Asthma Pill More User-friendly Than Inhalers - and No Less Effective

By University Of East Anglia, PRNE
Tuesday, May 3, 2011

NORWICH, England, May 4, 2011 - A rarely prescribed asthma drug is easier to use and just as effective as
conventional treatment with inhalers, according to a new study led by the
University of East Anglia (UEA).

Publishing tomorrow in the New England Journal of Medicine, the
researchers followed 650 patients with chronic asthma for two years. They
found that tablets called leukotriene receptor antagonists (LTRAs) managed
the disease equally successfully as steroid inhalers for patients with mild
asthma and in a parallel sample of patients with moderate asthma, LTRAs
managed the disease equally successfully as other "preventer" inhalers
when used in addition to steroid inhalers.

LTRAs - sold under the brand names 'Singulair' (montelukast) and
'Accolate' (zafirlukast) - have long been on the market as an alternative to
the steroid inhalers commonly used by asthmatics to ward off attacks. They
have historically been less fashionable than inhalers, however, and are
considered by some to be less effective. Under UK guidelines they are
currently recommended as third or fourth steps in asthma management. As a
result, LTRAs are far less frequently prescribed than inhalers.

The results indicate that LTRAs could provide an effective alternative to
steroid inhalers and other 'preventer' inhalers when used in addition to
steroid inhalers, which could be useful for the more than 80 per cent of
patients who have problems using inhalers, are unable to use them due to side
effects, or do not want to take steroids.

"We hope these findings will increase the options for healthcare
professionals when prescribing for this common but disruptive disease," said
lead author Prof David Price of the University of Aberdeen and UEA.

"We found that adherence to treatment was vastly improved - by as much as
60 per cent - when patients were given the once-a-day LTRA tablets and
patients did not have to worry about using appropriate inhaler technique."

Co-author Dr Stanley Musgrave of Norwich Medical School at UEA added:
"LTRAs are easy to use and can help patients control their asthma effectively
and improve their quality of life."

Known as ELEVATE, the randomised controlled trial was designed by the UEA
and University of Aberdeen team to examine asthma therapies in a real-world
setting. The volunteer patients were recruited from 53 doctors' surgeries in
Norfolk, Suffolk, Essex, Cambridgeshire, Hampshire and Dorset. All were
unpaid. The trial was sponsored by the NHS's Health Technology Assessment

Asthma is an increasing problem affecting around 300 million people
worldwide, including eight per cent of the UK adult population, and can
significantly impact on a person's quality of life. It is a chronic condition
characterised by inflammation of the airways causing wheezing, coughing,
chest tightness and shortness of breath. World Asthma Day took place on May 3

'Leukotriene antagonists as a first-line or add-on asthma controller
therapy' by D Price (UEA/University of Aberdeen), S Musgrave (UEA), L
Shepstone (UEA), E Hillyer (Research in Real Life), E Sims (UEA), R Gilbert
(Castle Partnership), E Juniper (McMaster University), J Ayres (University of
), L Kemp (Research in Real Life), A Blyth (UEA), E Wilson (UEA), S
Wolfe (Thorpewood Surgery), D Freeman (Sheringham Medical Practice), M
Mugford (UEA), J Murdoch (UEA) and I Harvey (UEA) will be published in the
May 5 2011 edition of the New England Journal of Medicine.

The full paper is available as a PDF on request.

Norwich Medical School is part of the University of East Anglia's
Faculty of Medicine and Health Sciences. In the last Research Assessment
Exercise (RAE), 78 per cent of the faculty's research was judged to be of
international standing and 37 per cent was assessed as world leading or
internationally excellent.

FOR MEDIA ONLY: Notes to Editors 1. The following authors are available for interview:
Dr Stanley Musgrave - general overview of the study ( +44(0)7710766246,
sdmusgrave at Prof David Price - lead author, general overview, away in India but
available for telephone interviews (+44(0)208-1233923, david at
Dr Erika Sims - general overview, interpretation of study results, clinical implications, health economics (+44(0)1603-594884, erikajsims at Stephanie Wolfe, Thorpewood Surgery - how the trial was carried out in a clinical setting (+44(0)7961-394-396, steph.wolfe at Prof Miranda Mugford - interpretation of health economics, study
design/methodology (+44(0)7949-212716, m.mugford at Ed Wilson - health economic analysis and interpretation ( ed.wilson at
Prof Ian Harvey - interpretation study results, importance of pragmatic
trials, study design/methodology (ian.harvey at Prof Lee Shepstone - statistical analysis and interpretation of results, study design/methodology (l.shepstone at, For further information or to arrange interviews, please contact: Simon Dunford at the University of East Anglia Communications Office: +44(0)1603-592203 or s.dunford at UEA Press Office, press at, +44(0)1603-593496

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