Nebulized hypertonic saline treatment reduced asthma exacerbations by 45% and hospital admissions by 63% in a study of 44 patients, offering a promising option for severe asthma patients with excessive mucus production, though larger clinical trials are needed to confirm effectiveness.
- Nebulized hypertonic saline reduced asthma exacerbations by 45%, dropping from 2.18 episodes per patient annually to 1.20 after treatment
- Hospital admissions for acute asthma attacks declined by 63%, falling from 19 to seven admissions in the year following treatment initiation
- The therapy works by drawing water into airways to hydrate thick mucus, making it easier to clear from the lungs
Scientists in North Wales have discovered a promising use of nebulized hypertonic saline (HS) to treat severe asthma. Their evaluation of patients from two hospitals within the Betsi Cadwaladr University Health Board was detailed in the paper, “Outcomes and Benefits of Using Twice Daily Nebulized Hypertonic Saline in T2-Low and T2-High Asthma With Bronchial Hypersecretion: A Retrospective Cohort Study,” and published in The Cureus Journal of Medical Science.
Researchers said their results may offer important benefits for patients with both T2-low and T2-high asthma and patients who experience chronic bronchial hypersecretion, a group with limited treatment options.
According to investigators, 44 patients with asthma who remained on 7% HS for at least one year experienced fewer asthma exacerbations over the course of a year, dropping from an average of 2.18 episodes per patient before treatment to 1.20 after treatment began. This represents a 45% reduction. Hospital admissions related to acute asthma attacks also declined substantially, falling by 63%, from 19 admissions in the year before treatment to seven in the year following initiation.
Treatment appeared to be well tolerated, researchers said. Of the 49 patients initially assessed, 48 successfully completed the tolerance trial and began therapy, while 44 remained on treatment after one year.
HS works by drawing water into the airways, helping to hydrate thick mucus and make it easier to clear from the lungs, investigators explained. Although the therapy has long been used in conditions such as bronchiectasis and cystic fibrosis, researchers said that evidence supporting its routine use in asthma has been limited. The new findings add to growing interest in targeting mucus hypersecretion as a means of improving asthma control, they noted.
The study’s retrospective design means the results cannot prove that HS alone caused the improvements, according to the paper’s authors. During the follow-up period, 25% of patients also began biologic therapies, including benralizumab, tezepelumab and omalizumab, which are known to reduce asthma exacerbations and may have contributed to the positive outcomes.
Despite these limitations, researchers said they believe the findings suggest nebulized HS could emerge as a valuable adjunct treatment for patients with severe asthma and excessive mucus production, particularly those who have exhausted conventional options. Investigators did urge larger prospective clinical trials to confirm the therapy’s effectiveness and identify which patient groups may benefit most.
