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https://www.readbyqxmd.com/read/29792288/tralokinumab-for-severe-uncontrolled-asthma-stratos-1-and-stratos-2-two-randomised-double-blind-placebo-controlled-phase-3-clinical-trials
#1
Reynold A Panettieri, Ulf Sjöbring, AnnaMaria Péterffy, Peter Wessman, Karin Bowen, Edward Piper, Gene Colice, Christopher E Brightling
BACKGROUND: Tralokinumab is an anti-interleukin-13 human monoclonal antibody developed for the treatment of severe, uncontrolled asthma. These clinical trials aimed to assess the efficacy and safety of tralokinumab in this population. METHODS: STRATOS 1 and STRATOS 2 were randomised, double-blind, parallel-group, placebo-controlled, phase 3 clinical trials that enrolled participants aged 12-75 years with severe asthma that was inadequately controlled despite use of inhaled corticosteroids (≥500 μg per day fluticasone or equivalent) and a long-acting β2 agonist (but not oral corticosteroids)...
May 18, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29790144/-prone-position-and-nursing-care
#2
Shu-Ju Lu, Shiao-Pei Wang
Acute respiratory distress syndrome (ARDS) is a life-threatening disease, as acute inflammation in the lungs typically leads to hypoxia and symptoms of dyspnea. The treatment modalities of ARDS include mechanical ventilation, corticosteroid, extracorporeal membranous oxygenation, inhaled nitrogen oxide, and the prone position. Among these, the prone position is supported by evidence showing significantly reduced mortality in patients that adopt this modality. Lying in the prone position reduces atelectatic lung volumes by recruitment of dependent parts and facilitates normal regulation of alveolar ventilation, giving better-matched ventilation perfusion and, thus, improved oxygenation...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29785128/methacholine-challenge-testing-comparative-pharmacology
#3
REVIEW
Beth E Davis, Christianne M Blais, Donald W Cockcroft
Standardization of the methacholine inhalation challenge, the most common direct bronchoprovocation test, is important. One aspect of standardization is the appropriate washout period for pharmacologic agents which affect the response. This review summarizes the available data on pharmacologic inhibition of the methacholine response. Specific (anti-muscarinic) agents demonstrate marked bronchoprotection (up to 7 days for the long-acting drugs) which lasts longer than the duration of bronchodilation. The functional antagonist (beta 2 agonist class of medications) shows marked, but less, bronchoprotection which is relatively short lived and is similar to the duration of bronchodilator efficacy...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29785104/respiratory-medication-used-in-copd-patients-from-seven-latin-american-countries-the-lassyc-study
#4
Alejandro Casas, Maria Montes de Oca, Ana Mb Menezes, Fernando C Wehrmeister, Maria Victorina Lopez Varela, Laura Mendoza, Larissa Ramírez, Marc Miravitlles
Background: Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region. Methods: This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29783858/effectiveness-and-safety-comparison-for-systemic-corticosteroid-therapy-with-and-without-inhaled-corticosteroids-for-copd-exacerbation-management
#5
Jordan A Pearce, Dane L Shiltz, Qian Ding
BACKGROUND: Only 1 small, single-center study has evaluated the combination of systemic plus inhaled corticosteroid (ICS) routes for chronic obstructive pulmonary disease (COPD) exacerbation management. This study aims to further improve the existing quantity and quality of evidence regarding the utility for combination therapy in the management of COPD exacerbation. OBJECTIVES: To evaluate length of hospital stay, readmission rate, incidence of infection, and mortality in hospitalized patients who experience a COPD exacerbation and receive systemic corticosteroid therapy with or without concurrent ICS...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29781332/a-novel-phenolic-propanediamine-moiety-based-lung-targeting-therapy-for-asthma
#6
Jianbo Li, Yang Yang, Didi Wan, Youmei Peng, Jinjie Zhang
Asthma is one of the most prevalent chronic inflammatory diseases of lung. Current asthma therapy using inhaled corticosteroid often results in undesired treatment outcome due to poor compliance and drugs' lack of tissue specificity. N,N,N'-trimethyl-N'-(2-hydroxyl-3-methyl-5-123 Iiodobenzyl)-1,3-propanediamine (HIPD), a phenolic propanediamine derivative, has been used as an imaging agent for localized pulmonary diseases. Inspired by this, N,N,N'-trimethyl-N'-(4-hydroxyl-benzyl)-1,3-propanediamine (TPD), a new HIPD analog, was proposed as a lung-targeting ligand and covalently conjugated to an anti-inflammatory compound Rhein for asthma therapy...
