Late Breaking Abstract - Risk of a severe exacerbation following higher reliever use: post-hoc analysis of SYGMA 1 in mild asthma
Bibliographic record
Abstract
Rationale: In mild asthma, as-needed budesonide/formoterol (BUD/FORM) reduces long-term severe exacerbation risk vs terbutaline as-needed, with similar reduction as maintenance BUD + terbutaline as-needed. In a post-hoc analysis of SYGMA 1 (NCT02149199) we examined the short-term risk of a severe exacerbation after a single day at various levels of reliever use, comparing BUD/FORM as-needed vs terbutaline as-needed ± maintenance BUD. Methods: 3836 patients with mild asthma were randomised to placebo twice-daily (bid) + terbutaline 0.5mg as-needed, placebo bid + BUD/FORM 200/6µg as-needed or maintenance BUD 200µg bid + terbutaline as-needed. The proportion of patients with >2, >4, >6 or >8 reliever inhalations on any day, with an exacerbation during the next 21 days were compared. Results: The proportion of patients with >4, >6 or >8 as-needed inhalation use days was lower with BUD/FORM as-needed vs terbutaline as-needed ± maintenance budesonide, with reduced risk of severe exacerbation during the next 21 days vs terbutaline as-needed (Fig). The safety of BUD/FORM as-needed was consistent across all inhalation groups, with no new safety findings. Conclusions: In mild asthma, anti-inflammatory reliever therapy with BUD/FORM as-needed reduces higher (>4 inhalations) reliever use days and reduces exacerbations within the next 21 days vs terbutaline as-needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.009 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.011 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.015 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".