Trial reportThorax2026
Blood eosinophil-guided systemic corticosteroid duration in adults hospitalised for asthma exacerbation: a randomised, controlled, open-label, non-inferiority trial.
Trial report in Thorax, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05417906 (Investigating the Blood Eosinophil Count as a Biomarker to Guide Systemic Corticosteroid Treatment in Hospitalized Exacerbations of Asthma), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Investigating the Blood Eosinophil Count as a Biomarker to Guide Systemic Corticosteroid Treatment in Hospitalized Exacerbations of Asthma: a Randomized, Controlled, Open-label, Noninferiority Trial
Who cites it
1 citing paper in PubMed.
- Type 2 Inflammation in Asthma and COPD: Biomarkers, Clinical Applications, and Targeted Therapies.Journal of inflammation research · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveSystemic corticosteroids for 5-7 days are standard care for asthma exacerbations, but the optimal duration and potential for precision prescribing remain unclear. Biomarker-guided approaches could reduce corticosteroid exposure without compromising outcomes. We aimed to evaluate whether the blood eosinophil count can be used to safely reduce systemic corticosteroid exposure in hospitalised asthma exacerbations.
methodsIn this open-label, two-centre randomised trial, adults hospitalised for asthma exacerbation were assigned 1:1 to usual care (5 days prednisolone) or eosinophil-guided care using blood eosinophil counts obtained prior to corticosteroid administration (3 days if eosinophils <300 cells/µL; 5 days if ≥300 cells/µL). The primary outcome was non-inferiority of treatment failure rates (composite of extension of steroid duration, mechanical ventilation or death), with a prespecified 20% non-inferiority margin.
resultsAmong 110 randomised patients (55 per group), 60% were eosinophilic, and 40% non-eosinophilic. Treatment failure occurred in 6/55 (10.9%) of eosinophil-guided versus 4/55 (7.3%) of usual care patients, with a 3.6% absolute difference (95% CI -8.9% to 16.2%), meeting non-inferiority. Cumulative corticosteroid dose per patient was similar between groups but significantly lower for non-eosinophilic than eosinophilic exacerbations in the eosinophil-guided group (136 vs 214 mg; p=0.0004), a difference not observed in usual care (186 vs 211 mg; p=0.18). Length of stay, Asthma Control Questionnaire-5 change, additional steroid bursts at 14 days or time to next exacerbation up to 1 year showed no significant differences.
conclusionEosinophil-guided therapy safely reduced systemic corticosteroid exposure in non-eosinophilic exacerbations while maintaining non-inferior outcomes in this proof-of-concept trial. TRIAL REGISTRATION NUMBER: NCT05417906.
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