Drug Combinations Are Just As Effective As High-Dose Steroids, Asthma Studies Find

Modest doses of inhaled steroids combined with other drugs control asthma as well as or better than high doses of steroids, while reducing the risk of side effects from long-term use, two studies found.

Steroids reduce the frequency of asthma attacks. But daily use over a few years has been linked to osteoporosis and cataracts in older adults and slowed growth in children.

Two studies published in today’s New England Journal of Medicine looked at drug combinations that might allow asthma sufferers to get by with lower doses of steroids.

Inhaled steroids - the first-line approach to treating moderate or severe asthma - reduce the chronic lung inflammation that makes it hard for patients to breathe.

One of the studies looked at formoterol, an inhaled airway-relaxing type of drug known as a long-acting beta-2-agonist, in combination with the inhaled steroid budesonide.

After a year of treatment, patients getting formoterol and low doses of budesonide had fewer symptoms, better lung function and more asthma attack-free days than those getting moderate doses of budesonide alone. However, the higher dose of budesonide was more effective at preventing the most severe asthma attacks.

The combination of formoterol and a moderate dose of budesonide proved to be the best treatment of all.

In the other study, researchers from the Imperial College School of Medicine in London compared patients treated with high doses of budesonide with those getting a moderate dose of budesonide plus theophylline pills.

The combination treatment was just as effective as high-dose treatment with the inhaled steroid alone.