New Data Raise Questions About the Use of Steroid Inhalers for Mild Asthma
For decades, the recommended course of action for patients with mild asthma has been to use a low dose steroid inhaler two times each day. However, a new study published in the highly reputable New England Journal of Medicine casts doubt on the value of this guideline, showing that many people suffering from mild asthma do not benefit anymore from this treatment approach than they would with a placebo.
The idea behind using a steroid inhaler is that the medicine in the inhaler fights inflammation by mimicking cortisol, a steroid hormone known to reduce inflammation. The problem is that most of the research that has suggested that this type of inhaler benefits asthma patients has been conducted on patients with severe asthma. According to this new research, only about 1 out of every 4 patients with mild asthma has the type of inflammation – termed Type 2 inflammation - that would likely be minimized by these steroids.
In their study, the researchers investigated nearly 300 patients with mild but persistent asthma who were at least 12 years of age. Some of the patients were given mometasone, a steroid inhaler treatment, and others were given a placebo. Of the patients who did not have Type 2 inflammation, 66% required urgent care visits a similar amount or even less frequently if they were on a placebo than if they used the steroid inhaler. According to the scientists conducting the study, these results suggest that most mild asthma patients do not significantly benefit from steroid inhalers.
The inhalers that are often prescribed to asthma patients tend to be largely safe. However, they do pose certain risks, with the ability to lead to glaucoma, cataracts, thinning of the skin, and bone loss. Additionally, the inhalers can be costly. It is therefore important that researchers continue to investigate the differences between mild and severe asthma as well as new treatment options that may better address mild asthma. Given the impact of this new study, it is likely that new options will become available for patients with asthma.