Asthma drugs could save 1,000 lives every year

GLENDA COOPER

More than 1,000 lives in Britain and 100,000 world-wide could be saved every year if people received effective asthma treatment, according to the Global Initiative for Asthma (Gina), which was launched yesterday in London.

If sufferers regularly used inhaled steroids, between 60 and 70 per cent of deaths could be prevented, said Dr Romain Pauwels, chairman of Gina. The initiative, the first time experts from around the world have joined forces, was launched by the World Health Organisation and the US National Heart Lung and Blood Institute.

At present 150 million people around the world suffer from asthma. But in recent decades it has become far more prevalent, increasing by 50 per cent in the most affluent countries over the past 25 years. Thirteen per cent of all children now suffer from asthma in Britain, and 6 per cent of adults.

In 1994, 1,640 people died from asthma in the United Kingdom; more than 1,000 lives a year and many thousands of days' sick-leave from work or school could be saved if all asthma patients were given inhaled steroids or other anti- inflammatory drugs.

Asthma occurs when the bronchial tubes swell and go into spasm, causing coughing and wheezing. The steroids work by soothing the basic inflammation of the airways, so reducing the number of asthma attacks.

Treatment with inhaled steroids or other anti-inflammatory therapies is more expensive than treatment with bronchodilators - drugs which relax and open up the tubes -but Gina believes it would be more economical in the long term to use the steroids because of the consequent reduction in hospital admissions and days lost at work and school. At present, Britain spends about pounds 400m on health care for asthma and a further pounds 400m because of days lost through illness.

Dr Martyn Partridge, chief medical adviser to the British National Asthma Campaign, said: "There has been a very significant increase in prevalence of asthma in all the developed countries of the world over the last 10 years." The reason for this is not known, although heavier exposure to microscopic house-dust mites in centrally heated homes or pollution in inner cities are possibilities. Exposing babies to cigarette smoke appears to sensitise them to environmental allergens.

Gina aims to find out why asthma is increasing, and why it varies so much in prevalence from country to country, by sponsoring research and exchange of clinical expertise.

"Only 2 per cent of people in rural China or Africa suffer from asthma," said Dr Partridge. "There appears to be some factor associated with the way people live in affluent societies which makes them prone to asthma. We don't know what it is but people who eat a natural diet with plenty of fresh fruit and vegetables and fish seem to have some protection against the disease."

Dr Partridge said studies in other countries showed that patients taught to help themselves had significantly less trouble from asthma.

In a study in southern Spain it was discovered that those asthma sufferers who had been taught to take their drugs regularly had an average of 4.92 days' sick-leave a year compared to 22.2 days beforehand.