Doctors Manage Asthma In Pregnancy With Algorithm Against Inflammation Marker

An Australian-designed asthma management program has the potential to halve asthma attacks in pregnant women, the most common chronic medical disorder experienced by this group.

AsianScientist (Sep. 13, 2011) – Professor Peter Gibson, a staff specialist at John Hunter Hospital, has developed an algorithm that adjusts inhaled therapies to better match airway inflammation.

Results of a randomized controlled trial published in The Lancet found that the asthma exacerbation rate of pregnant women could be halved if airway inflammation is closely monitored.

According to Gibson, improving asthma treatment for pregnant women was a priority, since these women refrain from treatments that may harm the fetus.

Inhaled therapies can effectively reduce the frequency and severity of asthma attacks, but treatments based on clinical symptoms alone can lead to over-treatment or under-treatment. Both can have a significant impact on the health of the mother and baby.

“While asthma is common in pregnancy, mothers and health professionals try to manage it by keeping drug exposure to the developing fetus to a minimum,” said Gibson.

Previous work by Gibson and his team found that steroid-based treatments may be more effective when based on actual measures of airway inflammation.

In his latest work, the Managing Asthma in Pregnancy (MAP) study, his team developed and tested an improved algorithm against a direct inflammation marker: the fraction of exhaled nitric oxide (FENO).

The study assessed 220 pregnant, non-smoking women with asthma and compared one group treated using clinical symptoms and another treated using the FENO model.

Patients treated using the algorithm and symptoms had a 50 percent reduction in asthma exacerbations, and was accompanied by important changes in asthma management including more frequent use of inhaled steroids, but at a lower total daily dose, and with the earlier introduction of long-acting treatments.

Further research is needed to determine whether this approach may also benefit asthma sufferers in general.

The article can be found at: Powell H et al. (2011) Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial.

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Source: Hunter New England Health.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

Anusuya Das received a Ph.D. in Biological Engineering from Massachusetts Institute of Technology (MIT), USA, and a B.A. in Bioelectrical/Cellular-Molecular Engineering from Arizona State University, USA. Anusuya is currently a post-doctoral researcher at the University of Virginia, USA.

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