@article{thomas_high-dose_2009,
	title = {High-dose inhaled corticosteroids versus add-on long-acting beta-agonists in asthma: an observational study},
	volume = {123},
	issn = {1097-6825},
	shorttitle = {High-dose inhaled corticosteroids versus add-on long-acting beta-agonists in asthma},
	doi = {10.1016/j.jaci.2008.09.035},
	abstract = {BACKGROUND: Guidelines recommend that for patients uncontrolled on inhaled corticosteroids (ICSs), step-up options include an increase in ICS dosage or addition of a long-acting beta-agonist (LABA). Controversy persists about the best option in routine practice.
OBJECTIVE: To compare asthma outcomes in patients whose first step-up from ICS monotherapy was by addition of LABA (LABA cohort) or increase in ICS dosage or formulation (ICS cohort).
METHODS: Observational study using the General Practice Research Database, comparing outcomes in the following 12 months with regression modeling allowing for baseline cohort differences: age, sex, socioeconomic status, body mass index, comorbidity (rhinitis, heart disease), smoking status, short-acting beta-agonist (SABA) use, oral corticosteroid use, and use of asthma complicating medication.
RESULTS: We found 46,930 patients in the ICS and 17,418 in the LABA cohort. In adjusted analysis, the odds ratio (95\% CI) of successful treatment (no hospitalization, no oral corticosteroid use, average daily SABA use {\textless}1 dose/d) was lower in the ICS cohort (0.75; 0.72-0.79). The adjusted odds ratio of needing rescue SABA prescriptions was higher in the ICS cohort (1.67; 1.59-1.76). However, the adjusted odds of using any oral corticosteroids were lower (0.75; 0.71-0.78), particularly of using 3 or more courses (0.50, 0.46-0.55), and the adjusted odds of respiratory hospitalization were lower (0.69; 0.59-0.81).
CONCLUSION: Although symptomatic control and rescue bronchodilator use may be improved by the addition of a LABA to ICS, there may be a lower risk of severe exacerbations and hospitalizations from ICS dose increase.},
	language = {eng},
	number = {1},
	journal = {The Journal of Allergy and Clinical Immunology},
	author = {Thomas, Mike and von Ziegenweidt, Julie and Lee, Amanda J. and Price, David},
	month = jan,
	year = {2009},
	pmid = {18986690},
	keywords = {Administration, Oral, Adolescent, Adrenal Cortex Hormones, Adult, Asthma, Bronchodilator Agents, Child, Databases, Factual, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Models, Theoretical, Regression Analysis, Risk Factors},
	pages = {116--121.e10}
}

{"_id":"93gjAJkeQBDFeE7qq","bibbaseid":"thomas-vonziegenweidt-lee-price-highdoseinhaledcorticosteroidsversusaddonlongactingbetaagonistsinasthmaanobservationalstudy-2009","downloads":0,"creationDate":"2017-08-15T09:38:11.410Z","title":"High-dose inhaled corticosteroids versus add-on long-acting beta-agonists in asthma: an observational study","author_short":["Thomas, M.","von Ziegenweidt, J.","Lee, A. J.","Price, D."],"year":2009,"bibtype":"article","biburl":"http://bibbase.org/zotero/veegee78","bibdata":{"bibtype":"article","type":"article","title":"High-dose inhaled corticosteroids versus add-on long-acting beta-agonists in asthma: an observational study","volume":"123","issn":"1097-6825","shorttitle":"High-dose inhaled corticosteroids versus add-on long-acting beta-agonists in asthma","doi":"10.1016/j.jaci.2008.09.035","abstract":"BACKGROUND: Guidelines recommend that for patients uncontrolled on inhaled corticosteroids (ICSs), step-up options include an increase in ICS dosage or addition of a long-acting beta-agonist (LABA). Controversy persists about the best option in routine practice. OBJECTIVE: To compare asthma outcomes in patients whose first step-up from ICS monotherapy was by addition of LABA (LABA cohort) or increase in ICS dosage or formulation (ICS cohort). METHODS: Observational study using the General Practice Research Database, comparing outcomes in the following 12 months with regression modeling allowing for baseline cohort differences: age, sex, socioeconomic status, body mass index, comorbidity (rhinitis, heart disease), smoking status, short-acting beta-agonist (SABA) use, oral corticosteroid use, and use of asthma complicating medication. RESULTS: We found 46,930 patients