Physician-, biomarker-, and symptom-based adjustment of inhaled steroids all similar for adult asthma control.

摘要

Clinical Question: Which strategy is superior in managing inhaled steroid therapy in adults with asthma: symptom-based, biomarker-based, or physician-based?Bottom Line: In this study, symptom-based dose adjustment of inhaled steroids (instructing patients to take two puffs of inhaled steroids every time they took two puffs of albuterol for relief of symptoms) resulted in similar treatment outcomes compared with a dosing strategy based on physician assessment using widely distributed and highly touted standard national guidelines, and compared with a biomarker-based strategy using exhaled nitric oxide. In addition, the symptom-based therapy resulted in only approximately one-half the amount of total monthly steroid use.