On demand use of β2-agonists led to better asthma control than regular use in moderate to severe asthma
QUESTION: In patients with moderate to severe asthma, is on demand β2-agonist inhalation as effective and safe as regular use?
Design
Randomised {allocation concealed}*, blinded (outcome assessors and statistician), crossover trial with 24 weeks of follow up for each treatment condition.
Setting
Outpatient clinic at Düsseldorf University Medical Centre, Germany.
Patients
80 patients (mean age 48 y, 74% women) with moderate to severe asthma on regularly scheduled β2-agonist (minimum daily intake of 6 puffs) and corticosteroid inhalation for ≥2 years. Exclusion criteria were non-respiratory illnesses or pregnancy. 73 patients (91%) completed the study.
Intervention
Two 24 week periods in which patients were allocated to on demand inhalation (salbutamol or fenoterol) or regular use β2-agonists (2 inhalations 4 times daily plus salbutamol or fenoterol on demand) and crossed over to the other regimen after completion of the first …
