Stepping Down Asthma Medications Can Be Safe with Appropriate Guidance

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New JACI Study Examines Cost, Safety of Stepping Down

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Researchers from Mayo Clinic and Kaiser Permanente have found that stepping down asthma controller medications can be achieved without compromising safety, while also introducing significant cost savings for the patient.

In a study published today by The Journal of Allergy and Clinical Immunology (JACI), the team of researchers identified 4,235 patients (including adults and children over five-years-old) with persistent asthma and continued participation in the two year Medical Expenditure Panel Survey (MEPS). The patients were then divided into two groups: patients who had stable asthma for at least one year who stayed on their same daily asthma medicine and patients who had stable asthma for at least one year who stepped down their daily asthma medicine.

“Trying to reduce the daily asthma controller medications speaks to the principle of using the least amount of medicine to control symptoms and prevent attacks,” study author Matthew Rank, MD, FAAAAI, from Mayo Clinic explained.

Among the entire cohort, 25.3% stepped down asthma medications (29.9% were eligible). Good candidates for stepping down had no recent hospitalizations or emergency room visits due to asthma, no systematic corticosteroid prescriptions linked to an outpatient visits and had three or fewer rescue inhalers filled. These were all measured in the same three period step down eligibility window, consisting of 12-15 months.

Reassuringly, 89.4% of those who stepped down when eligible continued to maintain complete asthma control. Likewise, adjusted missed school and work days were no different between those who stepped down and those who maintained their current treatment levels.

“This rate of complete asthma control is no different for those who were also eligible to step down but instead continued to use the same level of asthma medications,” Rank said.

Furthermore, this is the first known study to analyze costs associated with stepping down asthma medications. Rank said they observed an overall direct cost savings of $34 each month in those who were eligible and successfully stepped down, which could lead to decreased costs associated with asthma care.

“A good candidate who is ready to step down his or her asthma controller medications should work with their doctor to safely initiate this,” Rank said. “Many patients try to step down on their own, but we highly encourage them to consult with their doctor first.”

More information on asthma and stepping down asthma medications is available at the AAAAI website.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 6,800 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

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Melissa Graham, Media & Member Communications Manager
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