For those assigned to the internet-supported strategy, each patient had a password used to log in to a secure site where they recorded daily symptoms, lung function values, FENO value and dose of medicine that they took in the day. The values were controlled every day by a specialized asthma nurse and once a week patients received instructions about the dose of oral corticosteroids they should use. The process took about 5 minutes per day for the patient, and was well accepted. Patients could also contact the asthma nurse via the website or email in the event of questions or problems.

The researchers found that among patients assigned to the internet-supported strategy, cumulative 6-month dosing of OCS was significantly lower. "Of course, we hoped to find a positive result, because internet based self-management and management guidance by FENO has already been proven to be successful in adolescents with milder forms of asthma," said Dr. Hashimoto. "However, we were surprised that also in patients with severe prednisone-dependent asthma this strategy proved to be successful. These patients have years of continuous use of oral corticosteroids and a long history of attempts to taper their maintenance prednisone dose without success. This strategy gives them new hope that they can safely reduce the deleterious long-term side effects of prednisone."

"Our findings suggest that this novel internet-based strategy can and should be applied in all patients with severe prednisone dependent asthma to reduce total corticosteroid consumption. Internet technologies as well as biomarker driven therapies will become more and more common in future health care," Dr. Hashimoto concluded. "In the future, we will do more studies on a larger scale, to evaluate whether this strategy should be incorporated in guidelines for management of patients with severe asthma."

Source: American Thoracic Society