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The new BTS/SIGN asthma guidelines: where evidence leads the way
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  • Published on:
    Stepping-down inhaled corticosteroid therapy in stable asthma: a secondary care perspective
    • Daniel K C Lee, Prashant S Borade, Graeme P Currie*, D Anthony Promnitz

    Dear Editor,

    It is generally appreciated that the practice of stepping-down inhaled corticosteroid (ICS) therapy in patients with stable asthma is poorly implemented, albeit in the background of limited evidence.1 Indeed, the appreciation for stepping-down ICS therapy once asthma control is attained is well established within the Global Initiative for Asthma (GINA) guidelines2 and has recently been...

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    Conflict of Interest:
    None declared.
  • Published on:
    Author's Reply

    Dear Editor

    We thank Dr Chanarin for his interest in the new Asthma Guideline. We will answer the points made in the order in which he raises them.

    1. The quoted studies on breast-feeding appear to be equivocal in terms of the protective effect on asthma, but both show protection against wheezing illness in the first years of life. The recommendation in the guideline specifies such wheezing illne...

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    Conflict of Interest:
    None declared.
  • Published on:
    BTS and SIGN asthma guidelines

    Dear Editor

    The New Guidelines use evidence based methodology extensively. This methodology has been developed by the Scottish Intercollegiate Guidelines Network and is not only well respected but has been widely applied to develop other guidelines. The guidelines use levels of evidence, I quote
    “Level A is: At least one meta analysis, systematic review, or RCT rated as 1++ and directly applicab...

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    Conflict of Interest:
    None declared.