Extract
We read the study of Ruffles et al. [1] with great interest. The authors undertook one of the first randomised controlled trials (RCTs) assessing the potential benefit of personalised prescription of bronchodilators according to Arg16Gly beta-2 genotype in adolescent patients with asthma. Following a 1-month run-in with inhaled corticosteroid (ICS) monotherapy, the intervention group received a bronchodilator according to their genotype, where AA and AG genotypes received an oral leukotriene antagonist (LTRA), montelukast, and GG genotype received an inhaled long-acting β2-agonist (LABA), salmeterol. The control group received usual care based on the British Thoracic Society guidelines, where addition of a LABA is first choice when patients are uncontrolled on ICS alone. The authors found a small but significant (p=0.048) benefit on the Pediatric Asthma Quality of Life Questionnaire in the intervention group.
Abstract
Medication adherence and inhaler technique may confound, in both a positive and a negative manner, outcomes of pharmacogenetic asthma studies. The importance of understanding patient behaviour when interpreting their biology should be emphasised. https://bit.ly/3tQdh1p
Footnotes
Conflict of Interest: J.F.M. van Boven reports grants from AstraZeneca, grants and personal fees from Boehringer Ingelheim, Chiesi and Trudell Medical, personal fees from Menarini, Novartis and Teva, outside the submitted work; and has received funding from the European Commission to Chair the European Network to Advance Best practices and technoLogy on medication adherencE (COST Action CA19132, ENABLE).
Conflict of interest: B.J.H. Dierick has nothing to disclose.
Conflict of interest: O.S. Usmani reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi and GlaxoSmithKline, grants from Edmond Pharma, personal fees from Napp, Mundipharma, Sandoz, Takeda, Cipla, Covis, Novartis, Mereobiopharma, Orion and Menarini, outside the submitted work.
- Received January 31, 2021.
- Accepted February 8, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org