Individualizing Treatment for Asthma in Primary Care: Comparing Rescue Inhaled Corticosteroids and Azithromycin in a Randomized Trial

What this Trial Is About

Researchers are studying different ways to reduce asthma exacerbations in primary care patients who have persistent asthma. This study compares two treatment approaches: using inhaled corticosteroids (ICS) as rescue therapy, known as MART or PARTICS therapy, and using the antibiotic azithromycin as a preventive treatment. The study aims to find the best way to tailor asthma treatment to individual patient needs while monitoring for long-term side effects of ICS use. The study randomly assigns 3200 participants into four groups: one using rescue inhaled corticosteroids (R-ICS) alone, one using azithromycin alone, one using both R-ICS and azithromycin, and a control group receiving enhanced usual care. R-ICS treatment includes corticosteroid/formoterol inhalers or stand-alone ICS inhalers combined with usual rescue therapy. Azithromycin is given three times a week, starting at 500mg and possibly reduced to 250mg if side effects occur. All participants use a web-based Asthma Symptom Monitoring tool to track symptoms and communicate with their care team. Participants will be followed for up to 16 months to measure the rate of asthma exacerbations per year and assess asthma control, quality of life, and days lost from work or school due to asthma. The study collects symptom data weekly through the monitoring app, and exacerbations are reviewed blindly. Those experiencing frequent exacerbations may have their treatment adjusted. Participants completing azithromycin treatment may be followed for an additional 12 months after stopping the drug to monitor outcomes and safety.

Individualizing Treatment for Asthma in Primary Care (Full Study)