Asthma pills as good as inhaler: study

LONDON (Reuters) - Rarely prescribed asthma pills made by drugmakers such as AstraZeneca and Merck are easier to use and just as effective as conventional inhaler treatments, according to research by British scientists.

In a study in the New England Journal of Medicine, researchers tracked 650 patients with chronic asthma for two years and found the tablets, called leukotriene receptor antagonists or LTRAs, managed the disease as well as steroid inhalers.

Also, patients taking the pills were more likely to stick to their medication, the scientists said.

Their study was supported in part by Merck and AstraZeneca.

LTRAs -- sold under the brand names Accolate by AstraZeneca and Singulair by Merck -- have long been on the market as an alternative to steroid inhalers commonly used by asthmatics.

The researchers, led by David Price at University of Aberdeen and University of East Anglia (UEA), said the pills have proved less fashionable than inhalers, and were considered by some to be less effective.

"We hope these findings will increase the options for healthcare professionals when prescribing for this common but disruptive disease," Price said, adding adherence to treatment was "vastly improved -- by as much as 60 percent" when patients were given once-a-day LTRA pills.

Asthma is an increasing problem affecting around 300 million people worldwide, including around eight percent of Britain's adult population and about 25 million Americans.

It is a chronic condition characterized by inflammation of the airways causing wheezing, coughing, chest tightness and shortness of breath, and can significantly harm quality of life.

Stanley Musgrave of the UEA, who also worked on the research, said these were so-called "pragmatic trials" -- designed to assess the effectiveness of the treatments under real life conditions where patients may have other health problems and may sometime forget to take their medication.

"Adherence is really crucial in chronic illness therapy," he said in an interview. "LTRAs are easy to use and can help patients control their asthma effectively and improve their quality of life."

Singulair is Merck's biggest product but its importance will fade in coming months as it begins to face generic competition.

Generic drugmakers Dr Reddy's Laboratories and Par Pharmaceuticals make their own versions of Accolate, known generically as zafirlukast.

The British research included two sub-studies. One compared 158 patients on inhalers containing medicines known as inhaled glucocorticoids with 148 who were taking either Singulair, known generically as montelukast, or Accolate. In another, 352 people who were already taking inhaled glucocorticoids were offered either an LTRA or one of two types of long-acting inhalers.

After two months, both groups in the studies showed similar improvements in a questionnaire measuring quality of life. At the two-year mark, the treatments were almost equivalent.

In an NEJM commentary, Sven-Erik Dahlen and colleagues from the Karolinska Institute in Stockholm, who were not involved in the study, said it sent "an important message."

"We think this alternative approach works in the real world setting primarily because it is easier to take a pill once or twice a day than to use an inhaler," they wrote.

SOURCE: http://bit.ly/lWeFxp New England Journal of Medicine, May 5, 2011.