Start date: January 1999Planned end date: December 2001
Estimated cost: £401,646

Research objectives

The UK national guidelines for asthma management recommend a slow stepwise reduction of treatment in patients with chronic asthma which has been stable for a three to six month period. Inhaled steroids are highly effective in treating asthma, although, a plateau in the therapeutic response may exist for many asthmatic patients at doses below 1000mcg daily. Concerns have been raised that some patients may be receiving inappropriately high doses of inhaled steroids. The aims of this study are to assess the clinical and economic implications of stepping down inhaled steroid treatment over a 1-year period on patients with chronic stable asthma receiving ³ 1000mcg inhaled steroid daily. 240 adult asthmatic patients will be recruited to a prospective randomised double blind parallel group study in general practice. The primary objectives are:

• To compare the number of exacerbations of asthma in the group in whom the dose of inhaled steroid is reduced by up to 50% with those in whom the dose is unaltered over a 1 year period;
  
• To perform an economic evaluation of the two management plans. The benefit the proposed investigation may bring to the NHS is the cost-effective use of inhaled steroid treatment in asthma.

For further information contact

Professor Neil C. Thomson
Consultant Physician
Department of Respiratory Medicine
West Glasgow Hospitals University NHS Trust
1053 Gt. Western Street
Glasgow, G12 0YN

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