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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Determinants of response to fluticasone propionate and salmeterol/fluticasone propionate combination in the Gaining Optimal Asthma controL study
Journal of Allergy and Clinical Immunology, Volume 120, No. 5, Year 2007
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Description
Background: During the Gaining Optimal Asthma controL study, 3416 patients with uncontrolled asthma were randomized to receive salmeterol/fluticasone propionate combination (SFC) or fluticasone propionate (FP) for 1 year. Approximately two thirds of patients achieved well-controlled (WC) asthma, and one third continued to have asthma that was not well controlled (NWC). Objective: This analysis aimed to (1) identify factors influencing treatment response and (2) assess the clinical benefits of SFC and FP in patients with NWC asthma. Methods: Logistic regression analysis was used to investigate whether covariates influenced the achievement of at least WC asthma in the study population. In patients with NWC asthma, predefined criteria were used to assess improvements in 6 clinical outcomes. Results: Factors affecting the probability of having NWC asthma included smoking status (current vs never: odds ratio [OR], 2.757; 95% CI, 2.061-3.689; P < .0001; former vs never: OR, 1.274; 95% CI, 1.031-1.574; P = 0.0273), sex (women vs men: OR, 0.652; 95% CI, 0.527-0.806; P < .0001), history of inhaled corticosteroid use (no history vs history: OR, 0.546; 95% CI, 0.437-0.683; P < .0001), and treatment (FP vs SFC: OR, 1.972; 95% CI, 1.686-2.308; P < .0001). Of patients with NWC asthma, 86% to 96% showed improvements in 1 or more clinical outcomes. Conclusion: It is imperative for good asthma control that patients stop smoking. Patients who did not have at least WC asthma demonstrated clinical improvements in individual asthma outcomes. Clinical implications: Although not all patients can achieve guideline-defined control, long-term treatment with SFC or FP is associated with clinical improvements in nearly all patients, regardless of smoking history or inhaled corticosteroid use. © 2007 American Academy of Allergy, Asthma & Immunology.
Authors & Co-Authors
Pedersen, Soøren Erik
Denmark, Odense
Syddansk Universitet
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
Yoxall, Sally
United Kingdom, Brentford
Glaxosmithkline Plc.
Clark, Timothy J.H.
United Kingdom, London
National Heart and Lung Institute
Statistics
Citations: 81
Authors: 6
Affiliations: 6
Identifiers
Doi:
10.1016/j.jaci.2007.07.016
ISSN:
00916749
Study Design
Cross Sectional Study
Case-Control Study
Study Approach
Quantitative
Participants Gender
Male
Female