Despite the growing body of research on the use of biomarkers to guide asthma treatment, clinicians are still resistant to their use in daily practice, research shows.
A survey of Australian members of the TSANZ Asthma Special Interest Group found only 53% of the 17 respondents were using or would like to use biomarkers to adjust corticosteroid treatment.
Slightly more of the respondents (58%) did not agree that biomarker based adjustment of corticosteroid dose is currently the optimal way to adjust corticosteroid treatment in patients with severe asthma compared to symptoms, lung function and exacerbation history.
Most respondents said use of biomarkers would be justified if ≥20% of patients requiring maintenance OCS could have a dose reduction.
The consensus was that a ≥5 mg daily oral prednisolone dose reduction would be clinically meaningful.
Regarding inhaled corticosteroids (ICS), the majority of survey respondents (59%) said biomarkers would be justified if ≥50% of patients could have a dose reduction.
The consensus was that ≥400 μg reduction in daily ICS would be regarded as clinically meaningful.
Similarly, biomarkers would be justified if they could achieve a ≥25% reduction in asthma exacerbations.
Respondents also indicated about 40% of their severe asthma patients had suboptimal adherence to ICS treatment and ≥30% of severe asthma patients in their clinic had persistent symptoms that were not corticosteroid responsive.
Senior investigator Professor Peter Wark of the University of Newcastle, NSW, told the limbic it would be helpful if clinicians were more open to the possibilities of incorporating the current biomarkers into day-to-day practice.
However he acknowledged that it takes time for clinical practice to change.