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Asthma: Statistics and Alternative Treatments

Update Date: Sep 12, 2012 11:06 AM EDT

Asthma is a chronic lung disease characterized by reversible airway obstruction resulting from inflammation of the lung's airways and a tightening of the muscles around them, according to MedicalDaily.  

Some degree of airway obstruction is often constantly present in those with asthma, but more severe reactions can occur due to exposure to a variety of triggers. Asthma triggers may vary depending upon person and environment, but some known triggers include cigarette and other smoke, mold, pollen, dust, animal dander, exercise, cold air, household and industrial products, air pollutants, and pulminary infections.

Accepted treatment is a twice-daily dose of an inhaled corticosteroid (ICS), such as beclomethasone or fluticasone, supplemented with "rescue" doses of albuterol to open the airways during onset of severe symptoms. Under physician-assessment-based adjustment (PABA), the standard of care, doctors adjust ICS dose based on assessment of symptoms, rescue use of albuterol and pulmonary function at six-week intervals.

Approximately 25 million people in the United States suffer from asthma; the disease costs about $3,300 per person each year in medical expenses, missed days of school and work, and early deaths. In a blow to disadvantaged people in the U.S., the disease affects African-Americans and other minorities who live in poorer communities not only at a higher rate of occurrence, but with more debilitating effects.

According to the State of Lung Disease in Diverse Communities 2010, published by the American Lung Association, African Americans have one of the highest rates of current asthma compared to other racial/ethnic groups. In 2008, 105.5 per 1,000 Africans Americans had asthma, 35 percent higher than the rate of 78.2 per 1,000 among Caucasians.

This disparity in asthma prevalence rates is evident between blacks and whites at all age levels. A survey of children 6 to 12 years of age from Chicago elementary schools found that African-Americans were more than twice (21.2%) as likely to have been diagnosed with asthma compared to Caucasians (9.7%). This relationship remained true even when accounting for a number of factors including school district income levels, other household members with asthma, type of school, age, gender, and language preferences.

New research shows that daily treatment of asthma by use of corticosteriods may not be needed, thereby saving those individuals and families significant healthcare dollars.

These findings suggest a potential new treatment option that could change international standards of care, reduce patients' pharmacy costs, limit long-term exposure to corticosteroids and enable flexibility in managing the condition, according to researchers at the University of Texas Medical Branch at Galveston, which led the study. Findings were published in the Sept. 12th issue of the Journal of the American Medical Association.

"The discovery that these two courses of treatment do not differ significantly could eventually change the way doctors and patients manage asthma, providing an option that is easier to follow and possibly less expensive," said lead author Dr. William J. Calhoun, Renfert Professor and Vice Chair for Research in Internal Medicine at UTMB. "Our findings build on a considerable foundation of research in the field and come at a time when asthma cases are rising at an alarming rate - especially in lower-income communities."

"The current protocol of daily ICS use is effective but the flexibility and immediate probable cost savings for asthma medicine that a symptom-based approach may offer will appeal to many patients," said Calhoun. "We hope our findings prompt patients to talk with their doctors and become more active participants in effectively managing their condition."

This research not only shows the potential for asthma sufferers to save money, but also stave off the long term side effects of corticosteroid treatment, such as accelerated cataract development, vocal cord weakness and potential endocrine effects, as well as such side effects as mouth and throat irritation and oral yeast infections.

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