Step-up and step-down approaches in the treatment of asthma

References

• Cloutier MM, Baptist AP, Blake KV, et al. focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program coordinating committee expert panel working group. J Allergy Clin Immunol. 2020;146(6):1217–1270.
   PubMed Web of Science ®Google Scholar
• Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2021 Update. [cited 2021 May 20]. Available from: https://ginasthma.org/wp-content/uploads/2021/05/GINA-Main-Report-2021-V2-WMS.pdf.
   Google Scholar
• British Thoracic Society/SIGN. British guideline on the management of asthma. Revised edition published July 2019. [cited 2021 May 20]. Available from: www.brit-thoracic.org.uk.
   Google Scholar
• National Asthma Council Australia. Australian Asthma Handbook - Quick Reference Guide, v1.3. Melbourne: National Asthma Council Australia; 2017. Available from http://www.asthmahandbook.org.au
   Google Scholar
• FitzGerald JM, Lemiere C, Lougheed MD, et al. Recognition and management of severe asthma: a Canadian thoracic society position statement. Canadian J Respir Crit Care Sleep Med. 2017;1(4):199–221.
   Web of Science ®Google Scholar
• Beasley R, Hancox RJ, Harwood M, et al. Asthma and Respiratory Foundation NZ adult asthma guidelines: a quick reference guide. NZ Med J. 2016;129(1445):83–102.
   PubMed Web of Science ®Google Scholar
• Nakamura Y, Tamaoki J, Nagase H, et al. Japanese guidelines for adult asthma 2020. Allergol Int. 2020;69(4):519–548.
   PubMed Web of Science ®Google Scholar
• Beasley R, Braithwaite I, Semprini A, et al., Optimal asthma control: time for a new target. Am J Respir Crit Care Med. 201(12): 1480–1487. 2020.
   PubMed Web of Science ®Google Scholar
• Hagan JB, Rank MA. Assessing the risks and benefits of step-down asthma care: a case-based approach. Curr Allergy Asthma Rep. 2015;15(8):503.
   PubMed Web of Science ®Google Scholar
• Buhl R, Heaney LG, Loefroth E, et al. One-year follow up of asthmatic patients newly initiated on treatment with medium- or high-dose inhaled corticosteroid-long-acting β2-agonist in UK primary care settings. Respir Med. 2020;162:105859.
   PubMed Web of Science ®Google Scholar
• Bloom CI, de Preux L, Sheikh A, et al. Health and cost impact of stepping down asthma medication for UK patients, 2001-2017: a population-based observational study. PLoS Med. 2020;17(7):e1003145.
   PubMed Web of Science ®Google Scholar
• Krishnan JA, Cloutier MM, Schatz M. National Asthma Education and Prevention Program 2020 Guideline Update: where do we go from here? Am J Respir Crit Care Med. 2021;203(2):164–167.
   PubMed Web of Science ®Google Scholar
• US department of health and human services, National Institute of Health, National Heart, Lung, and Blood Institute. Expert panel report 3: guidelines for the diagnosis and management of asthma. [cited 2021 May 20]. Available from: https://www.nhlbi.nih.gov/sites/default/files/media/docs/EPR-3_Asthma_Full_Report_2007.pdf.
   Google Scholar
• Reddel HK, FitzGerald JM, Bateman ED, et al., GINA 2019: a fundamental change in asthma management: treatment of asthma with short-acting bronchodilators alone is no longer recommended for adults and adolescents. Eur Respir J. 53(6): 1901046. 2019.
   PubMed Web of Science ®Google Scholar
• Vignola AM, Chanez P, Campbell AM, et al. Airway inflammation in mild intermittent and in persistent asthma. Am J Respir Crit Care Med. 1998;157(2):403–409.
   PubMed Web of Science ®Google Scholar
• Beasley R, Braithwaite I, Semprini A, et al., ICS-formoterol reliever therapy stepwise treatment algorithm for adult asthma. Eur Respir J. 55(1): 1901407. 2020.
