Benefits from asthma drugs - what patients really want

asthma drugs


Traditionally, trials of new asthma medicines have studied objective outcomes such as improvements in lung function or symptoms, believing these to be important for both the doctor and the patient.

However, some of our preconceived ideas about what patients want are being challenged by studies which show that the benefits which patients experience are often not measured in traditional clinical trials. Lung function is commonly used as the primary endpoint in asthma clinical trials, but it may not reflect changes which are important to patients.

Christine Jenkins (Woolcock Institute of Medical Research, Camperdown, Australia) and her colleagues examined the traditional and patient-focussed benefits achieved by three commonly prescribed classes of asthma drugs. They compared and related the changes in lung function and symptoms with patient-centred endpoints such as quality of life and a global rating of asthma control during treatment with three classes of asthma medication - a long acting bronchodilator, an inhaled preventer and an oral preventer medication.

The study shows that the perceived effectiveness of a drug is dependent on the specific endpoints which are examined.

For example, an inhaled corticosteroid, fluticasone, was superior to a long-acting bronchodilator, formoterol, for clinic lung function and airway responsiveness (the sensitivity of the airways); equivalent to formoterol for symptom control, morning peak flow readings, daytime reliever use, quality of life and patient assessments of asthma control; and inferior to formoterol for night-time asthma prevention.

The study found that in asthma treatment, traditional endpoints do not fully capture patient-centred benefits.

It is important to understand more about the effects of medications that patients value, to appreciate that some treatments may be preferred by patients on the basis of changes which may not be measured in conventional clinical trials.

Patients may be aware of a day-to-day protective benefit which is not reflected in any single functional assessment, and clinical trials should aim to include these measures when assessing new treatments.




Title of the original article:
Traditional and patient-centred outcomes with three classes of asthma medication

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