A regular or an intermittent treatment for asthma: the long-term effect

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Pharmacology

Background:

• Asthma management often involves intermittent therapy due to poor patient compliance.
• The efficacy of intermittent asthma therapy in controlling disease and slowing lung function decline remains unclear.

Purpose of the Study:

• To compare the clinical outcomes and forced expiratory volume 1 (FEV1) decline between regular and intermittent inhaled corticosteroid (ICS) plus long-acting bronchodilator agent (LABA) therapy in persistent asthma patients over four years.

Main Methods:

• A retrospective study involving 165 persistent asthma patients (FEV1 > 70%).
• Patients were divided into two groups: regular ICS+LABA users (n=84) and intermittent ICS+LABA users (n=81).
• Clinical data and lung function parameters, including FEV1 and maximal mid expiratory flow (FEF25-75), were analyzed over a 4-year period.

Main Results:

• The regular therapy group showed significantly fewer patients requiring oral corticosteroids and less need for short-acting bronchodilators.
• More patients in the intermittent group required therapy escalation (step-up).
• While regular therapy led to better subjective symptom control, both groups exhibited similar FEV1 decline over 4 years, though maximal mid expiratory flow (FEF25-75) variation was lower in the regular group.

Conclusions:

• Regular use of ICSs plus LABAs offers superior asthma control compared to intermittent therapy over the long term.
• Despite improved asthma control, regular ICS+LABA therapy did not demonstrate a significantly greater reduction in FEV1 decline compared to intermittent therapy after four years.