   PubMed Web of Science ®Google Scholar
• Erin EM, Zacharasiewicz AS, Nicholson GC, et al. Rapid effect of inhaled ciclesonide in asthma: a randomized, placebo-controlled study. Chest. 2008;134(4):740–745.
   PubMed Web of Science ®Google Scholar
• Papi A, Caramori G, Adcock IM, et al. Rescue treatment in asthma. More than as-needed bronchodilation. Chest 2009;135(6):1628–1633.
   PubMed Web of Science ®Google Scholar
• Cazzola M, Grella E, Matera MG, et al. Onset of action following formoterol Turbuhaler and salbutamol pMDI in reversible chronic airway obstruction. Pulm Pharmacol Ther. 2002;15(2):97–102.
   PubMed Web of Science ®Google Scholar
• Bateman ED, Reddel HK, O’Byrne PM, et al. As-needed budesonide-formoterol versus maintenance budesonide in mild asthma. N Engl J Med. 2018;378(20):1877–1887.
   PubMed Web of Science ®Google Scholar
• Beasley R, Holliday M, Reddel HK, et al. Controlled trial of budesonide-formoterol as needed for mild asthma. N Engl J Med. 2019;380(21):2020–2030.
   PubMed Web of Science ®Google Scholar
• Rogliani P, Ritondo BL, Ora J, et al. SMART and as-needed therapies in mild-to-severe asthma: a network meta-analysis. Eur Respir J. 2020;56:2000625.
   PubMed Web of Science ®Google Scholar
• Lazarus SC, Krishnan JA, King TS, Lazarus SC, Krishnan JA, King TS, et al. Mometasone or tiotropium in mild asthma with a low sputum eosinophil level. N Engl J Med. 2019;380(21):2009–2019.
   PubMed Web of Science ®Google Scholar
• Domingo C, Rello J, As-needed SA. ICS-LABA in mild asthma: what does the evidence say? Drugs. 2019;79(16):1729–1737.
   PubMed Web of Science ®Google Scholar
• Rogliani P, Ritondo BL, Calzetta L. Triple therapy in uncontrolled asthma: a network meta-analysis of Phase III studies. Eur Respir J. 2021;2004233. Online ahead of print.
   PubMed Web of Science ®Google Scholar
• Casale TB, Bateman ED, Vandewalker M, et al. Tiotropium respimat add-on is efficacious in symptomatic asthma, independent of T2 phenotype. J Allergy Clin Immunol Pract. 2018;6(3):923–935.
   PubMed Web of Science ®Google Scholar
• Cazzola M, Rogliani P, Matera MG. The latest on the role of LAMAs in asthma. J Allergy Clin Immunol. 2020;146(6):1288–1291.
   PubMed Web of Science ®Google Scholar
• Buhl R, FitzGerald JM, Busse WW. Tiotropium add-on to inhaled corticosteroids versus addition of long-acting β2-agonists for adults with asthma. Respir Med. 2018;143:82–90.
   PubMed Web of Science ®Google Scholar
• Cazzola M, Ora J, Cavalli F, et al. Treatable mechanisms in asthma. Mol Diag Ther. 2021;25(2):111–121.
   PubMed Web of Science ®Google Scholar
• Hanania NA, Wenzel S, Rosén K, et al. Exploring the effects of omalizumab in allergic asthma: an analysis of biomarkers in the EXTRA study. Am J Respir Crit Care Med. 2013;187(8):804–811.
   PubMed Web of Science ®Google Scholar
• Korn S, Haasler I, Fliedner F, et al. Monitoring free serum IgE in severe asthma patients treated with omalizumab. Respir Med. 2012;106(11):1494–1500.
   PubMed Web of Science ®Google Scholar
• Calzetta L, Matera MG, Coppola A, et al. Prospects for severe asthma treatment. Curr Opin Pharmacol. 2020;56:52–60.
