Discontinuation of inhaled corticosteroids in patients with controlled asthma The DISCO (Discontinuation of Inhaled Steroid in Controlled asthmatics Over 6 months) study
- 주제(기타) Allergy
- 주제(기타) Immunology
- 설명문(일반) [Kim, Jung-Hyun; Jin, Juhae; Park, So-Young; Kim, Hyo-Jung; Kwon, Hyouk-Soo; Song, Woo-Jung; Cho, You Sook; Moon, Hee-Bom; Kim, Tae-Bum] Univ Ulsan, Dept Allergy & Clin Immunol, Asan Med Ctr, Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea; [Kim, Jung-Hyun; Kim, Sae-Hoon; Chang, Yoon-Seok] Seoul Natl Univ, Dept Internal Med, Bundang Hosp, Seongnam, South Korea; [Kim, Jung-Hyun] Korean Armed Forces Capital Hosp, Dept Internal Med, Seongnam, South Korea; [Park, Seo Young] Univ Ulsan, Dept Clin Epidemiol & Biostat, Asan Med Ctr, Coll Med, Seoul, South Korea; [Park, So-Young] Konkuk Univ, Div Pulm Allergy & Crit Care Med, Dept Internal Med, Med Ctr, Seoul, South Korea; [Kim, Hyo-Jung] Inje Univ, Haeundae Paik Hosp, Dept Internal Med, Coll Med, Busan, South Korea; [Kim, Min-Hye; Cho, Young-Joo] Ewha Women Univ, Dept Internal Med, Sch Med, Seoul, South Korea; [Park, Heung-Woo; Cho, Sang-Heon] Seoul Natl Univ, Dept Internal Med, Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 ELSEVIER SCIENCE INC
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000182207
- 본문언어 영어
- Published As http://dx.doi.org/10.1016/j.anai.2021.03.031
초록/요약
Background: Although inhaled corticosteroids (ICSs) are the recommended first-line therapy for asthma, determining whether to continue or discontinue ICS treatment in patients with mild asthma remains challenging for clinicians. Several studies have revealed that patients with mild-persistent asthma maintained a well-controlled state after ICS withdrawal. However, the long-term outcomes of ICS withdrawal have not yet been determined. Objective: To determine the possible clinical outcomes of the discontinuation of ICS in patients with well-controlled mild asthma. Methods: We investigated the clinical outcomes of discontinuing ICSs in patients with well-controlled mild asthma and compared the time to loss of control (LOC) between patients who stopped ICS treatment (ICS withdrawal group, IWG) and those who continued treatment for 3 years (continuous ICS group, CIG). Results: A significant difference in the time to LOC was observed between the IWG and CIG (hazard ratio, 2.56; 95% confidence interval, 1.52-4.33; P <.001). Increasing fractional exhaled nitric oxide levels (P = 0.008) and sputum eosinophil counts (%) (P = 0.015) revealed a weak but significant association with LOC risk in the CIG. The sputum eosinophil counts (P = 0.039) and serum total immunoglobulin E levels (P = 0.014) were significantly higher in the LOC group than in the non-LOC group of the CIG. Conclusion: Our results suggest that the maintenance of ICS treatment may help keep patients' asthma under control. Furthermore, patients with LOC had significantly higher sputum eosinophil counts in the CIG than those in the non-LOC group. Therefore, continuous ICS use by patients with mild, well-controlled asthma could be associated with good clinical outcomes. (C) 2021 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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