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Budesonide increased symptom free days in patients with recent onset mild asthma at an additional cost of US$0.42/day

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 Q In patients with recent onset mild asthma, what is the incremental cost effectiveness of early intervention with budesonide compared with usual care?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★☆☆☆ Respirology ★★★★★★☆ Allergy ★★★★★☆☆


Embedded ImageDesign:

cost effectiveness analysis of a randomised controlled trial (Inhaled Steroid as Regular Therapy in Early Asthma [START] study).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded {patients, clinicians, data collectors, outcome assessors, data analysts, and monitoring committee}.*

Embedded ImageFollow up period:

3 years.

Embedded ImageSetting:

{499 sites in 32 countries}.

Embedded ImagePatients:

7241 patients (mean age 24 y, 54% women; based on 7165 patients) who had received a diagnosis of asthma ⩽2 years before randomisation and had mild persistent asthma (ie, ⩾1 symptom such as wheeze, cough, or chest tightness per week, but not as often as every day, during the previous 3 mo) and airway reversibility. Exclusion criteria: significant comorbidity.

Embedded ImageInterventions:

budesonide (Pulmicort Turbuhaler, AstraZeneca, London, UK), 400 …

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  • * Data provided by author.


  • * See glossary.

  • Information provided by author.

  • For correspondence: Dr S D Sullivan, University of Washington, Seattle, WA, USA.

  • Source of funding: AstraZeneca Research and Development.

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