Asthma Clinical Trial
Official title:
Optimization of Inhaled Corticosteroid Treatment in Adult Patients With Asthma Guided by Exhaled NO Measurement at Home
To compare the clinical outcome (effectiveness) of single inhaled corticosteroid (ICS)
controller treatment guided by exhaled NO measurement made at home with usual care asthma
management with regard to asthma control (primary outcome), asthma-related quality of life,
lung function, airway inflammation, medication use, and asthma events.
To understand changes in patient behaviour triggered by daily FENO measurement at home, for
example treatment adherence and voluntary allergen exposure.
The design is a pragmatic randomized controlled, open-label, parallel group study Screening
visit 1 and visit 2 is separated with a 2-4 week run-in period. At screening visit, Informed
Consent is signed and atopic asthma confirmed, spirometry is performed and questionnaires
responded to. At visit 2 venous blood samples are taken and serum stored at -20 °C for later
transport to Uppsala Biobank, Exhaled NO is measured at both visit using NIOX MINO (blinded
in control group).
- The active group if on combination inhaler, will switch to Giona Easyhaler (same
budesonide equivalent as before study entry) and Oxis (same formoterol equivalent as
before study entry). These patients will receive a NIOX MINO and will be taught about
the adjustment of ICS treatment according to daily exhaled NO measurement at home and a
personalized treatment algorithm.
- The control group will stay on previous controller treatment (only changed if indicated
by symptoms at visit) according to usual care.
- Both groups will switch short-acting beta-2-agonist to Buventol Easyhaler.
- Both groups will report symptoms (ACQ) monthly and in connection to asthma events via an
ePRO system (ViedocMe, PCG). Active group will report NO values on a weekly basis via
the same system.
There will be a follow-up clinic visit 3 at 6 months with exhaled NO measurement (blinded in
control group) and limited set of questionnaires. A second follow-up visit 4 at 12 months
with exhaled NO, spirometry, full set of questionnaires and blood sample will be made.
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