Stepping down asthma medicines can be done safely and at less cost for patients says a new Mayo Clinic study published this week in The Journal of Allergy and Clinical Immunology. It is common for patients and doctors to test out if taking less daily asthma medicine is safe — primarily because of the high cost of asthma medicine. However, deciding when to step down daily asthma medicines can be challenging, and it would be helpful to understand the risks involved.
The study, led by Matthew Rank, M.D., an allergy and immunology specialist at Mayo Clinic in Arizona, analyzed asthma outcomes after patients stepped down their daily asthma medicines. The team studied more than 4,000 patients (adults and children) who were taking daily asthma medicines and focused their analysis on two groups: patients who had stable asthma for at least one year who stayed on their same daily asthma medicine and patients who had stable asthma for at least one year who stepped down their daily asthma medicine.
Stepping down asthma medicines in patients who have had stable asthma for at least one year appears to be as safe as continuing the same level of medicines, the study found. Only 11 percent of patients had problems with their asthma in the 4-5 months after stepping down their asthma medicines.
"Trying to reduce the daily asthma medicine speaks to the principle of using the least amount of medicine to control symptoms and prevent attacks," Dr. Rank says.
Additionally, the study is the first to broadly consider the financial costs. Patients who stepped down their asthma medicines saved an average $34 each month compared to patients who maintained their same level of medicines. The authors did not find increased costs for patients who stepped down for hospital or emergency asthma care. Also, patients who stepped down did not miss any more work or school than patients who kept their medicines at the same level.
"This study is important because many people with asthma may be able to safely reduce their asthma medicines with the appropriate guidance from their healthcare teams," Dr. Rank added. "Many patients try to step down on their own but we encourage patients to work with their doctors before doing so."
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