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A new study has found that a recently funded asthma medicine is almost twice as likely to control the symptoms of the disease than the usual medications taken by patients each day.
New Zealand has one of the highest rates of asthma in the world, occurring in around 20% of children and adults and affecting at least 600,000 people. The disease costs the country $800 million each year.
The new research which involved over 4000 patients, found that a significantly higher number (71%) of those treated with a medicine containing fluticasone furoate and vilanterol achieved better control of their asthma symptoms than those who continued with their usually prescribed inhaler medication (56%).
PHARMAC added this medicine to its list of funded medications last year. The medication is delivered to patients using the Ellipta inhaler.
Otago University Associate Professor Jim Reid says we have to better educate New Zealanders on the critical need to prevent their asthma symptoms from occurring, rather than try to control them when they have an episode.
“Last year we lost 70 Kiwis to asthma, many of them children and a significant number of these deaths were preventable. Taking the correct medication at the right time is essential for patients to control their symptoms and prevent more asthma attacks,” he says.
“I think we can treat asthma, but because it is an episodic disease and asthmatics respiratory function normalises between the attacks, many patients just don’t understand that they need to keep taking their medication to prevent further attacks from occurring,” he says.
“Asthma has a considerable impact on New Zealand, especially among children. We don't yet fully understand why its prevalence is so high in this country either - it could be housing, allergens or viral triggers,” he says.
He says the results from the 2017 Salford Lung Study are a significant advancement for his field of research.
“Clinical research of this nature is usually done with highly selective patient groups. The study authors have used a new methodology which allows them to examine thousands of asthmatics with very few exclusions,” he says.
The British study, published in The Lancet, is the world’s first Randomised Controlled Trial (RCT) to include a broad population of patients in an everyday clinical practice setting.
Conventional RCTs are usually conducted following strict inclusion criteria, which often exclude those patients with other multiple conditions. This study was designed to include those patients who would often be excluded.
“This gives us new, real world insights into how the disease can be better managed across a large population,” he says.
Professor Reid says while research is advancing in how we treat the symptoms of asthma we still don’t have a well-developed understanding of what causes asthma.
“Despite all of the research we are still not sure whether it's caused by the environment, or some types of moulds and pollens, certainly if you are continually exposed to those moulds then the asthma will continue to worsen”.
“The trigger factor is the real question, especially in New Zealand where we’ve got such a high prevalence of asthma and we just don’t know why,” he says.
Professor Reid says outside of the environmental variables there is also some indication a large number of patients, especially children, are born with hyperactive airways and any sort of stimulus will cause an attack.
“We used to believe asthma symptoms were exacerbated by cold air, but now the thinking is that it’s more about the osmotic pressure of the mucosa. The mucosa can dry out when people are exercising, that’s one of the reasons why it’s good for asthmatics to swim as they can retain moisture in their respiratory tract,” he says.
The 2017 Salford Lung Study showed that a once-daily inhalation of a Breo Ellipta was noticeably more effective at improving scores in the standard Asthma Control Test (a scientifically validated test for the assessment of asthma control), than taking regular maintenance inhaler therapy alone.
Professor Reid, says patients living with asthma should have a written action plan along with medicine at home in case they experience symptoms, most importantly, he says, they need to know when to call for help.