November 2018: Drug Delivery
https://www.readbyqxmd.com/read/29780238/update-on-new-biologics-for-intractable-eosinophilic-asthma-impact-of-reslizumab
#7
REVIEW
Jagdeep Sahota, Douglas S Robinson
A small percentage of patients with asthma have uncontrolled symptoms and frequent exacerbations, despite treatment with inhaled corticosteroids and other agents. It has become clear that different subtypes of this severe, treatment-resistant group exist due to different mechanisms of the disease. All such patients require detailed assessment in specialist centers to characterize the disease and assess treatment adherence. Recently, monoclonal antibodies have become available, which target specific pathways that may contribute to persistent inflammation and asthma exacerbations...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29780119/a-rare-case-of-isolated-chronic-cough-caused-by-pulmonary-lymphangitic-carcinomatosis-as-a-primary-manifestation-of-rectum-carcinoma
#8
Minami Okayama, Yoshihiro Kanemitsu, Tetsuya Oguri, Takamitsu Asano, Satoshi Fukuda, Hirotsugu Ohkubo, Masaya Takemura, Ken Maeno, Yutaka Ito, Akio Niimi
A 36-year old man was referred to our hospital due to isolated chronic cough that was refractory to anti-asthma medications, including inhaled corticosteroids/long-acting β2 agonists. Chest X-ray showed diffuse nodular and enhanced vascular shadows with Kerley lines in both lungs. A blood analysis showed elevated serum CEA and CA19-9 levels. A transbronchial biopsy revealed well to moderately differentiated adenocarcinoma, the origin of which was immunohistochemically suspected to be the gastrointestinal tract...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29778822/formulation-techniques-for-high-dose-dry-powders
#9
Ashlee D Brunaugh, Hugh D C Smyth
Delivery of drugs to the lungs via dry powder inhaler (DPI) is a promising approach for the treatment of both local pulmonary conditions and systemic diseases. Though DPIs are widely used for the pulmonary deposition of potent bronchodilators, anticholinergics, and corticosteroids, there is growing interest in the utilization of this delivery system for the administration of high drug doses to the lungs, as made evident by recent regulatory approvals for anti-microbial, anti-viral and osmotic agents. However, the formulation of high dose DPIs carries several challenges from both a physiological and physicochemical standpoint...
May 17, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29773947/efficacy-safety-and-pharmacokinetics-of-budesonide-formoterol-fumarate-delivered-via-metered-dose-inhaler-using-innovative-co-suspension-delivery-technology-in-patients-with-moderate-to-severe-copd
#10
Edward M Kerwin, Thomas M Siler, Samir Arora, Patrick Darken, Earl Rose, Colin Reisner
Purpose: This study investigated the efficacy, safety, and pharmacokinetics of the inhaled corticosteroid/long-acting β2 -agonist fixed-dose combination budesonide/formoterol fumarate (BFF) metered dose inhaler (MDI), compared with the monocomponents budesonide (BD) MDI and formoterol fumarate (FF) MDI, in patients with moderate-to-severe COPD. Materials and methods: In this Phase IIb, randomized, double-blind, four-period, five-treatment, incomplete-block, crossover study (NCT02196077), all patients received BFF MDI 320/9...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29773689/risk-factors-for-lung-disease-progression-in-children-with-cystic-fibrosis
#11
Marieke van Horck, Kim van de Kant, Bjorn Winkens, Geertjan Wesseling, Vincent Gulmans, Han Hendriks, Chris van der Grinten, Quirijn Jӧbsis, Edward Dompeling
To identify potential risk factors for lung disease progression in children with cystic fibrosis (CF), we studied the longitudinal data of all children with CF (aged ≥5 years) registered in the Dutch CF Registry (2009-2014). Lung disease progression was expressed as a decline in lung function (FEV1 %pred) and the pulmonary exacerbation rate (PEx). Potential risk factors at baseline included: sex, age, best FEV1%pred, best forced vital capacity (FVC)%pred, genotype, BMI z-score, pancreatic insufficiency, medication use (proton pump inhibitors [PPI], prophylactic antibiotics, and inhaled corticosteroids), CF-related diabetes, allergic bronchopulmonary aspergillosis, and colonisation with Pseudomonas aeruginosa The data of 545 children were analysed...
