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| Professor Phil Bardin |
High-doses of glucocorticoids are not effective in
preventing life-threatening asthma exacerbations, according to a landmark study
published in The New England Journal of Medicine last week.
Monash University’s Professor Phil Bardin was specially
invited by the NEJM to assess the evidence for this therapy based on two
recent asthma clinical trials.
“Inhaled glucocorticoids are pivotal to achieve asthma
control in both children and adults but despite their use, many patients with
asthma have flare-ups,” said Professor Bardin, Director Monash Lung &
Sleep.
“Acute flares of asthma are detrimental because they
adversely affect quality of life, lung function, and health care costs and have
the potential to end in death.”
“Everyone agrees that preventing exacerbations is a priority
in asthma care,” Professor Bardin said.
Professor Bardin said asthma specialists have long thought
that more aggressive use of inhaled glucocorticoids can prevent exacerbations
if initiated at the first signs of deterioration.
Professor Bardin found good
evidence that children, in particular, receive no significant benefit from
high-dose inhaled glucocorticoids in terms of their likelihood of having an
asthma attack.
“The evidence indicates that
substantial escalation of regularly used inhaled glucocorticoids, even by a
factor of 4 or 5, fails to prevent most asthma exacerbations,” Professor Bardin
said.
The editorial invitation by the
prestigious journal is due to Professor Bardin and his team’s significant
research into asthma at the Monash Health Translation Precinct (MHTP).
“The invitation to contribute to the NEJM on this
topic is a testament to our global reputation built upon the outstanding
clinical research done at Monash over many years,” Professor Bardin said.
“In particular, the Clinical Trials Unit in Monash Lung and
Sleep, Monash Health under the leadership of Ms Joanne McKenzie has recently
conducted ground-breaking research on monoclonal antibodies in asthma.”
This new treatment has had dramatic benefits for many
patients with crippling severe asthma.
