A pill to replace inhalers

A new drug that could replace the inhalers used by many asthma sufferers is being tried, for the first time, on patients who suffer exercise-induced asthma.

The drug, which attacks the cause of asthma symptoms on two different fronts, is being tested at centres in Southampton and London on a number of patients with the condition.

'The hope is that it will provide a tablet treatment for controlling asthma, which would be very important,' says Dr Peter Howarth, consultant at Southampton General Hospital. 'For some people, it could mean they would no longer need to use an inhaler.'

Although the new drug is being used for people with exercise-induced asthma, it is also likely to benefit those with other types of asthma.

Over the years, asthma has changed from being a relatively minor disease to one that has reached epidemic proportions. One in five children in Britain have been diagnosed with asthma, and one in 13 adults suffer.

Each year, in Britain there are 1,500 deaths related to asthma and 74,000 hospital casualty attendances.

An audit of the disease by the National Asthma Campaign found that 5.1 million people in the UK are affected - up from 3.7 million in 1999.

Asthma is a disease of the lungs and of the air tubes leading to them. It causes the walls of the bronchioles - the tiny airways in the lungs - to swell and produce mucus so that it becomes difficult to breathe.

The new drug acts against the two types of chemicals that are involved in the reaction causing these symptoms, leukotrienes and histamines.

Leukotrienes cause the muscles in the airways to tighten up, encourage lung cells to produce more mucus and make the lining of the airways more inflamed.

The new drug stops the production of these chemicals in asthma sufferers, resulting in a drop in the amount of inflammation.

The second group of chemicals, histamines, are linked to symptoms such as sneezes, a runny nose, itchy, watery eyes and itchy throats.

The tablet - which is taken once or twice a day - inhibits leukotrienes and blocks histamine.

'We have some drugs that block the end effect of these chemicals, but they are only partially effective,' says Dr Howarth. 'This drug blocks the actual production. It will have a profound effect.'

In the first trials of the drug, patients with exerciseinduced asthma will be given various strengths of the drug to measure the effects. Symptoms of this type of asthma include wheezing, difficulty in breathing and tightness in the chest.

Those taking part in the trial have to show that they suffer a significant narrowing of the airways when they exercise on a treadmill

Bryn Webber, a 25-year-old cardiac theatre nurse who ran the London marathon and plays hockey for Southampton, has suffered with exercise-induced asthma for as long as he can remember.

'I certainly remember having asthma when I was six or seven years old - it seems always to have been there. When I do exercise without having used my inhaler, I get very wheezy and find it difficult to draw breath.

When I ran the London marathon, I used my inhaler beforehand and took it with me, and fortunately everything worked out fine.

'I am very well controlled now, but before, I used to get real problems. Symptoms would be so bad that I would stop exercising and not be able to carry on.'

He is enthusiastic about the prospect of a daily tablet for people with severe symptoms. 'It would benefit a lot of people,' he says.

The Respiratory Research Group at Southampton General Hospital is looking for more people with exercise-induced asthma to take part in the trial.

Men aged 18 to 55 who are non- smokers and who are otherwise fit and healthy should contact the 24-hour answerphone: 023 8079 4343.