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Table 3 Treatment strategy algorithms

From: Asthma control cost-utility randomized trial evaluation (ACCURATE): the goals of asthma treatment

 

Levels of asthma control

 

Strategy

Strictly controlled

Sufficiently controlled

Uncontrolled

STRICT-strategy

- 3 mo: no change

step-up: treatment choice

step-up: treatment choice

 

- > 3 mo: step-down

  

SUFF-strategy

step-down

no change

step-up: treatment choice

FeNO strategy

   

- Low FeNO level

step-down

- 3 mo: no change/change within current step to LABA

step-up: LABA

  

- > 3 mo: step-down ICS

 

- Intermediate FeNO level

no change

step-up: treatment choice

step-up: treatment choice

- High FeNO level

step-up/change within current step to ICS

step-up: 1 × ICS

step-up: 2 × ICS*

  1. STRICT-strategy = strictly controlled strategy; SUFF-strategy = sufficiently controlled strategy. A raised FeNO level is indicative of eosinophilic airway inflammation; ICS = inhaled corticosteroids; LABA = long-acting ß2-agonist. *until a maximum high dose of ICS is reached