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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Stability of asthma control with regular treatment: An analysis of the Gaining Optimal Asthma controL (GOAL) study
Allergy: European Journal of Allergy and Clinical Immunology, Volume 63, No. 7, Year 2008
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Description
Background: Uncontrolled asthma is characterized by variability. Current asthma guidelines recommend focussing on the achievement and maintenance of control but few studies have examined in detail, using composite measures of control, the stability and potential duration of control once achieved. In this post-hoc analysis of the results of the Gaining Optimal Asthma controL (GOAL) study, we examine the association between the level of asthma control achieved during the step-up phase of the study and the stability of control experienced during the maintenance phase. Methods: GOAL was a 1-year, randomized, stratified, double-blind study of 3421 patients with uncontrolled asthma, which compared salmeterol/fluticasone propionate combination with fluticasone propionate in achieving two composite, guideline-based measures of control: totally controlled and well-controlled asthma. We analysed the proportion and duration of time spent in control, the effect of treatment on asthma stability, and the impact of asthma control stability on unscheduled use of healthcare resources. Results: In patients achieving well-controlled or totally controlled asthma, at least well-controlled asthma was maintained for a median of almost 3 and 6 months, and for more than 85% and 95% of weeks of follow-up, respectively. A high level of stability was confirmed in a Markov analysis investigating transitional probability of change in control status. Variability in control was associated with increased probability of an unscheduled healthcare resource use (odds ratio: 1.06, P < 0.001). Conclusions: Most patients achieving guideline-defined control can maintain at least a similar level of control with regular, stable dosing, with little likelihood of losing control. © 2008 The Authors.
Authors & Co-Authors
Bateman, E. D.
South Africa, Cape Town
University of Cape Town
Bousquet, Jean J.
France, Montpellier
Hopital Arnaud de Villeneuve
Busse, William Walter
United States, Madison
University of Wisconsin School of Medicine and Public Health
Clark, Timothy J.H.
United Kingdom, London
National Heart and Lung Institute
Gul, Nadeem
United Kingdom, Brentford
Glaxosmithkline Plc.
Gibbs, Michael
United Kingdom, Brentford
Glaxosmithkline Plc.
Pedersen, Soøren Erik
Denmark, Odense
Syddansk Universitet
Statistics
Citations: 106
Authors: 7
Affiliations: 6
Identifiers
Doi:
10.1111/j.1398-9995.2008.01724.x
ISSN:
01054538
e-ISSN:
13989995
Research Areas
Disability
Health System And Policy
Study Design
Cohort Study
Case-Control Study