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https://www.readbyqxmd.com/read/29044640/a-step-down-protocol-for-omalizumab-treatment-in-oral-corticosteroid-dependent-allergic-asthma-patients
#1
Christian Domingo, Xavier Pomares, Albert Navarro, María José Amengual, Concepción Montón, Ana Sogo, Rosa M Mirapeix
BACKGROUND: there are no specific criteria for a step-down or withdrawal dose of omalizumab. Our purpose was to evaluate the viability of a protocol for OMAlizumab DOse REduction (the OMADORE study) in severe allergic asthma (SAA). METHODS: the study population included 35 SAA patients treated during a minimum period of one year with oral corticosteroids (OC) equivalent to a mean daily dose of 4 mg of methyl-prednisolone. To qualify for the protocol, the patients had to have received treatment with OMA ≥ one year and a half, OC dose had to have reached the lowest tolerated dose and spirometry had to be ≥ at entry...
October 18, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29042832/evaluation-of-the-efficacy-of-a-onetime-injectable-dexamethasone-administered-orally-in-the-pediatric-emergency-department-for-asthma-exacerbation
#2
Ashley McCallister, Tsz-Yin So, Josh Stewart
OBJECTIVE: This study assessed the efficacy of injectable dexamethasone administered orally in pediatric patients who presented to the emergency department with asthma exacerbation. METHODS: This was a retrospective study of patients 0 to 18 years of age who presented to and who were directly discharged from the emergency department at Moses H. Cone Memorial Hospital between September 1, 2012, and September 30, 2015, for the diagnosis of asthma or asthma exacerbation...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29040210/anticholinergics-for-asthma-a-long-history
#3
Gustavo J Rodrigo
PURPOSE OF REVIEW: To provide a fast overview about the introduction and development of anticholinergic drugs in Western medicine to their current indications particularly in asthma. RECENT FINDINGS: Although short-acting muscarinic antagonists have been positioned in the last 15 years for the treatment of adults and children with moderate-to-severe acute asthma in the emergency setting (reducing the risk of hospital admissions and improving lung function), a growing body of evidence has recently emerged that positions the long-acting muscarinic anticholinergic tiotropium bromide as add-on therapy to at least inhaled corticosteroids (ICS) maintenance therapy in adults, adolescents, and children with symptomatic asthma...
October 16, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29038045/effects-of-procalcitonin-guided-treatment-on-antibiotic-use-and-need-for-mechanical-ventilation-in-patients-with-acute-asthma-exacerbation-meta-analysis-of-randomized-controlled-trials
#4
Wanis H Ibrahim, Kamran Mushtaq, Tasleem Raza, Anand Kartha, Ahmed O Saleh, Rayaz A Malik
OBJECTIVE: The primary outcome was to determine whether serum procalcitonin-guided antibiotic therapy can reduce antibiotic exposure in patients with an acute exacerbation of asthma presenting to the primary care facility, emergency department or during hospital admission. The secondary outcome was the need for mechanical ventilation. METHODS: In this meta-analysis, we performed extensive literature search for randomized controlled clinical trials (published in English) that compared serum procalcitonin-guided antibiotic therapy versus antibiotic use according to physician's discretion for adult participants with mild, moderate or severe acute asthma exacerbations...
October 13, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29036019/targeting-the-interleukin-4-and-interleukin-13-pathways-in-severe-asthma-current-knowledge-and-future-needs
#5
Amit D Parulekar, Christina C Kao, Zuzana Diamant, Nicola A Hanania
PURPOSE OF REVIEW: Severe asthma is a heterogeneous disease that can be classified into phenotypes and endotypes based upon clinical or biological characteristics. Interleukin (IL)-4 and IL-13 play a key role in type 2 (T2) asthma. This article reviews the signaling pathway of IL-4 and IL-13 and highlights its targeted therapy in severe asthma. RECENT FINDINGS: Several clinical trials of biologics targeting the IL-4/IL-13 pathway have recently been completed. In patients with severe, uncontrolled asthma, targeting IL-13 alone with biologics including lebrikizumab and tralokinumab has not shown consistent reduction in asthma exacerbations...
