Evaluation of asthma control by inhaled corticosteroids in general practice in Thailand

Inhaled corticosteroid (ICS) is the main treatment of asthma but the clinical data of its efficacy is limited. This study aimed to evaluate the therapeutic efficacy of ICS alone or combined with controllers other than LABA for persistent asthma in Thailand.

This cross-sectional study involved 1,206 patients with persistent asthma and was conducted at 38 hospitals across Thailand between May and November, 2009. Patients were enrolled if they were >12 years old, had persistent asthma, receiving ICS with/without controllers other than long-acting beta2-agonists (LABA) for at least 3 months, and smoked <10 packs-year.

Of 1,206 patients, 78.4% were females, age 49.4 ± 13.8 years old, 89.3% were nonsmokers, the median duration of illness was 11 years, the median duration of ICS treatment was 20.4 months, and the mean dose of ICS was 738 ± 258 microgram per day. The top three medications prescribed in combination to ICS were short-acting beta2- agonist inhalers, theophylline, and short-acting beta2- agonist tablets. The mean Asthma Control Test (ACT) score was 19.2 ± 4.4. The percentage of successful asthma control (ACT ≥ 20) was 53.5% (95% CI: 50.7 to 56.3). The rate per patient per year of emergency room visits and all urgent health care visits were 0.98 and 1.28.

In clinical practice, patients using ICS alone or combined with theophylline or short-acting b2 agonists had a low percentage of asthma control and a high number of urgent care visits. ICS either alone or combined with theophylline or short-acting b2 agonists is not sufficient.