Doctors often instruct patients suffering from mild persistent asthma to use a steroid inhaler every day—but nearly half of those patients receive no noticeable benefit from doing so, according to a recent study published in The New England Journal of Medicine

The study divided asthmatics into two groups—those who had high levels of a type of white blood cell called eosinophils in their sputum (phlegm) and those who did not. High levels of eosinophils are an indicator of a specific type of inflammation, and for patients suffering from this inflammation, the study confirmed that daily steroid use is beneficial. But 73% of the mild persistent asthma sufferers who participated in the study did not have indications of this type of inflammation—and for two-thirds of this larger group, daily steroid use was no more effective than a placebo. What’s more, daily steroid use is expensive and can have adverse side effects—including increased risk for bone loss, cataracts and glaucoma.

If a daily steroid is not providing any noticeable improvement, ask your health-care provider…

“Can you confirm I’m using my ­inhaler properly?” Improper inhaler use is more common than people realize. If this fails to solve the problem, ask…

“Is it worth trying a different treatment option, such as a long-­acting ­muscarinic antagonist (LAMA)?” LAMA is traditionally used for COPD. A LAMA inhaler can be effective for some asthma sufferers, with few side effects (notably, dry mouth). Note: As yet, there is no easy and accurate way to test eosinophil levels—you may just have to try a LAMA and see if it works.­