October 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29033947/interferon-%C3%AE-s-front-line-guardians-of-immunity-and-homeostasis-in-the-respiratory-tract
#6
REVIEW
Evangelos Andreakos, Maria Salagianni, Ioanna E Galani, Ourania Koltsida
Type III interferons (IFNs), also termed lambda IFNs (IFNλs) or interleukins-28/29, constitute a new addition to the IFN family. They are induced upon infection and are particularly abundant at barrier surfaces, such as the respiratory and gastrointestinal tracts. Although they signal through a unique heterodimeric receptor complex comprising IFNLR1 and IL10RB, they activate a downstream signaling pathway remarkably similar to that of type I IFNs and share many functions with them. Yet, they also have important differences which are only now starting to unfold...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29028809/nasal-dna-methylation-differentiates-corticosteroid-treatment-response-in-pediatric-asthma-a-pilot-study
#7
Xue Zhang, Jocelyn M Biagini Myers, Veda K Yadagiri, Ashley Ulm, Xiaoting Chen, Matthew T Weirauch, Gurjit K Khurana Hershey, Hong Ji
BACKGROUND: Treatment response to systemic corticosteroid in asthmatic children is heterogeneous and may be mediated by epigenetic mechanism(s). We aim to identify DNA methylation (DNAm) changes responsive to steroid, and DNAm biomarkers that distinguish treatment response. MATERIALS AND METHODS: We followed 33 children (ages 5-18) presenting to the Emergency Department (ED) for asthma exacerbation. Based on whether they met discharge criteria in ≤24 hours, participants were grouped into good and poor responders to steroid treatment...
2017: PloS One
https://www.readbyqxmd.com/read/29023163/asthma-exacerbations-and-socio-economic-status-in-french-adults-with-persistent-asthma-a-prospective-cohort-study
#8
Katia Mazalovic, Flore Jacoud, Alexandra L Dima, Eric Van Ganse, Maeva Nolin, Didier Cannet, Claire Zabawa
INTRODUCTION: Adults disadvantaged by poor socio-economic status (SES) are more severely affected by asthma compared to those with better SES. We aimed to determine whether the frequency of asthma exacerbations (AEx), as well as aspects related to AEx management, differed based on SES in patients treated with daily treatments. METHODS: This study, part of the prospective observational cohort ASTRO-LAB, included French adult patients with persistent asthma. Patients were considered as low SES if they benefited from publicly funded special health insurance and/or were perceived as low SES by their general practitioner...
October 12, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28993393/recurrent-wheeze-and-its-relationship-with-lung-function-and-airway-inflammation-in-preschool-children-a-cross-sectional-study-in-south-korea
#9
Ji Eun Soh, Kyung-Moon Kim, Ji-Won Kwon, Hyung Young Kim, Ju-Hee Seo, Hyo-Bin Kim, So-Yeon Lee, Gwang-Cheon Jang, Dae-Jin Song, Woo Kyung Kim, Young-Ho Jung, Soo-Jong Hong, Jung Yeon Shim
BACKGROUND: Relationship between recurrent wheeze and airway function and inflammation in preschool children is not fully known. OBJECTIVE: To investigate the relationship between recurrent wheeze and airway inflammation, lung function, airway hyper-reactivity (AHR) and atopy in preschool children. DESIGN: Observational study, comparing forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and mid-forced expiratory flow (FEF25%-75%), dose-response slope (DRS), exhaled nitric oxide (eNO) and atopic sensitisation between children with recurrent wheeze and those without...
October 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28986124/real-world-health-care-utilization-and-effectiveness-of-omalizumab-for-the-treatment-of-severe-asthma
#10
Mina Tadrous, Wayne Khuu, Gerald Lebovic, Matthew B Stanbrook, Diana Martins, J Michael Paterson, Muhammad M Mamdani, David N Juurlink, Tara Gomes
BACKGROUND: Omalizumab is indicated for the treatment of moderate to severe asthma. There is limited observational evidence on the costs and effectiveness of omalizumab. OBJECTIVE: To examine the costs and effectiveness of omalizumab for treatment of severe asthma relative to nonusers. METHODS: We conducted a within-person repeated-measures matched cohort study in Ontario, Canada from April 1, 2012 to March 31, 2014. Continuous users of omalizumab were matched with up to 4 nonusers according to age, sex, recent specialist visits, oral corticosteroid use, asthma severity, and Charlson comorbidity score...