in the ICS and 17,418 in the LABA cohort. In adjusted analysis, the odds ratio (95% CI) of successful treatment (no hospitalization, no oral corticosteroid use, average daily SABA use \\textless1 dose/d) was lower in the ICS cohort (0.75; 0.72-0.79). The adjusted odds ratio of needing rescue SABA prescriptions was higher in the ICS cohort (1.67; 1.59-1.76). However, the adjusted odds of using any oral corticosteroids were lower (0.75; 0.71-0.78), particularly of using 3 or more courses (0.50, 0.46-0.55), and the adjusted odds of respiratory hospitalization were lower (0.69; 0.59-0.81). CONCLUSION: Although symptomatic control and rescue bronchodilator use may be improved by the addition of a LABA to ICS, there may be a lower risk of severe exacerbations and hospitalizations from ICS dose increase.","language":"eng","number":"1","journal":"The Journal of Allergy and Clinical Immunology","author":[{"propositions":[],"lastnames":["Thomas"],"firstnames":["Mike"],"suffixes":[]},{"propositions":["von"],"lastnames":["Ziegenweidt"],"firstnames":["Julie"],"suffixes":[]},{"propositions":[],"lastnames":["Lee"],"firstnames":["Amanda","J."],"suffixes":[]},{"propositions":[],"lastnames":["Price"],"firstnames":["David"],"suffixes":[]}],"month":"January","year":"2009","pmid":"18986690","keywords":"Administration, Oral, Adolescent, Adrenal Cortex Hormones, Adult, Asthma, Bronchodilator Agents, Child, Databases, Factual, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Models, Theoretical, Regression Analysis, Risk Factors","pages":"116--121.e10","bibtex":"@article{thomas_high-dose_2009,\n\ttitle = {High-dose inhaled corticosteroids versus add-on long-acting beta-agonists in asthma: an observational study},\n\tvolume = {123},\n\tissn = {1097-6825},\n\tshorttitle = {High-dose inhaled corticosteroids versus add-on long-acting beta-agonists in asthma},\n\tdoi = {10.1016/j.jaci.2008.09.035},\n\tabstract = {BACKGROUND: Guidelines recommend that for patients uncontrolled on inhaled corticosteroids (ICSs), step-up options include an increase in ICS dosage or addition of a long-acting beta-agonist (LABA). Controversy persists about the best option in routine practice.\nOBJECTIVE: To compare asthma outcomes in patients whose first step-up from ICS monotherapy was by addition of LABA (LABA cohort) or increase in ICS dosage or formulation (ICS cohort).\nMETHODS: Observational study using the General Practice Research Database, comparing outcomes in the following 12 months with regression modeling allowing for baseline cohort differences: age, sex, socioeconomic status, body mass index, comorbidity (rhinitis, heart disease), smoking status, short-acting beta-agonist (SABA) use, oral corticosteroid use, and use of asthma complicating medication.\nRESULTS: We found 46,930 patients in the ICS and 17,418 in the LABA cohort. In adjusted analysis, the odds ratio (95\\% CI) of successful treatment (no hospitalization, no oral corticosteroid use, average daily SABA use {\\textless}1 dose/d) was lower in the ICS cohort (0.75; 0.72-0.79). The adjusted odds ratio of needing rescue SABA prescriptions was higher in the ICS cohort (1.67; 1.59-1.76). However, the adjusted odds of using any oral corticosteroids were lower (0.75; 0.71-0.78), particularly of using 3 or more courses (0.50, 0.46-0.55), and the adjusted odds of respiratory hospitalization were lower (0.69; 0.59-0.81).\nCONCLUSION: Although symptomatic control and rescue bronchodilator use may be improved by the addition of a LABA to ICS, there may be a lower risk of severe exacerbations and hospitalizations from ICS dose increase.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {The Journal of Allergy and Clinical Immunology},\n\tauthor = {Thomas, Mike and von Ziegenweidt, Julie and Lee, Amanda J. and Price, David},\n\tmonth = jan,\n\tyear = {2009},\n\tpmid = {18986690},\n\tkeywords = {Administration, Oral, Adolescent, Adrenal Cortex Hormones, Adult, Asthma, Bronchodilator Agents, Child, Databases, Factual, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Models, Theoretical, Regression Analysis, Risk Factors},\n\tpages = {116--121.e10}\n}\n\n","author_short":["Thomas, M.","von Ziegenweidt, J.","Lee, A. 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