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Stepping down asthma medication appears safe, reduces costs

Patients with controlled asthma who stepped down their medications experienced outcomes comparable to those who maintained treatment levels.

The step down approach also reduced treatment costs, results showed.

“This study is important because many people with asthma may be able to safely reduce their asthma medicines with the appropriate guidance from their health care teams,” Matthew A. Rank, MD, of the division of allergy, asthma and clinical immunology at Mayo Clinic in Scottsdale, Ariz., said in a press release. “Many patients try to step down on their own but we encourage patients to work with their doctors before doing so.”

Rank and colleagues used the U.S. Medical Expenditure Panel Survey to identify patients with persistent asthma who stepped down their asthma medication over 2 years.

The researchers divided the 2-year time frame into five periods of 4 to 5 months each.

The final analysis included patients who had no hospitalizations within the first three periods and required no rescue inhaler dispensation during the second and third periods.

Approximately one-third of the initial cohort (n = 4,235; 29.9%) met the criteria for stepping down their asthma medication.

Results showed 89.4% (95% CI, 86.4-92.4) of study participants who stepped down their medications maintained asthma control, compared with 83.5% (95% CI, 79.9-87) of those who were eligible to step down their medication but did not.

The stepped-down approach was associated with a monthly cost savings of $34.02 (95% CI, 5.42-61.24). – by Jeff Craven

Disclosure: Rank reports research support from the Agency for Healthcare Research and Quality. Please see the full study for a list of all other researchers’ relevant financial disclosures.