October 3, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28976789/estimating-asthma-control-questionnaire-acq-scores-from-claims-data
#11
Patrick W Sullivan, Vahram H Ghushchyan, Gary Globe
BACKGROUND: Asthma control is the main focus of treatment guidelines. Valid instruments such as the Asthma Control Questionnaire (ACQ) require prospective survey. These surveys may be challenging for large population health applications. OBJECTIVE: To develop an algorithm for estimating ACQ-5 scores from commonly available claims data. METHODS: Data was derived from four prospective surveys including the ACQ-5 combined with retrospective claims of Kaiser Permanente of Colorado (KPCO) patients...
October 4, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28975221/association-of-an-asthma-improvement-collaborative-with-health-care-utilization-in-medicaid-insured-pediatric-patients-in-an-urban-community
#12
Carolyn M Kercsmar, Andrew F Beck, Hadley Sauers-Ford, Jeffrey Simmons, Brandy Wiener, Lisa Crosby, Susan Wade-Murphy, Pamela J Schoettker, Pavan K Chundi, Zeina Samaan, Mona Mansour
Importance: Asthma is the most common chronic condition of childhood. Hospitalizations and emergency department (ED) visits for asthma are more frequently experienced by minority children and adolescents and those with low socioeconomic status. Objective: To reduce asthma-related hospitalizations and ED visits for Medicaid-insured pediatric patients residing in Hamilton County, Ohio. Design, Setting, and Participants: From January 1, 2010, through December 31, 2015, a multidisciplinary team used quality-improvement methods and the chronic care model to conduct interventions in inpatient, outpatient, and community settings in a large, urban academic pediatric hospital in Hamilton County, Ohio...
September 18, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28974953/poly-adp-ribose-polymerase-1-in-lung-inflammatory-disorders-a-review
#13
REVIEW
Gurupreet S Sethi, Vivek Dharwal, Amarjit S Naura
Asthma, acute lung injury (ALI), and chronic obstructive pulmonary disease (COPD) are lung inflammatory disorders with a common outcome, that is, difficulty in breathing. Corticosteroids, a class of potent anti-inflammatory drugs, have shown less success in the treatment/management of these disorders, particularly ALI and COPD; thus, alternative therapies are needed. Poly(ADP-ribose)polymerases (PARPs) are the post-translational modifying enzymes with a primary role in DNA repair. During the last two decades, several studies have reported the critical role played by PARPs in a good of inflammatory disorders...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28968051/gps-have-key-role-in-improving-outcomes-in-acute-asthma
#14
Helen L Grover, Bernard G Higgins
Asthma deaths in the UK remain among the highest in Europe. The 2014 National Review of Asthma Deaths looked at detailed data over a 12-month period assessing 195 patients who died from asthma and highlighted the avoidable factors in patient deaths. Although faults were found in secondary care, many of the problems related to poor management of patients in the community, both in terms of regular surveillance and assessment and treatment at the onset of attacks. Features which indicate a high risk of severe attacks include: previous admission to intensive care, particularly if requiring mechanical ventilation; previous admission with asthma especially in the past year or repeated emergency admissions; history of worsening asthma in January or February; use of three or more classes of asthma medication; heavy use of beta-2 agonists; anxiety traits; and marital stress...
