There has been some very interesting research published by
the Brighton and Sussex Medical School into children who suffer from severe asthma
but who do not respond well to Salmeterol . The researchers have demonstrated that
Salmeterol does not work well for patients who have a genetic mutation that causes
the shape of the Beta-2 receptors to be different. Around 1 in 7 children have
this genetic mutation and the same ratio of asthma sufferers do not respond
well to Salmeterol.
The researchers split a group of 62 children who did not
respond well to Salmeterol into two sub
groups; one was treated with Montelukast and the other was treated with
Salmeterol. The Montelukast group had a significantly better response.
The really exciting bit about this research was that the low
responders could be predicted using a very simple spit test to screen for the
mutation. This brings personalised
treatment for asthma that one step closer.
Please note that prescribing guidelines have not
been changed as a result of this small but important study and the spit test is
not yet commercially available so GPs do not have access to this type of
screening for their patients.