Extract
N.C. Thomson and R. Chaudhuri raise an important issue about treatment recommendations for patients with asthma who have a significant smoking history. The exclusion of such patients from most asthma studies appears to have largely been driven by the requirement by regulators for pure “asthma” and “COPD” populations in pharmacotherapy studies that are designed for obtaining regulatory approval. However, once that is obtained, there is an important need for additional clinical trials to be performed in broader populations, and with more pragmatic designs, to increase the generalisability of evidence to clinical practice. Considering the large number of randomised controlled trials in asthma in the past 20 years, very few studies have included patients with a significant smoking history; N.C. Thomson and R. Chaudhuri are to be commended for their work in this area.
Abstract
The 2019 GINA recommendations are supported by clinical trials in >10000 mild asthma patients. For any treatment decision, GINA recommends that clinicians should consider individual patient characteristics/risk factors as part of shared decision making. http://bit.ly/2ZqboJ2
Footnotes
Conflict of interest: H.K. Reddel reports research grants and personal fees for data monitoring committee work, consultancy, advisory board work and providing education from AstraZeneca, research grants, personal fees for data monitoring committee work, consultancy, advisory board work and providing education and non-financial support (study medication) from GlaxoSmithKline, personal fees for data monitoring committee work from Merck, research grants and personal fees for data monitoring committee work, advisory board work and providing education from Novartis, personal fees for providing education from Teva and Mundipharma, personal fees for advisory board work and providing education from Boehringer Ingelheim, personal fees for advisory board work from Sanofi Genzyme, outside the submitted work; and is Chair of the GINA Science Committee.
- Received January 13, 2020.
- Accepted January 13, 2020.
- Copyright ©ERS 2020
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