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In asthma
patients, stepping-down asthma controller treatment was not noninferior to the
maintenance of therapy.
Stepping-down asthma controller therapy displayed noninferiority to the maintenance of therapy in patients with asthma who had been stable with low-dose inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) for at least three months, concluded a trial published in "The Journal of Allergy and Clinical Immunology". Investigators compared the two kinds of step-down approaches for the maintenance of treatment.
This
three-arm parallel, open-label, pragmatic randomized controlled trial enrolled
a total of 225 participants (age 18 years or older) that were randomly divided
into three groups:
The primary outcome was an alteration in asthma control test scores between randomization and the final six-month follow-up. In the per-protocol population, alteration in the asthma control test was analyzed. As compared with the maintenance group, the non-inferiority was not illustrated in either of the step-down group. In the step-down groups, a greater rate of therapeutic failure was noted (although about 90% of patients were fine).
No vital differences
between the step-down approaches were witnessed in terms of asthma control test
change or therapeutic failure. The step-down strategy may be undertaken when
the asthma patients are stable. However, adequate monitoring and supervision
are crucial with precautions regarding the loss of disease control, concluded
the authors.
The Journal of Allergy and Clinical Immunology
Pragmatic Randomized Controlled Trial for Stepping Down Asthma Controller Treatment in Patients Controlled with Low-Dose Inhaled Corticosteroid and Long-Acting β2-Agonist: Step-Down of Intervention and Grade in Moderate Asthma Study
Sae-Hoon Kim et al.
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