FCAAIA Notes: Daily inhaled corticosteroids (ICS) are the treatment of choice to prevent symptoms in patients with persistent asthma. If such a patient starts to have flaring symptoms, does increasing the dose even 4-5 fold help? Maybe. Maybe not. Over the years, there have been conflicting studies, as described here.
It seems to me that it has become routine advice that patients double their ICS dose when symptoms flare and they enter the “yellow zone” of asthma control. But any one paying close attention to his patients will know it doesn’t always make a difference. Continue reading “NO BENEFIT TO UPPING INHALED STEROIDS DURING ASTHMA ‘YELLOW ZONE’”
FCAAIA Notes: It is encouraging that asthma is a less common cause of school absence and hospitalization than it was, but that doesn’t necessarily mean overall asthma control is that much better. Maybe we are treating more aggressively and earlier to avoid the necessity of hospitalization and thus getting children back to school sooner.
One of the best ways to avoid asthma exacerbations is to maintain the best possible control BETWEEN flares. Far too often, I see children and adults with asthma who think they are fine on a day-to-day basis but have frequent symptoms, poor sleep, exercise intolerance, and low lung function. Bodies are smart; Continue reading “CDC: PEDIATRIC ASTHMA CONTROL IMPROVING IN U.S.”
FCAAIA Notes: Ah….the Goldilocks paradigm! Too little or too much? Of course, the answer is “just the right amount.”
Oral corticosteroids (e.g., prednisone) are the treatment of choice for bad asthma exacerbations. Continue reading “CORTICOSTEROIDS AND ASTHMA: TOO MUCH OR TOO LITTLE?”
FCAAIA Notes: This study doesn’t actually show any new data. It has been known for years that in conjunction with usual care, montelukast (commercially known by its brand name, Singulair) is no more effective than placebo for acute asthma flares. This particular study of adults showed that montelukast did not shorten hospitalization or contribute to improving lung function in adults. There are also no data to suggest its role in children who have a significant asthma flare. Continue reading “A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF ORAL MONTELUKAST IN ACUTE ASTHMA EXACERBATION”