   PubMed Web of Science ®Google Scholar
• Diamant Z, Vijverberg S, Alving K, et al., Toward clinically applicable biomarkers for asthma: an EAACI position paper. Allergy. 74(10): 1835–1851. 2019.
   PubMed Web of Science ®Google Scholar
• Castro M, Corren J, Pavord ID, et al. Dupilumab efficacy and safety in moderate-to-severe uncontrolled asthma. N Engl J Med. 2018;378(26):2486–2496.
   PubMed Web of Science ®Google Scholar
• Hearn AP, Kavanagh J, d’Ancona G, et al. P103. The relationship between FeNO and response to anti-IL5/5R biologic therapies in severe eosinophilic asthma. Thorax. 2021;76(Suppl 1):A143–A144.
   Google Scholar
• Israel E, Panettieri RA, Israel E, Panettieri RA Jr. Anti-IgE or anti-IL5: that is the question. J Allergy Clin Immunol Pract. 2018;6(3):782–784.
   PubMed Web of Science ®Google Scholar
• Trevor JL, Chipps BE. Severe asthma in primary care: identification and management. Am J Med. 2018;131(5):484–491.
   PubMed Web of Science ®Google Scholar
• Price D, Musgrave SD, Shepstone L, et al. Leukotriene antagonists as first-line or add-on asthma-controller therapy. N Engl J Med. 2011;364(18):1695–1707.
   PubMed Web of Science ®Google Scholar
• Chauhan BF, Jeyaraman MM, Singh Mann A, et al. Addition of anti-leukotriene agents to inhaled corticosteroids for adults and adolescents with persistent asthma. Cochrane Database Syst Rev. 2017;3(3):CD010347.
   PubMed Web of Science ®Google Scholar
• Chipps BE, Corren J, Israel E; Chipps BE, Corren J, Israel E, et al. Asthma Yardstick: practical recommendations for a sustained step-up in asthma therapy for poorly controlled asthma. Ann Allergy Asthma Immunol. 2017;118(2):133–142.
   PubMed Web of Science ®Google Scholar
• Chipps BE, Bacharier LB, Farrar JR, et al. The pediatric asthma yardstick: practical recommendations for a sustained step-up in asthma therapy for children with inadequately controlled asthma. Ann Allergy Asthma Immunol. 2018;120(6):559–579.
   PubMed Web of Science ®Google Scholar
• Delgado J, Martinez-Moragón E, Fernández-Sánchez T. Factors affecting the success of step-up therapy in patients with moderate-severe asthma: a real-life study. J Investig Allergol Clin Immunol. 2021;31(2):145–150.
   PubMed Web of Science ®Google Scholar
• Gionfriddo MR, Hagan JB, Rank MA. Why and how to step down chronic asthma drugs. BMJ. 2017;359:j4438.
   PubMed Web of Science ®Google Scholar
• Rank MA, Johnson R, Branda M, et al. Long-term outcomes after stepping down asthma controller medications: a claims-based, time-to-event analysis. Chest. 2015;148(3):630–639.
   PubMed Web of Science ®Google Scholar
• DiMango E, Rogers L, Reibman J, et al. Risk factors for asthma exacerbation and treatment failure in adults and adolescents with well-controlled asthma during continuation and step-down therapy. Ann Am Thorac Soc. 2018;15(8):955–961.
   PubMed Web of Science ®Google Scholar
• Martínez-Moragón E, Delgado J, Mogrovejo S, et al., Factors that determine the loss of control when reducing therapy by steps in the treatment of moderate-severe asthma in standard clinical practice: a multicentre Spanish study. Rev Clin Esp. 220(2): 86–93. 2020.
   PubMed Web of Science ®Google Scholar
• Pérez de Llano L, García-Rivero JL, Urrutia I, et al. A simple score for future risk prediction in patients with controlled asthma who undergo a guidelines-based step-down strategy. J Allergy Clin Immunol Pract. 2019;7(4):1214–1221.
