Nocturnal temperature controlled laminar airflow for treating atopic asthma: a randomised controlled trial

• Published in: Thorax Vol. 67; no. 3; pp. 215 - 221
• Main Authors: Boyle, Robert J, Pedroletti, Christophe, Wickman, Magnus, Bjermer, Leif, Valovirta, Erkka, Dahl, Ronald, Von Berg, Andrea, Zetterström, Olof, Warner, John O
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group 01.03.2012; BMJ Publishing Group LTD; BMJ Group
• Series: Original article
• Subjects: Adolescent; Adult; Aged; Air Movements; Allergens; Allergens - adverse effects; Allergens - analysis; Allergies; Anti-Asthmatic Agents - administration & dosage; Asthma; Asthma - etiology; Asthma - physiopathology; Asthma - therapy; Asthma and the Environment; Biological and medical sciences; Cardiology. Vascular system; Child; Chronic obstructive pulmonary disease, asthma; Clinical Medicine; Double-Blind Method; Drug Administration Schedule; Environment, Controlled; Female; Humans; Immunoglobulin E - biosynthesis; Inflammation; Inhalation Exposure - adverse effects; Inhalation Exposure - prevention & control; Klinisk medicin; Laboratories; Lung - physiopathology; Lungmedicin och allergi; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Pneumology; Quality of Life; Questionnaires; Respiratory Medicine and Allergy; Sleep - physiology; Steroids; Temperature; Treatment Outcome; Young Adult; Sweden; Allergy; Immunopathology; Lung disease; Temperature; Respiratory disease; Asthma; Atopy; Air flow; Treatment; Bronchus disease; Anesthesia; Obstructive pulmonary disease; Circulatory system; Cardiology
• ISSN: 0040-6376; 1468-3296; 1468-3296
• DOI: 10.1136/thoraxjnl-2011-200665

ObjectiveTo determine whether environmental control using nocturnal temperature controlled laminar airflow (TLA) treatment could improve the quality of life of patients with persistent atopic asthma.DesignRandomised, double-blind, placebo-controlled, parallel-group trial.SettingNineteen European asthma clinics.Participants312 patients aged 7–70 with inadequately controlled persistent atopic asthma.Main outcome measureProportion of patients with an increase of ≥0.5 points in asthma quality of life score after 1 year of treatment.ResultsTLA devices were successfully installed in the bedrooms of 282 (90%) patients included in the primary efficacy analysis. There was a difference in treatment response rate between active (143 of 189, 76%) and placebo (56 of 92, 61%) groups, difference 14.8% (95% CI 3.1 to 26.5, p=0.02).3 In patients aged ≥12, on whom the study was powered, the difference in response rate was similar-active 106 of 143 (74%), placebo 42 of 70 (60%), difference 14.1% (0.6 to 27.7, p=0.059). There was a difference between groups in fractional exhaled nitric oxide change of −7.1 ppb (−13.6 to −0.7, p=0.03). Active treatment was associated with less increase in cat-specific IgE than placebo. There was no difference in adverse event rates between treatment groups.ConclusionInhalant exposure reduction with TLA improves quality of life, airway inflammation and systemic allergy in patients with persistent atopic asthma. TLA may be a treatment option for patients with inadequately controlled persistent atopic asthma.Trial registration numberClinical Trials NCT00986323.