November 2016: Practitioner
https://www.readbyqxmd.com/read/28962889/a-new-clerodane-furano-diterpene-glycoside-from-tinospora-cordifolia-triggers-autophagy-and-apoptosis-in-hct-116-colon-cancer-cells
#15
Neha Sharma, Ashok Kumar, P R Sharma, Arem Qayum, Shashank K Singh, Prabhu Dutt, Satya Paul, Vivek Gupta, M K Verma, N K Satti, R Vishwakarma
ETHNOPHARMACOLOGICAL RELEVANCE: Tinospora cordifolia is a miraculous ayurvedic herb used in the treatment of innumerable diseases such as diabetes, gonorrhea, secondary syphilis, anaemia, rheumatoid arthritis, dermatological diseases, cancer, gout, jaundice, asthma, leprosy, in the treatment of bone fractures, liver & intestinal disorders, purifies the blood, gives new life to the whole body; (rejuvenating herb) and many more. Recent studies have revealed the anticancer potential of this plant but not much work has been done on the anticancer chemical constituents actually responsible for its amazing anticancer effects...
September 27, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28958744/very-poorly-controlled-asthma-in-urban-minority-children-lessons-learned
#16
Arlene M Butz, Melissa Bellin, Mona Tsoukleris, Shawna S Mudd, Joan Kub, Jean Ogborn, Tricia Morphew, Cassia Lewis-Land, Mary Elizabeth Bollinger
BACKGROUND: Very poorly controlled (VPC) asthma in children is associated with ongoing acute exacerbations but factors associated with VPC are understudied. OBJECTIVE: To examine the risk factors associated with VPC asthma in urban minority children. METHODS: This descriptive study examined asthma control levels (well-controlled [WC], not well-controlled [NWC], and VPC) at baseline and 6 months in children participating in an ongoing randomized controlled trial of an emergency department/home environmental control intervention...
September 22, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28948572/overlapping-effects-of-new-monoclonal-antibodies-for-severe-asthma
#17
REVIEW
Christian Domingo
Among the monoclonal antibodies (mAbs) developed for severe asthma treatment, three have already been marketed. Omalizumab was the first, more than 10 years ago; today, mepolizumab and reslizumab are also available in the European Union and the US. Omalizumab blocks free immunoglobulin E (IgE), mepolizumab and reslizumab block an interleukin (IL-5). In the near future, dupilumab and benralizumab are expected to emerge as two new alternatives. Benralizumab blocks the receptor for IL-5 (IL5-Rα) and has a direct cytotoxic effect on eosinophils, and dupilumab blocks the α-unit of the heterodimeric receptor for IL-4 and IL-13 (IL-4Rα); as a result, dupilumab can block both IL-4 and IL-13...
September 25, 2017: Drugs
https://www.readbyqxmd.com/read/28947632/asthma-copd-overlap-syndrome-pathogenesis-clinical-features-and-therapeutic-targets
#18
REVIEW
Janice M Leung, Don D Sin
Asthma-COPD overlap syndrome (ACOS) or asthma-COPD overlap captures the subset of patients with airways disease who have features of both asthma and chronic obstructive pulmonary disease (COPD). Although definitions of ACOS vary, it is generally thought to encompass persistent airflow limitation in a patient older than 40 years of age with either a history of asthma or large bronchodilator reversibility. ACOS affects about a quarter of patients with COPD and almost a third of patients who previously had asthma...
September 25, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28941390/severe-forms-of-food-allergy
#19
REVIEW
Emanuel Sarinho, Maria das Graças Moura Lins
OBJECTIVES: To guide the diagnostic and therapeutic management of severe forms of food allergy. DATA SOURCES: Search in the Medline database using the terms "severe food allergy," "anaphylaxis and food allergy," "generalized urticaria and food allergy," and "food protein-induced enterocolitis syndrome" in the last ten years, searching in the title, abstract, or keyword fields. SUMMARY OF DATA: Food allergy can be serious and life-threatening...
September 21, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28931662/-i-have-lost-in-every-facet-of-my-life-the-hidden-burden-of-severe-asthma
#20
Juliet M Foster, Vanessa M McDonald, Michael Guo, Helen K Reddel
People with severe asthma are thought to face a sizeable daily disease burden. This study aimed to explore the little-known life experiences of people living with severe asthma.Adults with severe asthma were invited for telephone interview. Semistructured interviews were conducted until no new themes emerged. The 25 interviews were recorded, transcribed and analysed thematically.Four themes emerged. 1) "The body as a hindrance": severe asthma placed broad limits on life from daily chores to career, relationships and family life that left interviewees feeling emotionally distressed...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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