Aiming for Total Control

1. Aiming for Total Control Study Can it be achieved and what are the benefits?

2. Symptoms are the tip of the Iceberg Symptoms _____________ Inflammation

3. High frequency of hospital visits due to asthma in the previous year 15 Hospitalised in 7 past year 9 Asia Pacific Europe 19 Hospital 10 USA emergency room 23 visits 30 Unscheduled 25 emergency visits 29 0 10 20 30 40 50 Lai et al. Eur Respir J 2001 Rabe et al. Eur Respir J 2000 Rickard et al. J Allergy Clin Immunol 1999 www.asthmainamerica.com % of patients

4. Frequent school and work absence due to asthma in the previous year 36 School absence 43 49 Asia Pacific Europe USA 26 Work absence 17 25 0 20 40 60 % of patients Lai et al. Eur Respir J 2001 Rabe et al. Eur Respir J 2000 Rickard et al. J Allergy Clin Immunol 1999

5. Pediatric asthma deaths: patients with mild asthma are also at risk Total Asthma-related deaths split by severity Findings from a cohort study reviewing all asthma-related deaths (n=51) in patients aged <20 years in the Australian state of Victoria from 1986 to 1989. Robertson et al. Pediatr Pulmonol 1992

6. Patients currently achieving control Not Well-Controlled Only 5% of patientsachieve asthma control Well-Controlled Rabe et al. Eur Respir J, 2000

7. Low patient expectations Low physician expectations Compromise leading to poor asthma control Guidelines allow symptoms Lack of composite endpoint We are still not achieving a life free from asthma for our patients

8. Common views of control? Symptoms Some? Rescue SABA use A puff a day? Morning PEF 80% on most days? Night-time awakenings Occasional? Exacerbations Rarely? Emergency visits Rarely? Treatment-related adverse events enforcing change in therapy None?

9. No Symptoms No Rescue SABA use Every day 80% morning PEF No Night-time awakenings No Exacerbations No Emergency visits Treatment-related adverse events enforcing change in therapy No Total Control is ALL of these sustained for at least 7 of 8 weeks Total Control definition Symptoms Some? Salbutamol use A puff a day? PEF am 80% on most days? Night-time awakenings Occasional? Exacerbations Rarely? Emergency visits Rarely? Treatment related adverse events enforcing change in therapy None? GSK data on file, 2003

10. A landmark global study N America 11% Europe 50% L America 10% Asia–Pacific 29% 3421 patients

11. Seretide FP Week 21 Week 45 Total Control Time to achieve control Probability of control 1.0 0.8 0.6 0.4 0.2 0 0 4 8 12 16 20 24 28 32 36 40 44 48 52 Time to first Total Control weekPatients previously on low-dose ICS (S2) GSK data on file, 2003

12. Summary of GOAL results • TOTAL CONTROL of asthma is possible in about 40% of patients • Aiming for TOTAL CONTROL results in WELL-CONTROLLED asthma status in another 40% of patients • Combination therapy is superior to ICS and achieves control • in more subjects • earlier • at a lower ICS dose

13. THE PROMISE • Total Control can be achieved • Total Control can and shouldbe maintained • Total Control should be the aim for all patients with asthma

14. פרטים ראשונים על המחקר ניתן לקבל מנציגסרטייד באזורך, פרטים נוספים יפורסמו בעתיד הקרוב