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AAAAI: Add-On Inhaled Glucocorticoid Lowers Severe Asthma Exacerbations

Adding inhaled glucocorticoid to usual care beneficial for Black and Latinx adults with moderate-to-severe asthma

TUESDAY, March 1, 2022 (HealthDay News) — Provision of an inhaled glucocorticoid and instruction on its use, in addition to usual care, is associated with a lower rate of severe asthma exacerbations among Black and Latinx adults with moderate-to-severe asthma, according to a study published online Feb. 26 in the New England Journal of Medicine to coincide with the annual meeting of the American Academy of Allergy, Asthma & Immunology, held from Feb. 25 to 28 in Phoenix.

Elliot Israel, M.D., from Brigham and Women’s Hospital in Boston, and colleagues randomly assigned 603 Black and 598 Latinx adults with moderate-to-severe asthma to use a patient-activated, reliever-triggered inhaled glucocorticoid strategy (beclomethasone dipropionate) plus usual care or to continue usual care (600 and 601, respectively). Patients had one instructional visit and completed questionnaires for 15 months.

The researchers found that the annualized rate of severe asthma exacerbations was 0.69 and 0.82 in the intervention and usual care groups, respectively (hazard ratio, 0.85). Asthma Control Test scores increased by 3.4 and 2.5 points in the intervention and usual care groups, respectively, while Asthma Symptom Utility Index scores increased by 0.12 and 0.08, points, respectively. In the intervention and usual care groups, the annualized rate of missed days was 13.4 and 16.8, respectively (rate ratio, 0.80). Overall, 12.2 percent of participants experienced serious adverse events; these were distributed evenly between the groups.

“Such a strategy may be easy to implement in populations with disproportionate asthma morbidity, as we continue to assess the effectiveness of additional interventions in diverse populations,” the authors write.

QVAR and QVAR RediHaler inhalers were provided free of charge, and funding for the AssistRx pharmacy was provided by Teva Pharmaceuticals. Devices for measuring exhaled nitric oxide were provided free of charge by Circassia Pharmaceuticals.

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