May 16, 2007 (Insidermedicine) Patients with well-controlled asthma who take twice-daily Flovent can successfully “step down” to once-daily treatment with the combination therapy Advair, according to a new study published in the New England Journal of Medicine. 

Asthma is a chronic inflammatory disease that affects the lungs, and is characterized by attacks of breathlessness, tight chest, wheezing and coughing which are caused by the airways becoming narrowed and inflamed. As many as 20 million people in the US suffer from asthma, and the numbers have been increasing for decades. While there is still no cure for asthma, it can be controlled by medication in most people. 

Currently, the guidelines for treating asthma recommend ongoing evaluation of symptoms and decreasing the dose – or “stepping down” -  to the minimum dose needed to maintain control. It is not yet known, however, whether patients whose asthma is mild and well controlled with twice-daily treatment can be successfully stepped down to an alternative, less intensive drug regimen. Adopting a once-daily treatment would likely improve adherence, while also minimizing the potential for side effects. 

In the present study, 500 patients with asthma that was well controlled by two daily doses of inhaled fluticasone – or Flovent – were divided into three groups: the first group continued the therapy; the second received once-daily montelukast; and the third received a once-daily drug called Advair which is a combination of Flovent plus Serevent.  

The researchers found that 70% of the patients receiving montelukast continued to have good asthma control while 80% of patient receiving twice-daily Flovent, and once-daily Advair were well controlled. All of the patients experienced a high percentage of symptom free days. 

The results are promising for patients whose asthma is well controlled with the use of twice-daily Flovent. Stepping down to once-daily Advair could result in improved compliance and better asthma control. 

Reporting for Insidermedicine, I’m Dr. Susan Sharma.