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Identifying asthma patients who tolerate lower doses of steroids remains problematic
Date:5/22/2012

-smoking patients between 18 an d75 years of age who had been diagnosed by their general practitioner as having mild to moderate asthma. Patients were selected based on their responses to an asthma control questionnaire, their use of oral steroids, the frequency of exacerbations and hospitalizations, and their smoking history.

At the beginning of the study, the researchers performed baseline tests commonly used in primary care asthma assessment in the U.K. Once baseline measurements were collected, the ICS dose of each patient was reduced by 50 percent. Baseline measurements were repeated at the end of the study period. To quantify their results, the researchers defined loss of control as an increase of 0.5 or greater in a patient's asthma control questionnaire score, or an increase in the ICS dose equal to the original level. An exacerbation was defined as symptoms which did not respond to short-acting bronchodilator use, as well as a need for oral rescue steroids.

At the three-month follow-up, the researchers found that 128 patients (67 percent) were able to reduce their ICS dose by half with no loss of control or exacerbation. Of the remaining patients, 32 (17 percent) suffered from a loss of symptom control and 31 (16 percent) experienced an exacerbation. The researchers also found that there was no significant difference between the baseline characteristics of the subjects who remained well controlled and those who lost control or experienced exacerbations.

"Although we found that 67 percent of patients with well-controlled, mild to moderate asthma could successfully reduce their ICS dose by half without suffering from a loss of control or exacerbation at three months, none of the baseline measurements we evaluated in this study helped us to identify patients who could safely stepdown," Ms. Wilson said.

She added that while the measurements provide useful patient-specific clinical information, the study results suggest that
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Contact: Nathaniel Dunford
ndunford@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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