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https://www.readbyqxmd.com/read/28417456/interventions-to-improve-adherence-to-inhaled-steroids-for-asthma
#1
REVIEW
Rebecca Normansell, Kayleigh M Kew, Elizabeth Stovold
BACKGROUND: Despite its proven efficacy in improving symptoms and reducing exacerbations, many patients with asthma are not fully adherent to their steroid inhaler. Suboptimal adherence leads to poorer clinical outcomes and increased health service utilisation, and has been identified as a contributing factor to a third of asthma deaths in the UK. Reasons for non-adherence vary, and a variety of interventions have been proposed to help people improve treatment adherence. OBJECTIVES: To assess the efficacy and safety of interventions intended to improve adherence to inhaled corticosteroids among people with asthma...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28146601/stepping-down-the-dose-of-inhaled-corticosteroids-for-adults-with-asthma
#2
REVIEW
Iain Crossingham, David Jw Evans, Nathan R Halcovitch, Paul A Marsden
BACKGROUND: Asthma is a condition of the airways affecting more than 300 million adults and children worldwide. National and international guidelines recommend titrating up the dose of inhaled corticosteroids (ICS) to gain symptom control at the lowest possible dose because long-term use of higher doses of ICS carries a risk of systemic adverse events. For patients whose asthma symptoms are controlled on moderate or higher doses of ICS, it may be possible to reduce the dose of ICS without compromising symptom control...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28140686/role-of-muscarinic-antagonists-in-asthma-therapy
#3
Mario Cazzola, Josuel Ora, Paola Rogliani, Maria Gabriella Matera
Higher parasympathetic tone has been reported in asthmatics. In general, cholinergic contractile tone is increased by airway inflammation associated with asthma. Nevertheless, the role of muscarinic antagonists for the treatment of asthma has not yet been clearly defined. Areas covered: The use of SAMAs and LAMAs in asthma has been examined and discussed according with the published evidence. Particular attention has been given to the large Phase III clinical trial program designed to evaluate the efficacy and safety of tiotropium respimat added to standard treatment in adults, adolescents and children with persistent asthma across the spectrum of asthma severity...
March 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27965773/treatment-of-asthma-in-young-children-evidence-based-recommendations
#4
REVIEW
Jose A Castro-Rodriguez, Adnan Custovic, Francine M Ducharme
In the present review, we focus on evidence-based data for the use of inhaled corticosteroids (ICS), leukotriene receptor antagonist (LTRA), long-acting beta2-agonits (LABA) and oral corticosteroids (OCS), with a special emphasis on well-performed randomized clinical trials (RCTs) and meta-analyses of such trials for the chronic management of asthma/wheeze in infants and preschoolers. RESULTS: Seven meta-analyses and 14 RCTs were reviewed. Daily ICS should be the preferred drug for infants/preschoolers with recurrent wheezing, especially in asthmatics...
2016: Asthma research and practice
https://www.readbyqxmd.com/read/27931302/new-insights-into-treatment-of-children-with-exercise-induced-asthma-symptoms
#5
RANDOMIZED CONTROLLED TRIAL
Iwona Stelmach, Anna Sztafiska, Joanna Jerzyska, Daniela Podlecka, Pawe Majak, Wodzimierz Stelmach
BACKGROUND: Exercise is one of the most common triggers of bronchoconstriction and affects up to 80% of children with asthma. OBJECTIVE: The purpose of this randomized, double-blind, placebo-controlled study was to assess the effectiveness of treatment with ciclesonide 160 microgram, either alone, with a higher dose, with a leukotriene receptor antagonist (LTRA), or with a long-acting beta-agonist (LABA) in children with asthma with postexercise-induced symptoms...
November 2016: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27826962/asthma-severity-and-the-controller-prescription-in-children-at-12-tertiary-hospitals
#6
Dong In Suh, Hyeon Jong Yang, Bong Seong Kim, Youn Ho Shin, So Yeon Lee, Geunhwa Park, Woo Kyung Kim, Hyo Bin Kim, Heysung Baek, Ja Kyoung Kim, Jin Tack Kim, Dae Hyun Lim
PURPOSE: Guidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children. METHODS: Twelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4 categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27735927/inappropriate-asthma-therapy-a-tale-of-two-countries-a-parallel-population-based-cohort-study
#7
Manon Belhassen, Anjan Nibber, Eric Van Ganse, Dermot Ryan, Carole Langlois, Francis Appiagyei, Derek Skinner, Laurent Laforest, Joan B Soriano, David Price
Against recurrent controversies around the safety of short- and long-acting β2-agonists (SABA and LABA), and the National Review of Asthma Deaths inquiry in the United Kingdom, we investigated the prevalence of inappropriate therapy in asthma. Our study aimed to determine the prevalence of inappropriate use of asthma therapy in the United Kingdom and in France. Two interval, parallel, population-based cohorts (2007 and 2013) were developed in each country by using the UK OPCRD and the French EGB databases...
October 13, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27677381/prevalence-and-risk-factors-for-asthma-among-children-aged-0-14-years-in-hangzhou-a-cross-sectional-survey
#8
Dan Xu, Yingshuo Wang, Zhimin Chen, Shuxian Li, Yungai Cheng, Li Zhang, Lingzhi Zhao
BACKGROUND: Asthma is a global problem. Prevalence varies among different countries and cities. We aimed to obtain the prevalence, describe the characteristics, and discover factors that may relate to asthma in Hangzhou. METHODS: This cross-sectional study was conducted in Hangzhou. The subjects were children aged 14 years and younger. A control group of non-asthma children that matched in age and sex with each asthmatic patient was also randomly selected and interviewed...
September 27, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27615145/assessing-the-viability-of-long-acting-%C3%AE-2-agonists-in-paediatric-asthma-patients-a-pharmacokinetic-pharmacodynamic-perspective
#9
REVIEW
Maria Gabriella Matera, Barbara Rinaldi, Luigino Calzetta, Mario Cazzola
Long-acting β2-agonists (LABAs) combined with inhaled corticosteroids (ICSs) are still commonly prescribed to asthmatic children. Unfortunately, pediatric LABA use is based primarily on data from adults, despite the fact that children are not simply small adults and the magnitude of changes in dose exposure and/or exposure response may not be solely reflected by differences in body weight. Areas covered: The differences in pharmacokinetics (PK) and pharmacodynamics (PD) of LABAs are described and discussed with reference children and adults...
February 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27612491/tiotropium-in-the-add-on-treatment-of-asthma-in-adults-clinical-trial-evidence-and-experience
#10
REVIEW
Christian Vogelberg
Asthma is a chronic inflammatory airway disease, and its treatment is frequently challenging despite detailed national and international guidelines. While basic anti-inflammatory therapy usually consists of inhaled corticosteroids in doses adapted to the asthma severity, add-on treatment with bronchodilators is essential in more severe asthma. Only recently, the long-acting anticholinergic tiotropium was introduced into the GINA guidelines. This review reports on the studies that have been performed with tiotropium in adult asthmatic patients...
December 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27582089/vilanterol-and-fluticasone-furoate-for-asthma
#11
REVIEW
Kerry Dwan, Stephen J Milan, Lynne Bax, Nicola Walters, Colin Powell
BACKGROUND: Vilanterol (VI) is a long-acting beta2-agonist (LABA) that binds to the beta2-adrenoceptor on the airway smooth muscle, producing bronchodilation. LABA therapy, which is well established in adults as part of the British Thoracic Society (BTS) Guidelines for the Management of Asthma, leads to improvement in symptoms and lung function and reduction in exacerbations. At present, the commonly used LABAs licensed for use in asthma management (formoterol and salmeterol) require twice-daily administration, whereas VI is a once-daily therapy...
