these different types of asthma and how they vary in individuals. Ultimately, this knowledge could lead to much needed new treatments for people with severe asthma."

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the 'peer review' process, in which outside experts scrutinise the data prior to publication in a medical journal.

Reviewed on September 09, 2013

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