Using blood eosinophil counts to guide asthma care in primary care

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Adults with physician-diagnosed mild to moderate asthma (GINA step 1–3) are randomized in primary care to either biomarker-directed management using blood eosinophil counts or to usual care, with follow-up visits about every four months over one year. The biomarker arm uses peripheral blood eosinophil levels to tailor anti-inflammatory treatment decisions, while the control arm follows standard clinician-guided management. Primary outcomes include asthma exacerbations, symptom control, and quality of life over the 12-month period. The trial is conducted within National Healthcare Group Polyclinics in Singapore and enrolls patients aged 21–65 without a recent exacerbation.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Singaporeans or Singapore Permanent Residents
2. Patients aged ≥21 to 65 years old
3. Physician diagnosed asthma for duration of at least 4 weeks
4. On or will be initiated on Global Initiative for Asthma (GINA) 2025 step 1-3) treatment
5. No asthma exacerbations\* in the preceding 4 weeks before randomisation
6. Able and willing to attend study appointments approximately every 4-monthly over a 1-year period
7. Able to provide informed consent
8. Stable cardiovascular status (i.e. controlled hypertension, no active symptoms of heart disease or arrhythmias) \*Exacerbations are defined as worsening of asthma symptoms requiring systemic corticosteroid for 3 or more days, emergency department visit, or hospitalization

Exclusion Criteria:

1. History of life-threatening asthma requiring intubation or intensive care unit admission
2. Severe asthma or difficult to treat asthma
3. Current use of long-term immunosuppression, LTRA receptor antagonist (Montelukast) and Theophylline or long-term oral steroids
4. Presence of other known causes of eosinophilia besides asthma (e.g. parasitic infection), based on physician's discretion and investigation as per clinical practice and suspicion
5. Current use of beta-blocking agents including eye-drops
6. Use of oral, rectal, or parenteral glucocorticoid within 30 days and/or depot parenteral glucocorticoid within 12 weeks prior to recruitment
7. Known diagnosis of Chronic Obstructive Pulmonary Disease, Interstitial lung disease or bronchiectasis
8. Any significant disease or disorder (eg. Cardiovascular, pulmonary other than asthma, gastrointestinal, hepatic, renal, neurological, musculoskeletal, endocrine, metabolic, malignant, psychiatric, major physical impairment) which, in the opinion of the investigator, may either put the patient at risk because of participation in the study, or may influence the results of the study, or the patient's ability to participate in the study
9. Current enrolment in other interventional clinical trial for asthma
10. Female subjects who are pregnant or planning pregnancy during the study period
11. Planned travel outside of the country for ≥16 consecutive weeks during the study
12. Investigator's assessment of poor capability of following study instructions or comply with study procedures

Where it's running

• National Healthcare Group Polyclinics
  Singapore, Singapore Recruiting

Study contacts

• Study coordinator: Wern Ee Tang
• Email: wern.ee.tang@nhghealth.com.sg
• Phone: (65) 6355 3000

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.