   PubMed Web of Science ®Google Scholar
• Beasley R, Harper J, Bird G, et al., Inhaled corticosteroid therapy in adult asthma. Time for a new therapeutic dose terminology. Am J Respir Crit Care Med. 199(12): 1471–1477. 2019.
   PubMed Web of Science ®Google Scholar
• Crossingham I, Evans DJ, Halcovitch NR, et al. Stepping down the dose of inhaled corticosteroids for adults with asthma. Cochrane Database Syst Rev. 2017;2(2):CD011802.
   PubMed Web of Science ®Google Scholar
• Chipps BE, Bacharier LB, Murphy KR, et al., The asthma controller step-down Yardstick. Ann Allergy Asthma Immunol. 122(3): 241–262. 2019.
   PubMed Web of Science ®Google Scholar
• Wang K, Verbakel JY, Oke J, et al., Using fractional exhaled nitric oxide to guide step-down treatment decisions in patients with asthma: a systematic review and individual patient data meta-analysis. Eur Respir J. 55(5): 1902150. 2020.
   PubMed Web of Science ®Google Scholar
• Boer S, Honkoop PJ, Loijmans RJB, et al. Personalised exhaled nitric oxygen fraction (FENO)-driven asthma management in primary care: a FENO subgroup analysis of the ACCURATE trial. ERJ Open Res. 2020;6(3):00351–2019.
   PubMedGoogle Scholar
• Truong-Thanh T, Vo-Thi-Kim A, Vu-Minh T, et al. The beneficial role of FeNO in association with GINA guidelines for titration of inhaled corticosteroids in adult asthma: a randomized study. Adv Med Sci. 2020;65(2):244–251.
   PubMed Web of Science ®Google Scholar
• Bose S, Bime C, Henderson RJ, et al. Biomarkers of type 2 airway inflammation as predictors of loss of asthma control during step-down therapy for well-controlled disease: the long-acting beta-agonist step-down study (LASST). J Allergy Clin Immunol Pract. 2020;8(10):3474–3481.
   PubMed Web of Science ®Google Scholar
• Heaney LG, Busby J, Hanratty CE, et al., Composite type-2 biomarker strategy versus a symptom-risk-based algorithm to adjust corticosteroid dose in patients with severe asthma: a multicentre, single-blind, parallel group, randomised controlled trial. Lancet Respir Med. 9(1): 57–68. 2021.
   PubMed Web of Science ®Google Scholar
• Chang AB, Beasley R. More options for managing severe asthma in adults. Lancet Respir Med. 2021;9(1):3–5.
   PubMed Web of Science ®Google Scholar
• Tran TN, King E, Sarkar R, Tran TN, King E, Sarkar R, et al. Oral corticosteroid prescription patterns for asthma in France, Germany, Italy and the UK. Eur Respir J. 2020;55(6):1902363.
   PubMed Web of Science ®Google Scholar
• Suehs CM, Menzies-Gow A, Price D, et al. Expert consensus on the tapering of oral corticosteroids for the treatment of asthma: a Delphi study. Am J Respir Crit Care Med. 2020;201(2):260–261.
   PubMed Web of Science ®Google Scholar
• Ververeli K, Chipps B. Oral corticosteroid-sparing effects of inhaled corticosteroids in the treatment of persistent and acute asthma. Ann Allergy Asthma Immunol. 2004;92(5):512–522.
   PubMed Web of Science ®Google Scholar
• Maijers I, Kearns N, Harper J, et al. Oral steroid-sparing effect of high-dose inhaled corticosteroids in asthma. Eur Respir J. 2020;55(1):1901147.
   PubMed Web of Science ®Google Scholar
• Canonica GW, Blasi F, Paggiaro P, et al. Oral CorticoSteroid sparing with biologics in severe asthma: a remark of the severe asthma network in Italy (SANI). World Allergy Organ J. 2020;13(10):100464.
   PubMed Web of Science ®Google Scholar
• Bourdin A, Husereau D, Molinari N, et al. Matching-adjusted comparison of oral corticosteroid reduction in asthma: systematic review of biologics. Clin Exp Allergy. 2020;50(4):442–452.
