INITIAL - An observational study of disease severity in newly diagnosed asthma patients and initial response following 12 weeks' treatment

Jiangtao Lin, Xiuhua Fu, Ping Jiang, Weidong Song, Xiaoyun Hu, Zhijun Jie, Chuntao Liu, Zhengguang He, Xiangdong Zhou, Huaping Tang, Jiangtao Lin, Xiuhua Fu, Ping Jiang, Weidong Song, Xiaoyun Hu, Zhijun Jie, Chuntao Liu, Zhengguang He, Xiangdong Zhou, Huaping Tang

Abstract

In China, there are an estimated 30 million people with asthma, a condition that remains poorly controlled in many patients. The INITIAL study (NCT02143739) was a 12-week, multicentre, prospective, observational study comprising 45 centres across Northern and Southern China that aimed to assess asthma severity among newly diagnosed patients as well as their prescribed medications and response to treatment. The primary objective was to evaluate asthma severity using Global Initiative for Asthma (GINA) 2006 research criteria. Secondary objectives included the distribution of asthma medication by GINA severity category and evaluation of GINA 2012-defined control levels. Medications were prescribed as per usual clinical practice. At baseline, among 4491 patients, 3.9%, 12.0%, 22.6% and 61.6% had intermittent, mild persistent, moderate persistent and severe persistent asthma, respectively. Inhaled corticosteroid/long-acting β2 agonist was the most common initial therapy in 90.2% of patients. GINA 2012-defined controlled asthma levels increased in all groups, rising from 6.1% at baseline to 43.0%, 53.8% and 67.8% at Weeks 4, 8 and 12, respectively. Most patients presented with severe persistent asthma. Newly diagnosed patients with asthma could benefit from at least 3 months of regular treatment followed by long-term pharmacological management.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Patient flow. *One patient was considered to have completed the study as they were interviewed by telephone at Week 12 despite being considered discontinued by investigators. FAS, full analysis set.
Figure 2
Figure 2
GINA 2012-defined asthma control levels. *Missing data for one patient; †Missing data for 2942 patients; ‡Missing data for 2947 patients; §Missing data for 964 patients.

References

    1. Lin J, et al. Review and outlook of asthma management within the past 60 years in China. Zhonghua Jie He He Hu Xi Za Zhi. 2013;36:907–910.
    1. Zhong N, et al. Uncontrolled asthma and its risk factors in adult Chinese asthma patients. Ther. Adv. Respir. Dis. 2016;10:507–517. doi: 10.1177/1753465816663978.
    1. Yan B, et al. Asthma control and severe exacerbations in patients with moderate or severe asthma in Jilin Province, China: a multicenter cross-sectional survey. BMC Pulm. Med. 2016;16:130. doi: 10.1186/s12890-016-0292-3.
    1. Su N, et al. Evaluation of asthma control: a questionnaire-based survey in China. Chin. Med. J. 2014;127:2030–2036.
    1. Schatz M, et al. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J. Allergy Clin. Immunol. 2006;117:549–556. doi: 10.1016/j.jaci.2006.01.011.
    1. Global Initiative for Asthma (GINA). GINA report: global strategy for asthma management and prevention (2006).
    1. Thompson PJ, et al. Insights, attitudes and perceptions about asthma and its treatment: findings from a multinational survey of patients from 8 Asia-Pacific countries and Hong Kong. Respirology. 2013;18:957–967. doi: 10.1111/resp.12137.
    1. Global Initiative for Asthma (GINA). GINA report: global strategy for asthma management and prevention (2018).
    1. Chinese Thoracic Society Guideline for management of asthma (definition, diagnosis, treatment and management of asthma) from Asthma Study Group of Chinese Thoracic Society. Zhonghua Jie He He Hu Xi Za Zhi. 2008;31:177–185.
    1. Asthma Workgroup, Chinese Thoracic Society & Chinese Medical Association Chinese expert consensus on bronchial asthma control. J. Thorac. Dis. 2014;6:E61–E69.
    1. Global Initiative for Asthma (GINA). GINA report: global strategy for asthma management and prevention (2012).
    1. Juniper EF, O’Byrne PM, Roberts JN. Measuring asthma control in group studies: do we need airway calibre and rescue beta2-agonist use? Respir. Med. 2001;95:319–323. doi: 10.1053/rmed.2001.1034.
    1. Juniper EF, Svensson K, Mork AC, Stahl E. Measurement properties and interpretation of three shortened versions of the asthma control questionnaire. Respir. Med. 2005;99:553–558. doi: 10.1016/j.rmed.2004.10.008.
    1. Chen W. The natural history of severe asthma and influences of early risk factors: a population-based cohort study. Thorax. 2016;71:267–275. doi: 10.1136/thoraxjnl-2015-207530.
    1. Firoozi F, Lemière C, Beauchesne M, Forget A, Blais L. Development and validation of database indexes of asthma severity and control. Thorax. 2007;62:581–587. doi: 10.1136/thx.2006.061572.
    1. Global Initiative for Asthma (GINA). GINA report: global strategy for asthma management and prevention (2014).

Source: PubMed

3
Iratkozz fel