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Partial asthma control therapy decreased use, sustained control

A treatment approach aimed at partial asthma control in adult patients significantly decreased medication use and associated costs and sustained asthma control when compared with a controlled-asthma approach, according to recent study results.

In a cluster-randomized trial in the Netherlands, researchers studied 611 asthmatic adults, aged 18 to 50 years, who were prescribed inhaled corticosteroids. The patients received one of three treatment strategies aimed at: partly controlled asthma (PCA; n=219 patients; Asthma Control Questionnaire [ACQ] score <1.5); controlled asthma (CA; n=203 patients; ACQ score <0.75); or fraction of exhaled nitric oxide (FENO)-driven controlled asthma (FCA; n=189; ACQ score <0.75 and FENO value <25 ppb). An online tool was used to determine treatment adjustment every 3 months during 12 months follow-up.

Incremental cost per quality-adjusted life year gained, asthma control, quality of life, asthma medication use and severe exacerbation rate were measured outcomes.

Asthma control showed a greater improvement in the FCA treatment cohort compared with the PCA cohort (P<.02). Quality of life and severe exacerbation rate showed no significant differences between groups.

“Asthma medication use was significantly lower for the PCA and FCA strategies compared with the CA strategy (medication costs: PCA, $452; CA, $551; FCA, $456; P≤.04),” the researchers wrote. “The FCA strategy had the highest probability of cost-effectiveness at a willingness to pay of $50,000/quality-adjusted life year (86%; PCA, 2%; CA, 12%).”

“We found that a treatment approach aiming at PCA instead of CA significantly decreases asthma medication use and associated costs, whereas asthma control, quality of life and severe exacerbation rates remain similar,” the researchers reported. “Treatment aimed at achieving and maintaining CA as such offers no additional benefits from the health economic, patient and clinical perspective over aiming for PCA.”

Disclosure: See the study for a full list of relevant financial disclosures.