New breath test reduces need for steroids in asthma treatment

• Asthma patients were able to reduce their inhaled steroid drugs by a net 40 per cent when their dosages were tailored using a new type of breath test.
• Doctors at present adjust patients' intake of drugs such as Flixotide - which prevent asthma breathlessness and wheezing - mainly based on their reports of symptoms.
• But the breath-testing machine, which measures exhaled nitric oxide, has proven more effective, say Otago University researchers.
• The results of the study, the first to show the machine can be used to improve asthma care, are published today in a leading American journal, the New England Journal of Medicine.
• They reduce with inhaled steroid treatment, but rise again when asthma worsens.
• By measuring nitric oxide, the machine assesses inflammation in the breathing tubes of the lungs, allowing doctors to adjust the dosage of inhaled steroid.
• "Our study showed that we can use nitric oxide measurements to take some of the guesswork out of deciding how much treatment to give patients with asthma," said Professor Taylor.
• "In some cases, using nitric oxide results meant that the treatment dose could be reduced substantially, in some cases to almost zero.
• The machines, available since 1998, had reduced in price, now costing about US$5000 ($7059).
• Professor Taylor said all public hospitals ought to have one, but only several did - including two in Auckland hospitals.
• He said that inhaled steroids were safe, but carried a degree of side-effect risk at high doses, over 1000 mcg a day of Flixotide or its equivalents.
• The president of Asthma New Zealand, Allen Liang, said the breath-testing method was useful but the cost of administering each test may prove prohibitive.
• Dr Wong said research showed that people taking steroids through puffers had a very small chance of experiencing bone thinning, or osteoporosis.