Pharmacy Times

ASTHMA WATCH



Home Allergen Levels Linked to Asthma

A new national survey found that elevated allergen levels in the home are associated with asthma symptoms in allergic individuals, suggesting that individuals with asthma and allergies may get symptom relief by reducing allergen exposure inside their home.

For the study, the researchers used data from the National Survey of Lead and Allergens in Housing to analyze factors that contribute to high allergen levels in homes and to determine whether higher household allergen levels were linked with occupants? asthma status. The group surveyed the homes of nearly 2500 individuals in 75 locations. The findings showed that exposure to multiple indoor allergens was common in US households, with 52% having at least 6 detectable allergens and 46% having 3 or more allergens at increased levels. Race, income, type of home, and sources of allergens also added to the increased concentration of allergens. The study indicated that homes with children were less likely to have high allergen levels. The findings were published in the March 2008 issue of the Journal of Allergy & Clinical Immunology.


Obesity Impacts Asthma Symptoms

Obese individuals tend to experience more severe asthma symptoms, compared with their normal-weight counterparts. The researchers suggest that the extra pounds exacerbate the condition.

Studies have shown that obese individuals face greater odds of developing asthma, but whether weight affects asthma severity has been unclear. The current study included 3095 adults who were questioned about their asthma symptoms over the previous 5 years. Of the participants, one third were obese. The researchers found obese patients were 66% more prone to report experiencing continuous symptoms over the past month, and 42% were more apt to have symptoms consistent with severe, persistent asthma, compared with normal-weight adults. The patients with both obesity and asthma also needed more medication and missed more workdays, according to findings recently published in Thorax.

The data connecting obesity and asthma severity are strong enough to have a bearing on asthma management, concluded the researchers.


Oral Meds May Replace Allergy Shots

In the future, oral allergy immunotherapy, instead of injections, may be used to treat children with allergic asthma, according to a study published in Chest (March 2008).

Commonly known as allergy shots in the United States, allergy immunotherapy works in a manner similar to vaccines. Whereas this therapy can be effective, it is currently only available via injections in this country, and usually results in at least 1 to 2 shots a week for 3 to 6 months. The FDA has not approved these oral medications, but the treatment is available in Europe.

Researchers reviewed 9 studies that examined the use of sublingual (oral) immunotherapy (SLIT) in children with asthma. A total of 441 children aged 3 to 18 who had been diagnosed with allergic asthma were included in the 12-month studies. Of the participants, 232 children received oral immunotherapy, and 209 received a placebo. The dosing schedule varied depending on the study and whether droplets or tablets were used. During the maintenance phase of immunotherapy, droplets or tablets were given 3 times a week.

The findings indicate that the children taking SLIT had considerably fewer symptoms and needed less asthma medication. Because not enough of the studies included measurement of lung function, the current study was unable to assess whether SLIT affects lung function significantly. Furthermore, SLIT appeared to be better, compared with allergy shots.


Daily Asthma Meds Keep Lungs Going During Exercise

A study of 100 children with exercise-induced bronchoconstriction found that taking asthma medication daily can help prevent tightening of the airways with physical exertion that affects many children with asthma, according to a study reported in the February 2008 issue of the Journal of Allergy & Clinical Immunology.

For the study, researchers compared the effectiveness of 4 daily treatment approaches by administering 1 of the treatments or placebo for 4 weeks to the children. The treatment options included budesonide and formoterol; budesonide and montelukast; montelukast alone; and budesonide alone. All the children had a treadmill test before and after treatment.

The findings showed that all the children who received active asthma treatment had a significant reduction in exerciseinduced bronchoconstriction, but the greatest improvements were in the montelukast-only and montelukast-plus-budesonide groups. The researchers concluded, "It can be argued that adding montelukast should be recommended to achieve better control of exercise-induced bronchoconstriction in children with asthma."

F A S T   F A C T : Allergic disease is the fifth leading chronic disease in the United States among all ages.