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

OBJECTIVE To determine whether environmental control using nocturnal temperature controlled laminar airflow (TLA) treatment could improve the quality of life of patients with persistent atopic asthma. DESIGN Randomised, double-blind, placebo-controlled, parallel-group trial. Setting Nineteen European asthma clinics. PARTICIPANTS 312 patients aged 7-70 with inadequately controlled persistent atopic asthma. MAIN OUTCOME MEASURE Proportion of patients with an increase of ≥0.5 points in asthma quality of life score after 1 year of treatment. RESULTS TLA 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. CONCLUSION Inhalant 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 number Clinical Trials NCT00986323.