December 20, 1996

Asthma sufferers may breathe easier with new treatment

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Research Clinical Specialist Brendie Keane (left) and Tracy Waggoner demonstrate a new asthma inhaler as part of a drug study.

Asthma sufferers may breathe easier with new treatment

A new drug to treat asthma is showing very promising results, say doctors at Vanderbilt University Medical Center.

In a study just getting under way, researchers are testing a new inhaled steroid, which was recently approved for general use by the Food and Drug Administration.

"It is a more powerful inhaled steroid than those that are available on the market," said Dr. John J. Murray, associate professor of Medicine and Pharmacology.

"The key with this new drug is that only two puffs, twice-a-day, are needed, compared with other inhaled steroids, which require four-to-eight puffs twice-a-day to help prevent an asthma attack."

Murray says it is easier for patients to comply with the dosage when less medication has to be taken. Steroids, Murray said, are still the best medication available to treat allergic diseases, but the problem has been the side effects they cause.

"When you use steroid inhalers, you can get thrush in your mouth and other fungal infections in your sinuses and your lungs because the steroids get rid of the normal bacteria that helps fight thrush.

"Another problem of the traditional inhaled steroids and oral steroids is that they can cause adrenal system shutdown, affecting blood pressure and heart rate."

VUMC is one of 25 centers in the U.S. participating in this study, which will include a total of 400 patients. The study will last approximately 14 weeks.

Murray said investigators have been trying to develop more potent inhaled steroids that affect only the surface of the tissue.

"The key is for them not to get absorbed and if they do, to be rapidly metabolized. This new steroid does just that."

Twenty five million people in the U.S. suffer from asthma, 10 percent of the population. It is the number one reason why children are hospitalized.

Murray has seen some remarkable results in patients who have taken the new drug.

"Some patients have been on it for only two months and have already made remarkable progress at controlling their asthma."

Murray said while many people think of asthma as a reversible disease, that is not so.

"Many people have traditionally thought that if you use your beta agonist inhaler (which helps relax the airway) and you get better, that your asthma has been reversed without any additional problems. But studies now show us that asthma is an inflammatory disease that can cause permanent scarring in the lungs.

"So it's important to treat it from the beginning with anti-inflammatory or steroid-like medicines that stop the inflammation so you don't have the long-term consequences of scarred lungs resulting in poor lung function."

In this study, Murray will be looking at the safety and effectiveness of the new steroid. He is quick to say that while promising, it is not a wonder drug.

"We are doing the study because there is some concern that because it is so potent, it may cause more side effects in the system. That is why we are comparing it to another currently available steroid inhaler to see if the systemic side effects between the two are the same. We believe they probably will be."

Murray will also be investigating to see if using a beta agonist along with the inhaled steroid will help treat asthma. Quality of life of the patient will also be considered, Murray said.

"We will be looking to see if the medication interferes with their daily activities. Are they still being limited by their asthma? Are they having less problems using the stronger inhalers? Are they waking up less in the night and does it enable them to do more activities without interruption from the asthma? Do they have more sore throats with the new medication?"

Anyone with asthma who would like to participate in the study at VUMC can call Brendie B. Keane, clinical research specialist, at 343-1209. Patients will be paid for participating in the study.

"Patients will be required to come in for check-ups every few weeks and will be required to keep a diary of symptoms," Murray said

"There is no magic drug yet. We are continuing to work at improving them. But this study is one step further in helping us reach that goal."