I’m excited to share some recent articles which shed light on topics I’ve covered previously here. This is a banner week for exciting new research due to the American Thoracic Society Conference. In an upcoming post I’ll highlight some great information on sleep research and posts from around the web.
I’ve written previously on the possible link between acetaminophen use and asthma. To summarize, there has been some limited research to suggest that this commonly used pain and fever medication might worsen or even cause asthma. However, the research was limited by the nature of the way the data was collected. In an article this week in the New York Times, Pain Relievers Do Not Cause Asthma, Study Finds, the author describes a new study which refutes this link. The study followed the children from birth (a strength of the design) and found that acetaminophen and ibuprofen use was associated with an increased risk of asthma at age 7. However, when they took into account the frequency of respiratory infections (colds, bronchitis, etc) this relationship disappeared. It is not clear if a) children likely to develop asthma were at higher risk for having more frequent infections when they are younger or b) children with more frequent infections were more likely to get asthma. I have not reviewed the study myself but I am looking forward to its publication.
I also want to highlight a great new blog by Dr. Ann Wu, an asthma physician and researcher across town at Children’s Hospital Boston. She is also the parent of a child with asthma. She has a lot of terrific information about asthma on her blog Asth.ma. Earlier this month she wrote a great post called “Why is everyone on Flovent?” If your child suffers from asthma, there is a good chance that he or she has been prescribed fluticasone (brand name Flovent) for a controller medication at some point. It is the dominant asthma controller medication nationally although there are plenty of alternatives. In my clinical experience, some children respond to some inhaled steroids better than others. Dr. Wu points out that fluticasone is frequently more expensive than other medications. She also references a recent clinical trial showing that extrafine hydrofluoroalkane (HFA)-beclomethasone (brand name QVAR) showing equivalency between this agent and fluticasone, and perhaps some modest advantages. I always find it surprising how few head to head trials there are comparing one treatment to another. Personally, I frequently use beclomethasone now when patients have not done well on fluticasone, and am more frequently using it as a first line agent. (Dr. Wu also has an interview with the author of the acetaminophen study referenced above).
Another trial recently published in the New England Journal of Medicine describes impressive results for a new asthma treatment which is a monoclonal antibody against a leukotriene receptor. This trial was only in adults who met very specific criteria and thus it does not have wide utility at this time. It is unclear when it will be studied in children. However, I’m always excited to see new asthma treatments on the horizon.
Finally, another large study was presented at the ATS conference detailing a relationship between asthma, poor sleep quality, and difficulties in school. It comes as little surprise that children who are having difficulty breathing may have problems paying attention in school. I’m curious to read this research when it is published. I wonder if the school issues are due to the effects of disrupted sleep associated with poorly controlled asthma alone. As I’ve written previously, unrecognized or under-treated medical disorders are associated with disrupted sleep. Encouragingly, better controlled asthmatics did not seem to have these problems.
Any other exciting asthma research you have come across of late? Please share any thoughts or questions.
