TY - JOUR T1 - Comparative effectiveness of paediatric asthma step-up options: Increasing ICS dose vs adding separate LABA JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 434 AU - Clare S. Murray AU - Stephen Turner AU - Mike Thomas AU - Kathryn Richardson AU - Annie Burden AU - Daniel West AU - David Price Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/434.abstract N2 - Aim: In children who remain symptomatic despite maintenance inhaled corticosteroid therapy (ICS), step-up options include addition of a long-acting beta-agonist (LABA) or increasing existing ICS dose (INC). We compared the effectiveness of adding a separate LABA (+LABA) vs INC in a real-life paediatric population.Method: Clinical records were selected from 2 UK databases for patients aged 5–12yrs with an asthma diagnosis who stepped up therapy as +LABA or INC, had 1 year of baseline data prior to, and 1 year of outcome data after, step up. Patients were matched on baseline age, step-up year, ICS dose, reliever usage & exacerbations (EXBs). Outcomes over the following year included EXBs: oral steroid courses with evidence of respiratory review, asthma-related hospital admission or emergency room attendance, and asthma control (AC), defined as absence of: exacerbations, asthma-related out patient appointments, and antibiotic prescription following respiratory review. Conditional logistic/negative binomial regression was used to adjust for residual confounders.Results: +LABA and INC patients were matched 1:1 (n=3129). 59% were boys, mean(standard deviation[SD]) age was 9(2)yrs. Mean(SD) exacerbations were 0.09(0.37) and 0.07(0.31) for +LABA and INC patients, respectively.View this table:Outcome summary: adjusted odds/rate ratio (AOR/ARR)Conclusion: Compared with addition of separate LABA therapy, increasing ICS dose achieved significantly lower exacerbation rates and similar attainment of AC. Further work will compare INC vs addition of LABA as part of a fixed dose combination. ER -