May 17, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29766487/inhaled-corticosteroids-for-bronchiectasis
#12
REVIEW
Nitin Kapur, Helen L Petsky, Scott Bell, John Kolbe, Anne B Chang
BACKGROUND: Bronchiectasis is being increasingly diagnosed and recognised as an important contributor to chronic lung disease in both adults and children in high- and low-income countries. It is characterised by irreversible dilatation of airways and is generally associated with airway inflammation and chronic bacterial infection. Medical management largely aims to reduce morbidity by controlling the symptoms, reduce exacerbation frequency, improve quality of life and prevent the progression of bronchiectasis...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#13
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29765586/design-of-a-clinical-decision-support-system-for-fracture-prediction-using-imbalanced-dataset
#14
Yung-Fu Chen, Chih-Sheng Lin, Kuo-An Wang, La Ode Abdul Rahman, Dah-Jye Lee, Wei-Sheng Chung, Hsuan-Hung Lin
More than 1 billion people suffer from chronic respiratory diseases worldwide, accounting for more than 4 million deaths annually. Inhaled corticosteroid is a popular medication for treating chronic respiratory diseases. Its side effects include decreased bone mineral density and osteoporosis. The aims of this study are to investigate the association of inhaled corticosteroids and fracture and to design a clinical support system for fracture prediction. The data of patients aged 20 years and older, who had visited healthcare centers and been prescribed with inhaled corticosteroids within 2002-2010, were retrieved from the National Health Insurance Research Database (NHIRD)...
2018: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29765200/efficacy-and-safety-of-the-crth2-antagonist-azd1981-as-add-on-therapy-to-inhaled-corticosteroids-and-long-acting-%C3%AE-2-agonists-in-patients-with-atopic-asthma
#15
Eric D Bateman, Christopher O'Brien, Paul Rugman, Sally Luke, Stefan Ivanov, Mohib Uddin
Objectives: To evaluate the efficacy and safety of AZD1981, a potent, specific antagonist of the CRTh2 receptor, as add-on therapy to inhaled corticosteroids (ICS) and long-acting β2 -agonists (LABA), in patients with persistent asthma with an allergic component. Patients and methods: In this placebo-controlled, parallel-group Phase IIb study, patients with persistent atopic asthma on ICS and LABA were randomized to receive 12 weeks of treatment with placebo or AZD1981 (80 mg daily, 200 mg daily, and 10 mg, 40 mg, 100 mg, or 400 mg twice daily [BID])...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29763411/characteristics-and-health-care-resource-use-of-subjects-with-copd-in-the-year-before-initiating-lama-monotherapy-or-lama-laba-combination-therapy-a-u-s-database-study
#16
Saurabh Nagar, Jeetvan Patel, Richard H Stanford
PURPOSE: To characterize subjects with chronic obstructive pulmonary disease (COPD) newly initiated on long-acting muscarinic antagonists (LAMA) or dual LAMA/long-acting β2-adrenergic agonist (LABA) therapy. DESIGN: This pilot/preliminary analysis was a retrospective crosssectional study of subjects with COPD from the Optum Impact National Managed Care Benchmark Database. METHODOLOGY: Subjects with at least one LAMA prescription in the index period (July 2008-June 2009) were included and stratified by treatment...
