An article by Ms. Claire Hayes, a doctoral student in the LSU Health New Orleans School of Public Health (SPH) Community Health Sciences (CHS) program, was published in Journal of Asthma, September 29.
Entitled “Use of asthma control indicators in measuring inhaled corticosteroid effectiveness in asthmatic smokers: a systematic review,” the article reviewed 13 English language articles about studies conducted from 2004 to 2015 reporting the use “of guideline-based asthma control indicators. These indicators specifically measured the therapeutic effects of inhaled corticosteroid (ICS) “or ICS combination therapies.”
As lead author on this article, Ms Hayes was joined in conducting the literature review of the 13 studies by three CHS faculty members, Drs. Henry Nuss, Tung-Sung Tseng and Sarah Moody-Thomas.
Only one indicator (such as lung function) was used to measure asthma control in six of these studies. Of these, only one found ICS therapeutic benefits in asthmatic smokers. The authors concluded that if solely one indicator is evaluated clinicians may be “led to decide ICS drugs are ineffective.” This could unnecessarily lead to more aggressive therapies.
The systematic review exposed the “need to evaluate the effectiveness of ICS therapy using multiple asthma control indicators.”
The review also found that in studies evaluating combination therapy, three of four reported beneficial results. Its authors concluded that combination therapy could improve asthma symptoms more effectively than ICS-only drugs.
The article encourages future asthma treatment studies to actively recruit smokers with “varying pack year histories,” recognizing that former and current smokers “represent a substantial portion of adult asthmatics. Asthma control assessments also should be performed in future studies that evaluate asthma drug effects. These measures will assist clinicians in deciding whether “specialized guidelines should be considered” for treatment of the adult asthmatic smoker.