Using blood eosinophil counts to guide asthma care in primary care
Randomised Controlled Trial Of Blood Eosinophil Guided Versus Usual Care In The Management Of Mild To Moderate Asthma at Primary Care (BEAM)
This trial tests whether using blood eosinophil counts to guide treatment can reduce exacerbations and improve symptoms and quality of life for adults with mild to moderate asthma managed in primary care.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 240 (estimated) |
| Ages | 21 Years to 65 Years |
| Sex | All |
| Sponsor | National Healthcare Group Polyclinics Government |
| Locations | 1 site (Singapore) |
| Trial ID | NCT07486401 on ClinicalTrials.gov |
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.
Who should consider this trial
Good fit: Adults aged 21–65 who are Singapore citizens or permanent residents with physician-diagnosed mild to moderate asthma on GINA step 1–3 therapy and no exacerbation in the prior 4 weeks are ideal candidates.
Not a fit: Patients with severe or difficult-to-treat asthma, a history of life‑threatening asthma, current long-term immunosuppression, or those who do not meet the age or residency criteria are unlikely to benefit from this trial.
Why it matters
Potential benefit: If successful, using blood eosinophil levels to guide treatment could reduce asthma exacerbations and improve symptom control and quality of life by personalizing therapy.
How similar studies have performed: Prior research indicates blood eosinophil counts can predict exacerbation risk and corticosteroid responsiveness, but randomized evidence for biomarker-guided management in primary care for mild–moderate asthma remains limited.
Eligibility criteria
Show full inclusion / exclusion criteria
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 this trial is running
Singapore
- 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
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.