Page 87 - Comprehensive treatment of patients with glucocorticoid-dependent severe asthma

Predictors of benefit from high altitude treatment
Furthermore, although the current study was not designed to compare high altitude climate therapy with similar in-house treatment at sea level, it would have been worth to evaluate the effect of a similar program at sea level for these patients. A prospective comparative study is currently ongoing in the Netherlands (NTR5182).
Finally, some parameters (total IgE, blood eosinophils, 6 minutes walking distance) were not assessed on two occasions in all patients, which might have affected the power of our study. Still, meaningful results could be obtained, despite this potential lack of power.
In conclusion, this study shows that high altitude climate therapy improves quality of life and lung function in all patients with severe asthma. Maintenance oral steroid use, body weight, and blood eosinophils improve to a variable extent depending on patient characteristics, such as age, degree of asthma control, total IgE and fatigue score before admission. For clinicians these results show that the benefits of high altitude are multiple and diverse, and that for each patient with severe asthma a specific treatment target can be formulated. Identifying predictors of improvement of high climate therapy is the first step toward understanding mechanisms of the different phenotypes of severe asthma, as well as the beneficial effects of a low-trigger environment.
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