Source: Annual Congress 2002 - Asthma - Therapy and management -2
Disease area: Airway diseases

Abstract

The GINA/NIH aims of asthma treatment constitute asthma control. However, in clinical trials and clinical practice there is little consensus on how asthma control should be assessed, and often only single endpoints, such as lung function, are used. The Gaining Optimal Asthma controL (GOAL) study has used a rigorous, composite target for asthma control, derived from the GINA/NIH guidelines, using multiple endpoints. Following a 4 week run-in on current treatment, patients not well-controlled according to this guideline-based definition were randomised into the GOAL study. Using baseline data available from 3323 not well-controlled, randomised patients we investigated which parameters had the greatest impact on control status. The most common reasons for failing to achieve control were morning PEF <80% predicted (88%); rescue medication use (86%); daily symptoms (76%) and night-time awakenings (71%). Patients frequently failed to achieve control for more than one reason: 45% of patients failed on a combination of rescue medication use, daily symptoms, night-time awakenings and PEF. These data show that up to 29% of patients assessed as being not well-controlled overall using the composite endpoint, passed on single parameters, such as PEF, daily symptoms and night-time awakenings. These GOAL baseline data demonstrate that the use of a single endpoint overestimates the level of control achieved. The GOAL study will prospectively test the proportion of patients in whom guideline-defined asthma control can be achieved, using a composite endpoint derived from GINA/NIH guidelines.

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Citations should be made in the following way:
T. J. H. Clark, E. D. Bateman, M. H. James, on Behalf of the GOAL Steering Committee (London, Uxbridge, United Kingdom; Cape Town, South Africa). Assessing asthma control using a composite measure based on GINA/NIH guidelines: an analysis of GOAL baseline data. Eur Respir J 2002; 20: Suppl. 38, 406

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