   PubMed Web of Science ®Google Scholar
• McGregor MC, Krings JG, Nair P, et al., Role of biologics in asthma. Am J Respir Crit Care Med. 199(4): 433–445. 2019.
   PubMed Web of Science ®Google Scholar
• Rabe KF, Nair P, Brusselle G, et al. Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma. N Engl J Med. 2018;378(26):2475–2485.
   PubMed Web of Science ®Google Scholar
• Domingo C, Pomares X, Navarro A, et al. A step-down protocol for omalizumab treatment in oral corticosteroid-dependent allergic asthma patients. Br J Clin Pharmacol. 2018;84(2):339–348.
   PubMed Web of Science ®Google Scholar
• Kupryś-Lipińska I, Kuna P. Loss of asthma control after cessation of omalizumab treatment: real life data. Postepy Dermatol Alergol. 2014;31(1):1–5.
   PubMed Web of Science ®Google Scholar
• Darveaux J. So, you’ve prescribed a biologic: now what? Ann Allergy Asthma Immunol. 2020;125(2):122–123.
   PubMed Web of Science ®Google Scholar
• Rogers L, Sugar EA, Blake K, Rogers L, Sugar EA, Blake K, et al. Step-down therapy for asthma well controlled on inhaled corticosteroid and long-acting beta-agonist: a randomized clinical trial. J Allergy Clin Immunol Pract. 2018;6(2):633–643.
   PubMed Web of Science ®Google Scholar
• Weinstein CLJ, Ryan N, Zhang X, et al. Serious asthma outcomes and asthma exacerbations with maintenance on inhaled corticosteroid (mometasone furoate)/long-acting beta agonist (formoterol) combination compared to step down to mometasone monotherapy. J Allergy Clin Immunol Pract. 2020;8(5):1634–1644.
   PubMed Web of Science ®Google Scholar
• Crespo-Lessmann A, Plaza V, González-Barcala FJ, et al. Concordance of opinions between patients and physicians and their relationship with symptomatic control and future risk in patients with moderate-severe asthma. BMJ Open Respir Res. 2017;4(1):e000189.
   PubMed Web of Science ®Google Scholar
• Gillis RME, van Litsenburg W, Van Balkom RH, et al. The contribution of an asthma diagnostic consultation service in obtaining an accurate asthma diagnosis for primary care patients: results of a real-life study. NPJ Prim Care Respir Med. 2017;27(1):35.
   PubMed Web of Science ®Google Scholar
• Braido F, Baiardini I, Alleri P, et al. Asthma management in a specialist setting: results of an Italian respiratory society survey. Pulm Pharmacol Ther. 2017;44:83–87.
   PubMed Web of Science ®Google Scholar
• Dziewa I, Craig T, Al-Shaikhly T. How frequently is asthma objectively demonstrated before starting a biologic? Quality assessment of a group practice of allergists and immunologists. Int J Environ Res Public Health. 2020;17(24):9482.
   Web of Science ®Google Scholar
• Pérez de Llano L, Martínez-Moragón E, Plaza MV, et al. Unmet therapeutic goals and potential treatable traits in a population of patients with severe uncontrolled asthma in Spain. ENEAS study. Respir Med. 2019;151:49–54.
   PubMed Web of Science ®Google Scholar
• Fahy JV. Type 2 inflammation in asthma - present in most, absent in many. Nat Rev Immunol. 2015;15(1):57–65.
   PubMed Web of Science ®Google Scholar
• Fitzpatrick AM, Chipps BE, Holguin F, et al. T2-”low” asthma: overview and management strategies. J Allergy Clin Immunol Pract. 2020;8(2):452–463.
   PubMed Web of Science ®Google Scholar
• Teague WG. Tiotropium: an effective bronchodilator in severe asthma independent of type 2 inflammation. J Allergy Clin Immunol Pract. 2019;7(7):2296–2297.
   PubMed Web of Science ®Google Scholar