TY - JOUR
T1 - The Asthma Controller Step-down Yardstick
AU - Chipps, Bradley E.
AU - Bacharier, Leonard B.
AU - Murphy, Kevin R.
AU - Lang, David
AU - Farrar, Judith R.
AU - Rank, Matthew
AU - Oppenheimer, John
AU - Zeiger, Robert S.
N1 - Funding Information:
Disclosures: Dr. Chipps serves as a consultant and a member of speakers' bureaus for AstraZeneca, Boehringer Ingelheim, Genentech/Novartis, and Merck. Dr. Bacharier has received consulting and/or lecture fees from Aerocrine, AstraZeneca, Cephalon, GlaxoSmithKline, Genentech/Novartis, TEVA, Merck, and Boehringer Ingelheim; serves on advisory boards for Merck, Sanofi, Vectura Group and Circasia; serves on a data and safety monitoring board for DBV Technologies; and reports honoraria for CME program development from WebMD/Medscape. Dr. Murphy has received consultancy and speaker fees and has participated in advisory boards for AstraZeneca, Boehringer Ingelheim, Genentech, Greer, Merck, Mylan, Novartis, and Teva. Dr. Lang serves as a consultant for GlaxoSmithKline, AstraZeneca, and Merck; and serves as a consultant, performs research, and receives honoraria from Genentech and Novartis. Dr. Farrar has no financial interests to disclose. Dr Rank has no financial interests to disclose. Dr. Oppenheimer is a consultant or advisor to AstraZeneca, GlaxoSmithKline, Mylan, Novartis, and Teva; received royalties from UpToDate, and received research funding from AstraZeneca, MedImmune, Novartis, and Sanofi. Dr. Zeiger is a consultant for Genentech/ Novartis, TEVA, AstraZeneca, Patara, and Regeneron.Funding Sources: The American College of Allergy, Asthma and Immunology was the sponsor for this article, which included editorial support and an honorarium for each of the authors.
Funding Information:
Disclosures: Dr. Chipps serves as a consultant and a member of speakers’ bureaus for AstraZeneca, Boehringer Ingelheim, Genentech/Novartis, and Merck. Dr. Bacharier has received consulting and/or lecture fees from Aerocrine, AstraZeneca, Cephalon, GlaxoSmithKline, Genentech/Novartis, TEVA, Merck, and Boehringer Ingelheim; serves on advisory boards for Merck, Sanofi, Vectura Group and Circasia; serves on a data and safety monitoring board for DBV Technologies; and reports honoraria for CME program development from WebMD/Medscape. Dr. Murphy has received consultancy and speaker fees and has participated in advisory boards for AstraZeneca, Boehringer Ingelheim, Genentech, Greer, Merck, Mylan, Novartis, and Teva. Dr. Lang serves as a consultant for GlaxoSmithKline, AstraZeneca, and Merck; and serves as a consultant, performs research, and receives honoraria from Genentech and Novartis. Dr. Farrar has no financial interests to disclose. Dr Rank has no financial interests to disclose. Dr. Oppenheimer is a consultant or advisor to AstraZeneca, GlaxoSmithKline, Mylan, Novartis, and Teva; received royalties from UpToDate, and received research funding from AstraZeneca, MedImmune, Novartis, and Sanofi. Dr. Zeiger is a consultant for Genentech/ Novartis, TEVA, AstraZeneca, Patara, and Regeneron.Funding Sources: The American College of Allergy, Asthma and Immunology was the sponsor for this article, which included editorial support and an honorarium for each of the authors.
Publisher Copyright:
© 2018
PY - 2019/3
Y1 - 2019/3
N2 - Asthma guidelines recommend a control-based approach to disease management in which the assessment of impairment and risk is linked to step-based therapy. Using this model, controller treatment is adjusted—upward or downward—according to a patient's level of asthma control over time. Strategies for stepping up controller therapy are well described, and the adult and pediatric Asthma Yardsticks provide operational recommendations based on patient profiles. Strategies for stepping down controller treatment are less clear, although stepping down to the minimum effective therapy is important and should be considered when a patient's asthma has been well controlled for an adequate period as defined by risk and impairment. This Yardstick presents recommendations for when and how to step down asthma controller therapy according to guideline-defined control levels. The objective is to provide clinicians who treat patients with asthma with a practical and clinically relevant framework for implementing a step-down in controller therapy.
AB - Asthma guidelines recommend a control-based approach to disease management in which the assessment of impairment and risk is linked to step-based therapy. Using this model, controller treatment is adjusted—upward or downward—according to a patient's level of asthma control over time. Strategies for stepping up controller therapy are well described, and the adult and pediatric Asthma Yardsticks provide operational recommendations based on patient profiles. Strategies for stepping down controller treatment are less clear, although stepping down to the minimum effective therapy is important and should be considered when a patient's asthma has been well controlled for an adequate period as defined by risk and impairment. This Yardstick presents recommendations for when and how to step down asthma controller therapy according to guideline-defined control levels. The objective is to provide clinicians who treat patients with asthma with a practical and clinically relevant framework for implementing a step-down in controller therapy.
UR - http://www.scopus.com/inward/record.url?scp=85059648885&partnerID=8YFLogxK
U2 - 10.1016/j.anai.2018.12.004
DO - 10.1016/j.anai.2018.12.004
M3 - Article
C2 - 30550809
AN - SCOPUS:85059648885
SN - 1081-1206
VL - 122
SP - 241-262.e4
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 3
ER -