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  • A management strategy that controls lower airway eosinophilic inflammation and symptoms reduced exacerbations in asthma

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Therapeutics
A management strategy that controls lower airway eosinophilic inflammation and symptoms reduced exacerbations in asthma

https://doi.org/10.1136/ebm.8.4.113

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    (2002) Lancet 360, 1715. Green RH, Brightling CE, McKenna S, et al.. Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial.. ;. :. –21.
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 QUESTION: In patients with asthma, is a management strategy that controls lower airway eosinophilic inflammation and symptoms more effective than standard care for reducing asthma exacerbations?

    Design

    Randomised {allocation concealed*}†, blinded (clinicians and patients),* controlled trial with 12 months of follow up.

    Setting

    3 specialist clinics at a hospital in Leicester, UK.

    Patients

    74 patients (54% men, age range 18–75 y) who had moderate to severe asthma and probably needed continued hospital follow up. Exclusion criteria included current smokers, a smoking history of >15 pack years, clinically important comorbidity, poor compliance with treatment, aggravating factors that were inadequately controlled (eg, rhinitis), and a severe exacerbation within 4 weeks of entry to the trial. Follow up was 92%.

    Intervention

    37 patients each were allocated to management with reference to the induced sputum eosinophil count (eosinophil group) or management by a modified …

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    Footnotes

    • Source of funding: Trent NHS Regional Research Scheme.

    • For correspondence: Dr I D Pavord, Glenfield Hospital, Leicester, UK.ian.Pavord{at}uhl-tr.nhs.uk

    • Abstract and commentary also appear in ACP Journal Club.

    • ↵* See glossary.

    • ↵† Information provided by author.