The incidence of hospital admissions for acute asthma episodes varies almost 20-fold between areas of the UK.

Data released by Asthma UK for 2010–11 show that variations in access to ambulances and A&E facilities are putting many asthma patients at risk.

The charity has launched an online tool to help patients and their families compare local asthma care with national standards.

The variations cannot be attributed to differences in the incidence of asthma attacks, since some areas – such as Tower Hamlets in east London – where hospital admissions are low have high air pollution rates.

The charity called the inequalities “alarming”, since three in every 200 acute asthma episodes are fatal.

In 2010–11, 39 in every 100,000 children in Tower Hamlets were admitted to hospital as an emergency asthma case, compared to 733 in Liverpool.

Adult asthma care also showed wide variation: 30 in every 100,000 adults in Bromley, Kent underwent emergency admissions, compared to 193 in Newham, east London.

Dr Samantha Walker, Director of Policy and Research at Asthma UK, commented: “Guidelines are in place to give doctors and nurses the information and advice they need to prevent asthma attacks and save lives. But if these are not put into practice, they’re just a piece of paper.”

Asthma UK’s Compare Your Care tool offers comparative information to help local health providers meet national standards in asthma care, and help patients make informed choices about their care.

Emily Humphreys, the charity’s Head of Policy and Public Affairs, said: “We’re alarmed to see that people’s risk of ending up in hospital with an asthma attack depends on where they live. The next step is to build a picture of where care is good and where it may be falling behind.”

The UK’s first combined Maintenance and Reliever Therapy (MART) for asthma that can treat small as well as large airways has been launched on World Asthma Day.

Fostair (beclometasone + formoterol) from Chiesi is also the first MART therapy to be available in a pressurised Metered Dose Inhaler – the UK’s most widely used inhaler type.

The launch follows a clinical study showing that beclometasone + formoterol used as a MART reduced the incidence of severe asthma episodes by 34% relative to its use with a separate ‘rescue’ inhaler.

The MART 2 study, involving 1,714 patients with inadequately controlled asthma, also showed that the combination used as a MART reduced the rate of hospitalisations by 33%.

Fostair has been approved for use in patients whose asthma is not adequately controlled on inhaled corticosteroids (ICS) alone. It contains extra-fine particles of the active ingredient, enabling it to treat small as well as large lung airways.

Professor Peter Barnes, Head of Respiratory Medicine at Imperial College London, said: “The use of beclometastone + formoterol as Maintenance and Reliever Therapy is an effective treatment approach that has been shown to reduce exacerbations of asthma. I have found it to be both effective and simple to use.”

“Chiesi is committed to addressing unmet medical needs by bringing new and innovative medicines to patients,” said Dr Mark Bechter, the company’s Medical Director. “Our beclometasone + formoterol combination inhaler is the only pMDI combination with particles small enough to reach the small airways of the lung.

“We are delighted that this is now available in the UK to be used as Maintenance and Reliever Therapy.”

Chiesi UK specialises in modified release preparations in a number of medical areas, including respiratory medicine.

Boots UK has taken the lead in providing pharmacist support for people with asthma, helping them to improve their inhaler use.

The company’s new in-store asthma support programme aims to provide an accessible resource for the three million adults in the UK whose asthma is not well controlled.

The project reflects the growing role of community pharmacists in helping people to manage their long-term conditions through more effective medication use and self-monitoring.

Research commissioned by Boots UK found that 45% of asthma patients felt they needed more support within the community – for example, only 26% had been encouraged to take up therapeutic activities.

All of Boots UK’s in-store pharmacists have now received training to help patients improve their self-management of asthma – including optimal inhaler use, which 71% of patients find difficult.

Peter Bainbridge, Director of Pharmacy at Boots UK, said: “An easily accessible conversation with a trained Boots UK pharmacist can empower patients to take control of their asthma,” improving their medication use and symptom management.

The new programme would complement the services provided by GPs and hospitals, he said – and would also “enable pharmacists to make relevant clinical interventions and onward referrals”.

Manny Johal, a pharmacist at Boots UK, noted that adults with asthma often lack the clinical support and guidance offered to children. “Pharmacists are ideally placed in the local community to support people with asthma to take the right steps to improving their inhaler technique or raising awareness of their triggers,” he added.

Boots UK also provides online resources for patients at boots.com/asthma and an Asthma Health Centre at BootsWebMD.com.