May 2018: Managed Care
https://www.readbyqxmd.com/read/29762633/using-a-mixture-of-bivariate-regression-model-to-explore-heterogeneity-of-effects-of-use-of-inhaled-corticosteroids-on-gestational-age-and-birthweight-among-pregnant-women-with-asthma
#17
Mariia Samoilenko, Lucie Blais, Isabelle Boucoiran, Geneviève Lefebvre
Asthma is a heterogeneous disease, and responses to asthma medications vary noticeably among patients. A substantively oriented objective of this study was to explore the potential heterogeneous effects of maternal inhaled corticosteroids (ICS) exposure on gestational age (GA) at delivery and birthweight (BW) using a cohort of 6,197 pregnancies from women with asthma (Quebec, Canada, 1998-2008). A methodologically oriented objective was to comprehensively describe the application of a Bayesian two-component mixture of bivariate regressions to address this issue and estimate the effects of ICS on GA and BW jointly...
May 14, 2018: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29759659/the-global-development-and-clinical-efficacy-of-sublingual-tablet-immunotherapy-for-allergic-diseases
#18
REVIEW
Hendrik Nolte, Jennifer Maloney
Allergy immunotherapy (AIT) is a treatment option for respiratory allergy that is complementary to pharmacotherapy, with a distinct mechanism of action. Alternative methods to subcutaneous administration of AIT that enable patients to safely self-administer AIT is considered an unmet clinical need. The sublingual immunotherapy tablet (SLIT-tablet) is an orally disintegrating pharmaceutical formulation (oral lyophilisate) containing standardized allergens. SLIT-tablets have been developed for sublingual immunotherapy (SLIT) of cedar-pollen, grass-pollen, ragweed-pollen, tree-pollen, and house dust mite allergies...
May 12, 2018: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/29755346/a-multicenter-randomized-double-blind-placebo-controlled-study-of-the-effects-of-loki-zupa-in-patients-with-chronic-asthma
#19
Yubao Lv, Ying Wei, Muhammadjan Abduwaki, Tohti Jurat, Fengsen Li, Huaizhen Wang, Yuhua Wu, Zheng Li, Bo Liu, Hongjun Yin, Yuxue Cao, Mammat Nurahmat, Zihui Tang, Jingcheng Dong
The purpose of this study was to evaluate the efficacy and safety of Uyghur medical formula Loki zupa in patients with chronic asthma. Adult patients with chronic asthma randomly received placebo or Loki zupa as add-on to inhaled corticosteroids (ICS) maintenance treatment. Loki zupa or mimics was administered orally 10 ml per time, three times a day for 8 weeks. The primary endpoints were asthma control test (ACT) score and peak expiratory flow (PEF). The secondary endpoints were acute exacerbation rate, lung function, night waking days, and symptom-free days in the near 2 weeks, Asthma Quality of Life Questionnaire (AQLQ) score and some inflammatory cytokines in peripheral blood...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29754592/general-practitioners-views-on-the-influence-of-cost-on-the-prescribing-of-asthma-preventer-medicines-a-qualitative-study
#20
Jacqueline Tudball, Helen K Reddel, Tracey-Lea Laba, Stephen Jan, Anthony Flynn, Michele Goldman, Kirsty Lembke, Elizabeth Roughead, Guy B Marks, Nick Zwar
Objective Out-of-pocket costs strongly affect patient adherence with medicines. For asthma, guidelines recommend that most patients should be prescribed regular low-dose inhaled corticosteroids (ICS) alone, but in Australia most are prescribed combination ICS-long-acting β2-agonists (LABA), which cost more to patients and government. The present qualitative study among general practitioners (GPs) explored the acceptability, and likely effect on prescribing, of lower patient copayments for ICS alone. Methods Semistructured telephone interviews were conducted with 15 GPs from the greater Sydney area; the interviews were transcribed and thematically analysed...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
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