Page 125 - Comprehensive treatment of patients with glucocorticoid-dependent severe asthma

Internet-based tapering of OCS in severe asthma
Mixed-effects regression model analysis showed a total decrease in daily prednisone requirement from baseline of -4.79 mg/day (daily decrease of -0.019 (SE 0.0014) in the internet group as compared to + 1.59 mg/day (daily increase +0.001 (SE 0.0032)) in the conventional management group, p<0.001 (Figure 2). Ten out of 51 patients in the internet group (and none of the patients in the conventional management group, p=0.004) managed to taper their oral corticosteroid dose to zero mg, with a mean (SD) duration of 79.7(12.8) oral corticosteroid free days over 6 months.
Figure 2. Changes in maintenance dose of corticosteroids over 6 months
Legend figure 2. The figure shows the change in maintenance dose of prednisone from baseline in each study group over the course of 180 days. • and ▲ represent the mean daily changes of prednisone equivalent in the internet group and the conventional management group, respectively; lines represent the slope from mixed-effects regression model. P<0.001 is for the comparison between the two groups according to mixed-effects regression model.
ACQ and AQLQ
Asthma control remained stable in both groups, with a mean change in ACQ score of 0.26 (95% CI: 0.07 to 0.45) and 0.12 (95% CI: -0.12 to 0.36) in the internet group and conventional management group, respectively (p=0.37).
Similarly, AQLQ changes were not different between the study groups (Table 3) with mean changes of -0.03 (95% CI: -0.24 to 0.18) and 0.14 (95% CI: -0.13 to 0.41) in the internet and conventional management group, respectively (p=0.30).
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