Millions of people who suffer from asthma take daily medication to alleviate their wheezing, coughing, and chest tightness. But, as researchers from around the country discovered, for those with mild asthma—two or fewer attacks a week—using either inhaled or oral medications only when needed may work just as well.

What the researchers wanted to know: Should people with mild asthma take medication daily or only when their symptoms worsen?

What they did: The researchers split about 200 patients with mild asthma into three groups and tracked them for a year. All of the patients were taught how to treat asthma attacks and given medication to take when they felt symptoms come on. One group of patients was also given a budesonide inhaler (a corticosteroid often sold under the brand name Pulmicort) and instructed to take it twice daily no matter how they were feeling, one group got zafirlukast pills (another anti-inflammatory often sold under the brand names Zyflo or Singulair), which they were instructed to take twice daily, and the third group received placebo pills to take daily. The researchers compared the groups after a year using peak expiratory flow, which measures how well a person can push air out of his or her lungs.

What they found: After a year, the researchers found no difference in the severity of asthma between the treatment groups. On average, the peak expiratory flow was about the same for all groups as were answers to questions on a survey about participants' quality of life. Patients who took the daily budesonide inhaler did do better on some clinical measures of lung function such as bronchial reactivity and had 26 more symptom-free days per year than other patients.

What it means to you: Although all patients need to talk to their doctor about what treatment it right for them, people with mild asthma could be just as well off without daily therapy. Because peak expiratory flow and quality of life measures were the same for all treatment groups, the researchers concluded that taking medication only when needed, which is a cheaper and has less risk of side effects, may be a good option for those with mild asthma.

Caveats: One of the things that the doctors said made a huge difference was the education that patients got in how to deal with their symptoms. Knowledge about how to control their asthma could be the key factor—not the frequency of treatment.

Find out more: The American Academy of Asthma, Allergy, and Immunology has a webpage with a list of medicines and links to their descriptions.

The American Lung Association also has pages about asthma, including descriptions of the different types of medicines used to treat it.

Read the article: Boushey, H.A. et al. "Daily versus As-needed Corticosteroids for Mild Persistent Asthma." New England Journal of Medicine. Vol. 352, No. 15, pp. 1519-1556.

Abstract online: http://content.nejm.org