Cited 0 times in Scipus Cited Count

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

DC Field Value Language
dc.contributor.authorKim, SH-
dc.contributor.authorLee, T-
dc.contributor.authorJang, AS-
dc.contributor.authorPark, CS-
dc.contributor.authorJung, JW-
dc.contributor.authorKim, MH-
dc.contributor.authorKwon, JW-
dc.contributor.authorMoon, JY-
dc.contributor.authorYang, MS-
dc.contributor.authorLee, J-
dc.contributor.authorChoi, JH-
dc.contributor.authorShin, YS-
dc.contributor.authorKim, HK-
dc.contributor.authorKim, S-
dc.contributor.authorKim, JH-
dc.contributor.authorLee, SY-
dc.contributor.authorNam, YH-
dc.contributor.authorKim, SH-
dc.contributor.authorKim, TB-
dc.contributor.authorCohort for Reality and Evolution of Adult Asthma (COREA) Study Group-
dc.date.accessioned2023-01-05T03:03:46Z-
dc.date.available2023-01-05T03:03:46Z-
dc.date.issued2021-
dc.identifier.issn2213-2198-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/23773-
dc.description.abstractBackground: Current asthma guidelines recommend stepping down controller treatment when the condition is well-controlled for a certain time. However, the optimal step-down strategy for well-controlled patients receiving a low-dose inhaled corticosteroid (ICS) with a long-acting β2-agonist (LABA) remains unclear. Objective: This study was a randomized, open-label, three-arm, parallel pragmatic trial comparing two kinds of step-down approaches for maintaining treatment. Methods: Adults with asthma who were aged 18 years or older, and who had been stable with low-dose ICS/LABA for at least 3 months, were enrolled. Subjects (n = 225) were randomly allocated into one of three groups (maintaining low-dose ICS/LABA [G1], discontinuing LABA [G2], and reducing ICS/LABA to once daily [G3]), and were observed for 6 months. The primary end point was a change in Asthma Control Test (ACT) scores between randomization and the final 6-month follow-up. Results: The change in ACT was analyzed in the per-protocol population; noninferiority was not demonstrated in either step-down group compared with the maintenance group (95% confidence interval of the difference, G2 vs G1 = –1.40-0.55; G3 vs G1 = –1.19-0.77). Although over 90% of patients were fine, higher rates of treatment failure were observed in step-down groups (G1: 0%; G2: 9.46%; and G3: 9.09%; P = .027). There were no significant differences between step-down approaches in terms of ACT change or treatment failure. Conclusions: Both step-down methods were not noninferior to maintenance of treatment. Step-down therapy can be attempted when patients are stable, but appropriate monitoring and supervision are necessary with precautions regarding loss of disease control.-
dc.language.isoen-
dc.subject.MESHAdministration, Inhalation-
dc.subject.MESHAdrenal Cortex Hormones-
dc.subject.MESHAdrenergic beta-2 Receptor Agonists-
dc.subject.MESHAdult-
dc.subject.MESHAnti-Asthmatic Agents-
dc.subject.MESHAsthma-
dc.subject.MESHDrug Therapy, Combination-
dc.subject.MESHHumans-
dc.subject.MESHTime Factors-
dc.titlePragmatic 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-
dc.typeArticle-
dc.identifier.pmid33940213-
dc.subject.keywordAsthma-
dc.subject.keywordController treatment-
dc.subject.keywordInhaled corticosteroid-
dc.subject.keywordLong-acting β2-agonist-
dc.subject.keywordStep-down-
dc.contributor.affiliatedAuthorShin, YS-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.jaip.2021.04.042-
dc.citation.titleThe journal of allergy and clinical immunology. In practice-
dc.citation.volume9-
dc.citation.number10-
dc.citation.date2021-
dc.citation.startPage3638-
dc.citation.endPage3646.e1-e3-
dc.identifier.bibliographicCitationThe journal of allergy and clinical immunology. In practice, 9(10). : 3638-3646.e1-e3, 2021-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn2213-2201-
dc.relation.journalidJ022132198-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
Files in This Item:
There are no files associated with this item.

qrcode

해당 아이템을 이메일로 공유하기 원하시면 인증을 거치시기 바랍니다.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse