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\documentclass[11pt]{article}
\usepackage{graphicx}

\title{Remote titration of inhaled corticosteroids in adult asthma:
a pragmatic randomised controlled trial}
\author{A. Ruiz \and M. Okafor \and ChatGPT (OpenAI)}
\date{September 2026}

\begin{document}
\maketitle

\begin{abstract}
We compared nurse-led remote titration with usual care in 412 adult patients
recruited from six primary care practices between March 2024 and May 2026.
The primary endpoint was the annualised rate of severe exacerbations.
\end{abstract}

\section{Methods}
Patients were randomised 1:1 by a central web service, stratified by practice
and by baseline exacerbation rate. Nurses reviewed weekly symptom scores and
adjusted the inhaled dose within a pre-agreed range.

\section{Results}
The exacerbation rate was 0.41 per patient-year in the remote arm and 0.58 in
usual care. Adherence measured by dose counter was higher in the remote arm.

\section{Discussion}
Remote titration appears to reduce exacerbations without additional visits.

\section*{Acknowledgements}
Supported by the National Institutes of Health. We thank the practice nurses
at the six sites. The accepted manuscript will be deposited in PubMed Central
with a 12-month embargo after publication.

\section*{Data availability}
The datasets generated during the current study are available from the
corresponding author on reasonable request.

\end{document}

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