News in brief: Budesonide-formoterol for teens; Light smoking still a cancer risk; High rate of asthma admissions

More evidence supports GINA advice in teens

As-needed budesonide-formoterol is a safe and viable treatment option in adolescent patients with mild asthma.

A post hoc pooled analysis of the 889 adolescents in the SYGMA 1 and 2 trials found as-needed budesonide-formoterol was associated with a 77% reduction in the severe exacerbation rate compared to terbutaline, and with a similar efficacy to budesonide maintenance plus as-needed SABA.

“Furthermore, the reduction in severe exacerbation risk, and hence in exposure to oral corticosteroids (OCS), was similar to that with BUD maintenance, with a lower ICS load and no need for daily treatment. A therapy delivering an overall lower corticosteroid load would be a desirable treatment choice for many patients,” the study said.

The study, led by Professor Helen Reddel from the Woolcock Institute of Medical Research, said the findings support the Global Initiative for Asthma (GINA) positioning.

The study also debunked the fear that regular ICS may stunt growth. It found no evidence of growth suppression in adolescents randomised to as-needed BUD-FORM.

J Allergy Clin Immunol Pract

Quit advice means quit, not cut back

Cutting back on the cigarettes isn’t enough as even light smoking is doing people harm, according to a study from the Daffodil Centre.

The study, using data from the Sax Institute’s 45 and Up Study, said lung cancer risk increases by 7% with every cigarette per day. Even ‘light’ smokers of 1-5 cigarettes per day had an almost 10-fold increased risk of lung cancer.

Dr Marianne Weber, Senior Research Fellow at The Daffodil Centre said some smokers are at the point where they are smoking a few cigarettes a day but don’t realise the cancer risks they are still running.

“The good news is that the risk of cancer was significantly reduced among participants who had quit smoking – and the younger they quit, the better. These results demonstrate that quitting smoking is much more effective at reducing disease than ‘cutting down’ the number of cigarettes smoked.”

Asthma admissions increasing in Qld

Almost half (47%) of asthma-like ED presentations in Queensland result in admissions to hospital, a new study has found.

ED data from 28 public hospitals over the years 2012-2017 found 30,219 asthma hospital admissions – 16,744 ward admissions (55%) and 13,476 short-stay unit admissions (45%).

The study showed an increasing trend for asthma admissions over time – from 37% in 2012 to 55% in 2017 – driven by increasing utilisation of the short-stay units across all regions.

“It may be important to consider whether patients managed by ED teams in SSU need to receive specialist care and whether this differs to patients admitted to wards,” the study said.

The odds of asthma hospital admission from ED varied significantly by region – with patients outside metropolitan areas at higher risk for attending an ED for asthma but having lower odds of being admitted into hospital.

Emergency Medicine Australasia

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