Today’s Solutions: June 29, 2022

The problem with the standard treatment for asthma is that it’s not beneficial for all patients. In fact, research suggests that one in seven kids has a small difference in their DNA that can cause their symptoms to get worse if given the standard treatment. Fortunately, new research may have an answer to this problem in the form of a simple, cheap genetic test.

Prescribing an asthma treatment: The standard asthma treatment for children is a combination of a steroid inhaler and a medication called salmeterol that opens up the airways. This drug targets a molecule called the beta-2 receptor, and in some people, the gene that produces this molecule is slightly altered — for them, salmeterol can do more harm than good.

In a study at Royal Alexandra Children’s Hospital, researchers set out to see whether testing children for that altered gene prior to prescribing an asthma treatment could improve their quality of life. 241 patients were divided into two groups. One group got the standard treatment, while the other group underwent a genetic test to see if one or both of their copies of the beta-2 receptor gene were altered. This test used samples collected via a simple cheek swab and cost less than $25 per patient. If a patient had at least one altered copy of the gene, they received an alternative to salmeterol (montelukast).

The next step in the study was seeing whether prescribing an asthma treatment based on a young patient’s genetics made a difference in their quality of life. For a year, the researchers checked in with the children to ask them about the severity of their symptoms, how their asthma affected their daily activities, and how it affected their feelings. Each patient received a score between one and seven to rate their quality of life. The researchers then compared the average scores of the patients in the group that underwent genetic testing prior to being assigned an asthma treatment with those that didn’t.

For patients with just one copy of the altered gene, the genetic testing didn’t make much of a difference — their average quality of life score was less than .2 points higher than those in the standard care group. The impact was slightly more pronounced among patients with two altered copies of the gene — their score was more than .4 points higher, which the researchers say translates to a notable improvement in the quality of life.

The results are notable because they show for the first time that “it could be beneficial to test for certain genetic differences in children with asthma and select medication according to those differences.”

Moving forward, the researchers plan to conduct larger trials with children who have less control over their asthma.

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