PT  - JOURNAL ARTICLE
AU  - May Al-moasseb
AU  - Victoria Worrall
AU  - Philip Lawrence
AU  - Ian Sinha
TI  - Switching to maintenance and reliever inhaled corticosteroid/long acting beta agonist: a real-world pilot evaluation in a regional paediatric difficult asthma clinic
AID  - 10.1183/13993003.congress-2020.583
DP  - 2020 Sep 07
TA  - European Respiratory Journal
PG  - 583
VI  - 56
IP  - suppl 64
4099  - http://erj.ersjournals.com/content/56/suppl_64/583.short
4100  - http://erj.ersjournals.com/content/56/suppl_64/583.full
SO  - Eur Respir J2020 Sep 07; 56
AB  - Introduction: In a meta-analysis of randomised controlled trials in people with mild/moderate asthma, inhaled corticosteroid/long-acting beta agonist (ICS/LABA) is more effective in a Maintenance and Reliever Therapy (MART) regime than a fixed dose strategy.Objective: To describe scores from the asthma control test (ACT) and Fractional Exhaled Nitric Oxide (FeNO) in children/adolescents, managed in a regional multidisciplinary clinic for paediatric difficult asthma (MDAS), who were switched from fixed dose ICS/LABA to MART.Methods: Casenote review of children switched from ICS/LABA to MART in our clinic. We compared Asthma Control Test (ACT) scores and FeNO before and after switching to MART. We classified responders as those who continued MART, and showed improved ACT and FeNO in the subsequent clinic.Results: Over an 18-month period, of 80 children in the clinic, 33 were switched from fixed dose ICS/LABA to MART (median age 14 years). Before/after data was unavailable for 18 children. 9/15 (60%) were classed as responders (median ACT score change +8 points [IQR 2 to 9]; median change in FeNO -36 ppb [IQR-23 to -69]. 11/15 continued on the SMART regime, 4/15 reverted back to the fixed dose.Conclusion: In a real-world evaluation, amongst children/adolescents in a regional MDAS, switching from fixed-dose ICS/LABA to MART regime appeared to improve asthma control and airway inflammation. Future multicentre prospective studies should aim to evaluate ICS/LABA strategies in children with severe asthma, to identify those most likely to benefit from switch to MART.References: Sobieraj, JAMA. 2018;319(14):1485-1496FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 583.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).