دورية أكاديمية
Step-down of inhaled corticosteroids in non-eosinophilic asthma: A prospective trial in real life.
| العنوان: | Step-down of inhaled corticosteroids in non-eosinophilic asthma: A prospective trial in real life. |
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| المؤلفون: | Demarche, Sophie, SCHLEICH, FLorence, HENKET, Monique, PAULUS, Virginie, Louis, Renaud, Van Hees, Thierry |
| المصدر: | Clinical and Experimental Allergy, 48 (5), 525-535 (2018-01-09) |
| بيانات النشر: | Blackwell, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | asthma, asthma control, blood, eosinophils, exacerbation, inhaled corticosteroids, non-eosinophilic, sputum, Human health sciences, Cardiovascular & respiratory systems, Sciences de la santé humaine, Systèmes cardiovasculaire & respiratoire |
| الوصف: | BACKGROUND: While non-eosinophilic asthmatics are usually considered poorly responsive to inhaled corticosteroids (ICSs), studies assessing a step-down of ICS in this specific population are currently lacking. OBJECTIVES: To assess the proportion of non-eosinophilic asthmatics in whom ICS may be withdrawn without any clinical degradation and to determine the predictive markers of a failure to stop treatment with ICS. METHODS: This prospective study was completed by 36 non-eosinophilic asthmatics, defined by sputum eosinophils <3% and blood eosinophils <400/muL. In these patients, whichever the baseline asthma control level, the dose of ICS was gradually reduced every 3 months until they met the failure criteria or successfully discontinued ICS for 6 months. The failure criteria were an ACQ score >/=1.5 with an increase from baseline >0.5 or a number of severe exacerbations during the study which was greater than the number during the year prior to the baseline visit. Receiver-operating characteristic (ROC) curves were constructed to assess predictors of a failure to stop ICS. This study is registered with ClinicalTrials.gov, number NCT02169323. RESULTS: In 14 patients (39%), ICSs were completely withdrawn, and in 10 further patients (28%), ICS were stepped-down to a reduced ICS dose without any deterioration of asthma control and exacerbation rate. Baseline predictors of a failure to stop ICS were a greater age (area under ROC curve [ROC AUC] and [95% CI]: 0.77 [0.62-0.93]) and elevated blood eosinophils (ROC AUC [95% CI]: 0.77 [0.61-0.93]). After the first step-down of ICS, the best predictor was an elevated blood eosinophil count (ROC AUC [95% CI]: 0.85 [0.72-0.99]). CONCLUSIONS & CLINICAL RELEVANCE: Withdrawing or reducing the dose of ICS is feasible in two-thirds of non-eosinophilic asthmatics irrespective of baseline asthma control. An elevated blood eosinophil count may predict the failure to stop ICS. |
| نوع الوثيقة: | journal article http://purl.org/coar/resource_type/c_6501Test article peer reviewed |
| اللغة: | English |
| العلاقة: | urn:issn:0954-7894; urn:issn:1365-2222 |
| DOI: | 10.1111/cea.13106 |
| الوصول الحر: | https://orbi.uliege.be/handle/2268/226775Test |
| حقوق: | open access http://purl.org/coar/access_right/c_abf2Test info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsorb.226775 |
| قاعدة البيانات: | ORBi |
| DOI: | 10.1111/cea.13106 |
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