Asthma treatment Xolair (omalizumab) has been recommended by NICE in final guidance as an option for treating adults, adolescents and children with severe or persistent allergic forms of the condition.

Xolair has been recommended in people aged 6 years and older as an add-on to optimised standard therapy for patients who require continuous or frequent treatment with oral corticosteroids.

However, the treatment can only be used by the NHS if Novartis Pharmaceuticals UK provides the treatment under the terms of an agreed patient access scheme to lower its price.

The treatment has a UK marketing authorisation as an add-on therapy to standard care to improve asthma with severe persistent allergic asthma. Currently, it is only prescribed to those whose condition remains poorly controlled, despite receiving standard therapy options.

Professor Carole Longson, Health Technology Evaluation Centre Director at NICE, commented: “NICE is pleased to recommend omalizumab, with the agreed patient access scheme submitted by the manufacturer, as an effective add-on therapy for adults, adolescents and children with severe, persistent allergic asthma, which can have a significant effect on a person’s life.”

Over two million asthma sufferers in the UK do not fully understand the dangers they face, according to Asthma UK.

A survey of over 50,000 people with asthma found that 52% did not think they were at risk of acute episodes – yet 93% of them were.

Better monitoring and regular inhaler use could prevent most of the 1,000 asthma-related deaths that occur in the UK each year, the charity said.

Asthma UK published the survey results as part of its Stop Asthma Deaths campaign, which focuses on preventing acute and potentially lethal attacks.

A total of 5.4 million people in the UK (one in 12) suffer from asthma, one of the highest rates in Europe. The disease caused 1,143 deaths in the UK in 2010. The treatment and care of asthma patients costs the NHS around £1 billion per year. However, 75% of hospital admissions for asthma are preventable.

Neil Churchill, Chief Executive of Asthma UK, said: “Millions of people with asthma are unaware that the condition can be fatal and that they are regularly taking huge risks with their lives. We can all help stop asthma deaths, and we need to start by changing the attitude that ‘it’s just asthma’.

The charity recommends three steps to minimise the risk of an asthma attack: daily use of a preventer inhaler, immediate inhaler use to correct worsening symptoms, and developing a personal asthma action plan.

“We’ve launched the Stop Asthma Deaths campaign to help people reduce their chance of having of an attack – but they can’t do this alone. Healthcare professionals also have a crucial part to play in helping people manage their asthma and spotting who may be in danger.”

NICE has reversed its recommendation on Novartis’ Xolair (omalizumab) and has now backed the treatment as an option for severe and persistent allergic asthma in final draft guidance.

The decision by NICE’s Appraisal Committee comes after Novartis supplied additional analysis on the product and submitted a patient access scheme to provide Xolair at a discounted rate.

Professor Carole Longson, Health Technology Evaluation Centre Director at NICE, said the Institute was “pleased to now be able to recommend Xolair as an effective therapy for adults, adolescents and children with this condition.”

Xolair was originally recommended for use in adults but not for use in children.

But after additional analysis the health-related quality of life benefits – which NICE said were “not quantifiable” – were acknowledged alongside the cost effectiveness of the treatment.

Final guidance is now expected to be published next month.

The Department of Health has published a ‘pledge’ to improve health outcomes for children and young people through co-ordinated activity across the NHS.

Stated aims include a reduction in the child mortality rate, improved care for children with long-term conditions, and better mental health care for the young.

A new Children and Young People’s Health Outcomes Board, led by the Chief Medical Officer, will focus on improving outcomes across paediatric care.

The DH is responding to a report from the Children and Young People’s Health Outcomes Forum, warning that child mortality rates in England are among the worst in Europe and that 26% of children’s deaths are linked to failures in direct care.

The Forum calls for attention to obesity, maintenance of long-term conditions, earlier diagnosis of mental health disorders, and better attention to the health needs of looked-after children.

GPs will be offered specialised training or support in paediatric health, and provided with new colour-coded health maps showing trends in conditions such as asthma and diabetes.

The CCGs will be asked to review their provision of services for children and investigate poor outcomes.

The DH also said it would investigate proposals by the Royal College of General Practitioners to extend GP training for a fourth year to include child health and mental health.

Health Minister Dan Poulter said: “It is a shocking fact that child mortality in Britain is the worst when compared to other similar European countries. There is unacceptable variation across the country in the quality of care for children – for example in the treatment of long-term conditions.

“Our pledge demonstrates how all parts of the system will play their part and work together to improve children’s health.”

Hilary Cass, President of the Royal College of Paediatrics and Child Health, commented: “It’s crucial that this momentum is maintained and that outcomes are regularly measured to drive improvements.

“We will be directly involved in a number of areas, which include enhancing the use of medicines in children and working with GPs to ensure paediatrics is part of their training.”

Signatories to the pledge include the DH, Healthwatch, the NHS Commissioning Board, NICE, MHRA and Public Health England.

A key principle of the pledge is that improving children’s health outcomes will not only reduce child mortality but lay the foundations for healthier adult lives.

GlaxoSmithKline (GSK) plans redundancies in its European sales and administration force to help it cut £1bn from its annual European, R&D and manufacturing costs by 2016.

The London-based pharma giant said it will achieve most of the cost reductions through technical improvements in its R&D and manufacturing processes.

According to CEO Andrew Witty, the cost savings plan has been driven by drug pricing pressures across Europe as the recession continues to worsen.

He also noted that job cuts would primarily affect sales and administration staff across Europe, but did not indicate the likely numbers.

Witty emphasised that GSK has six new drugs (including treatments for HIV, type 2 diabetes, melanoma and asthma) under review by regulatory bodies, with late-stage clinical trial data expected for another nine products within two years.

The company aims to launch up to 15 products within three years, he told business analysts. But given the economic uncertainties affecting Europe, 2013 would be a year of “twists and turns” and “not everything is going to go smoothly”.

According to a company spokeswoman, the technical and staffing changes (including redundancy payments) will have a combined one-off cost of £1.5bn, and will primarily be focused on Europe.

Olympic gold medal winner Laura Trott OBE is supporting charity Asthma UK as the face of its online resource for young people.

Trott, 20, who won two gold medals in track cycling at the London 2012 Olympics, has suffered from severe asthma – her career is a testament to the successful management of this long-term condition.

Asthma UK’s award-winning Facebook page Big Up Your Chest provides health information and a forum for 16–25 year olds living with asthma.

The charity supports over five million young people living with asthma, and aims to halve their hospitalisation rate over the next five years.

As a young child, Trott developed severe asthma and took up sport to help her regulate her breathing.

“I was overjoyed when I won two gold medals for track cycling at the London 2012 Olympics – I couldn't believe how far I'd come and I was so proud to fly the flag for Britain!” she said.

“I was able to achieve these amazing victories because I manage my asthma by taking my medicines and making sure I’m looking after my condition sensibly. It still impacts me physically as I tend to get a dry cough after I’ve been training, so I have to be aware of my limits.

“I hope that I can inspire other people my age with asthma through my own accomplishments and show that with the right treatment, management and attitude to asthma, it doesn’t have to hold you back.”

David Hiles, Head of Health Promotion at Asthma UK, commented: “We are thrilled to have Laura on board. Her fantastic achievements make her a huge inspiration to young people with asthma, who can ensure they are managing their condition properly by using the Big Up Your Chest page.”

NICE has failed to recommend Xolair (omalizumab) for the treatment of severe persistent allergic asthma in adults and children in draft guidance after reviewing new evidence.

The guidance reviewed two separate appraisals in 2007 – one which recommended Xolair for adults and one which did not for use in children.

Sir Andrew Dillon, Chief Executive of NICE, said that new data showed that the treatment is “not as clinically or cost-effective as was first thought.”

Xolair has a UK marketing authorisation as an add-on therapy to standard care to improve control of asthma in adults and youngsters aged 6 and above with severe persistent allergic asthma.

However, after new evidence was made available, particularly on mortality data, NICE’s independent Appraisal Committee decided that the draft guidance should not recommend the treatment for either children or adults.

In addition, the Committee also took into account changes to the dosing schedule and the effect this would have on the cost effectiveness of the treatment. This, when combined with uncertainties over the new clinical data, did not support a positive recommendation.

The Committee did recognise that Xolair was an effective therapy for asthma sufferers but said evidence submitted as part of the appraisal included people whose condition was less severe than those currently being treated in the UK.

“The Committee is aware that severe, persistent allergic asthma can have a detrimental effect on a person’s life and that omalizumab is an effective therapy for children, adolescents and adults with severe persistent allergic asthma,” said Sir Andrew Dillon.

“Unfortunately, the Committee was unable to continue to recommend omalizumab for use in the NHS.”

Patients currently taking Xolair should be able to continue treatment until their clinician considers it appropriate to stop.

Final guidance is now expected in April 2013.