Abstract
Introduction: Today there is no clear answer to the question which therapy regimen will be optimal for disease control maintenance in real clinical practice.
Aim: To compare the efficiency of strategies of control achievement from position of maintenance control in patients with persistent asthma in real clinical practice by ACT-test.
Methods: Multicenter prospective 24-week observation study was conducted in 19 centers in Russia. Investigator was only to record the changes of therapy prescribed by the attending physician. Patients were aposterior stratified into three groups: A – step-up regime of combined therapy (salmeterol/fluticasone propionate), B – stable regime, C – step-down regime.
Result: According to the inclusion criteria the patients in all groups had the uncontrolled disease course (ACT score <20). Of the 288 patients (50%) who achieved control in the first 3 months of observation, 263 (91.3%) persons maintained or increased the disease control level and only 23 (8.0%) of the patients “lost” the disease control. The ACT score decreasing to the uncontrolled level (<20 points) in group A and B was registered in 7.7% and 2.8% of cases, respectevely. The significantly biggest proportion of patients with the loss of asthma control was registered in group C - 24,3% (p<0,05). Declining therapy is associated with a decrease in the proportion of controlled patients and fold increase in the probability of loss of control.
Conclusion: Combined therapy at step-up and stable regimes are optimal in real clinical practice from position of maintenance control in patients with persistent asthma.
- © 2011 ERS
