New tendencies in vision of asthma. Therapy of asthma by antiepileptic drugs
Bronchial asthma as neurogenic inflammatory paroxysmal disease: mechanisms and therapy
[ Carbamazepine in Asthma Therapy ] [ Valproates in Asthma Therapy ] [ Author ] [ Scientific Background ] [ For Patients ] [ Articles, Congresses and Patent ] [ Similarities in Asthma, Migraine, Trigeminal Neuralgia and Epilepsy ] Antiepileptic drugs against asthma in ERS Congresses: Glasgow, 2004, Copenhagen, 2005, [ Presentation ] and Munich, 2006 [ In Russian ] [ Russian version ] [ Links to Other Authors ] [ Neuroasthma Group ] [ In Georgian ]
[ For Patients ]
[ Articles ]
[ Author ]
[ In Russian ]
Areas with low
rates of asthma:
Bronchial asthma remains a worldwide problem. Up to 7-10% of population in developed countries has asthma. Every 3 minutes 1 patient dies in the world due to asthma. Two thirds of patients with asthma have or had asthmatic attacks every day.
Despite definite progress in asthma therapy, the real break-throw in asthma treatment is still unreachable. Moreover, in every 10-12 years the number of patients with asthma doubles and reasons of this are not known.
Twelve years ago we paid attention on definite similarities between asthma and epilepsy. It is known that during focal or partial epileptic seizures patients do not lose consciousness, and seizures are localized only in limited groups of muscles. But patients with bronchial asthma also have spasm of limited groups of muscles in respiratory tree. In 19th century many physicians called asthma "bronchial seizures". Moreover, some patients have aura before the asthma attacks.
We also found similarities in mechanisms of asthma, migraine and trigeminal neuralgia. According to modern definitions, asthma is a chronic inflammatory disease. Besides, some authors consider asthma as paroxysmal and neurogenic inflamamtory disease. But we know that migraine and trigeminal neuralgia also are neurogenic inflammatory diseases with paroxysmal clinical picture, and antiepileptic drugs like valproats are highly effective in pharmacotherapy of these disorders.
We also found that in some patients with asthma use of antiepileptic drugs for treatment of concomitant trigeminal neuralgia induced significant reduction of severity and frequency of asthma attacks.
Taking this in consideration, we decided to investigate the efficacy of antiepileptic drugs in treatment of asthma.
Twelve years ago we performed first small observational study in patients with stable and poorly controlled asthma. We simply added antiepileptic drug carbamazepine to routine antiasthmatic therapy.
First results were promising. Asthma symptoms disappeared in these patients after carbamazepine indication. Moreover, allergens and physical exercises did not provoke asthma exacerbations if patients continued to receive carbamazepine.
Then we performed other clinical studies, including double-blind placebo-controlled trials. We studied antiasthmatic activity of carbamazepine and some other antiepileptic drugs. It was found that in more than 70% of patients with asthma these medicines completely prevent asthma attacks, restoring respiratory indices to normal level. After 2-3 years of antiepileptic drug administration it was gradually discontinued, and patients remained in good condition, having no asthma symptoms.
We found that phenytoin sodium is less effective: up to 60-65% of cases. We also found that barbiturates and ethosuximide derivatives have no antiasthmatic activity at all.
Results of our studies were published in several medical journals, including peer-review journals, and were presented on Annual Congresses of European Respiratory Society in Glasgow (2004), in Copenhagen (2005) and in Munchen (2006).
In Copenhagen we had oral presentation in session dedicated to asthma treatment in harder-to-reach population.
We patented use of antiepileptic substances for production of antiasthmatic drugs: materials of patents you can see here.
We tried to rouse interest of leading pharmaceutical companies in our discovery. The most important goal for us is to reduce severity of asthma and mortality in patients. We also understand that the cost of asthma therapy with antiepileptic drugs is significantly less in comparison with modern antiasthmatic treatment. The price of monthly dose of carbamazepine needed for asthma treatment is about 20-25$, but that of other newest antiasthmatic medicines - about 200$ per month. We should remember that in more than 70% of patients carbamazepine leads to total abortion of asthma symptoms and therefore induces complete and stable remission of asthma.
Thus, we would like to inform physicians and patients with asthma about high antiasthmatic efficacy of some antiepileptic drugs. We can offer you data of our clinical trials (you can see them here), and scientific background of our pharmacotherapeutical approaches (see here).
It is not possible to explain high antiasthmatic efficacy of antiepileptic drugs by modern definition and conceptions of asthma. Due to this we suggest new conceptual approach and definition of asthma.
We can provide additional information concerning our method of asthma therapy by some antiepileptic drugs.
Please, contact us.
Our address: Neuroasthma Group, "Rea" Rehabilitation Centre, 18a Vazha Pshavela ave., 0160 Tbilisi, Georgia.
Merab Lomia, MD, PhD.
Head of Neuroasthma Group.
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Copyright: 2005 Merab Lomia
Last modified: September 24, 2015
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