November 4, 2015
Reducing Asthma Medication in Stable Patients Appears Safe

Phoenix—Reducing medication in patients who have had stable asthma for at least a year appears to be as safe as continuing the same level of therapy, according to a new study.

The study, published recently in The Journal of Allergy and Clinical Immunology, found that only 11% of patients had problems with their asthma in the 4 to 5 months after stepping down their asthma medicines.

Researchers from the Mayo Clinic in Arizona and colleagues looked at more than 4,000 patients of all ages who were taking daily asthma medicines, focusing the analysis on two groups: those who had stable asthma for at least 1 year who remained on the same therapy and those had stable asthma for at least 1 year but stepped down their daily asthma medicine.

Using two years of Medical Expenditure Panel Survey data for each patient, the study team divided the information into five periods of 4 to 5 months each. Eligibility for stepping down asthma controller medications included no hospitalizations or emergency department visits for asthma in periods 1 to 3 and no systemic corticosteroid and three or less rescue inhalers dispensed in periods 2 and 3. Overall, 89.4% of patients who were stepped down had preserved asthma control compared with 83.5% of those who maintained their current treatment level despite eligibility, according to the results.

Background information in the article notes that, because of the high cost of asthma therapy, patients and physicians often test whether stepping down medications is effective.

“Trying to reduce the daily asthma medicine speaks to the principle of using the least amount of medicine to control symptoms and prevent attacks,” lead author Matthew Rank, MD, an allergy and immunology specialist, said in a Mayo Clinic press release.

The study also considered financial implications, finding that patients who stepped down their asthma medicines saved an average $34 each month compared to patients who maintained the same level. At the same time, hospitalization and emergency care costs didn’t go up, nor did the patients taking less medication miss more work or school.

“This study is important because many people with asthma may be able to safely reduce their asthma medicines with the appropriate guidance from their healthcare teams,” Rank explained. “Many patients try to step down on their own but we encourage patients to work with their doctors before doing so.”
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