September 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27579634/safety-of-adding-salmeterol-to-fluticasone-propionate-in-children-with-asthma
#12
RANDOMIZED CONTROLLED TRIAL
David A Stempel, Stanley J Szefler, Søren Pedersen, Robert S Zeiger, Anne M Yeakey, Laurie A Lee, Andrew H Liu, Herman Mitchell, Kenneth M Kral, Ibrahim H Raphiou, Barbara A Prillaman, Kathleen S Buaron, Suyong Yun Kirby, Steven J Pascoe
BACKGROUND: Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children. It is unknown whether the concomitant use of inhaled glucocorticoids with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children. METHODS: We randomly assigned, in a 1:1 ratio, children 4 to 11 years of age who required daily asthma medications and had a history of asthma exacerbations in the previous year to receive fluticasone propionate plus salmeterol or fluticasone alone for 26 weeks...
September 1, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27421902/long-acting-%C3%AE-agonist-in-combination-or-separate-inhaler-as-step-up-therapy-for-children-with-uncontrolled-asthma-receiving-inhaled-corticosteroids
#13
Steve Turner, Kathryn Richardson, Clare Murray, Mike Thomas, Elizabeth V Hillyer, Anne Burden, David B Price
BACKGROUND: Adding a long-acting β2-agonist (LABA) to inhaled corticosteroids (ICS) using a fixed-dose combination (FDC) inhaler is the UK guideline recommendation for children aged more than 4 years with uncontrolled asthma. The evidence of benefit of adding an FDC inhaler over a separate LABA inhaler is limited. OBJECTIVE: The objective of this study was to compare the effectiveness of a LABA added as an FDC inhaler, and as a separate inhaler, in children with uncontrolled asthma...
July 12, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/26774659/childhood-asthma-exacerbations-and-the-arg16-%C3%AE-2-receptor-polymorphism-a%C3%A2-meta-analysis-stratified-by-treatment
#14
Steve Turner, Ben Francis, Susanne Vijverberg, Maria Pino-Yanes, Anke H Maitland-van der Zee, Kaninika Basu, Lauren Bignell, Somnath Mukhopadhyay, Roger Tavendale, Colin Palmer, Daniel Hawcutt, Munir Pirmohamed, Esteban G Burchard, Brian Lipworth
BACKGROUND: The Gly-to-Arg substitution at the 16 position (rs1042713) in the β2-adrenoceptor gene (ADRB2) is associated with enhanced downregulation and uncoupling of β2-receptors. OBJECTIVES: We sought to undertake a meta-analysis to test the hypothesis that there is an interaction between the A allele of rs1042713 (Arg16 amino acid) and long-acting β-agonist (LABA) exposure for asthma exacerbations in children. METHODS: Children with diagnosed asthma were recruited in 5 populations (BREATHE, Genes-Environments and Admixture in Latino Americans II, PACMAN, the Paediatric Asthma Gene Environment Study, and the Pharmacogenetics of Adrenal Suppression with Inhaled Steroid Study)...
July 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/26725997/changing-patterns-of-asthma-medication-use-related-to-us-food-and-drug-administration-long-acting-%C3%AE-2-agonist-regulation-from-2005-2011
#15
Melissa G Butler, Esther H Zhou, Fang Zhang, Yu-te Wu, Ann Chen Wu, Mark S Levenson, Pingsheng Wu, Sally Seymour, Sengwee Toh, Aarthi Iyer, Solomon Iyasu, Meghan A Baker
BACKGROUND: Safety concerns associated with long-acting β2-agonists (LABAs) have led to many US Food and Drug Administration (FDA) regulatory activities for this class of drugs. Little is known about the effect of these regulatory activities on use of LABA-containing agents or other asthma medications. METHODS: We created rolling cohorts of pediatric and adult asthmatic patients in the Mini-Sentinel Distributed Database between January 2005 and June 2011. The proportions of asthmatic patients using LABA-containing products, inhaled corticosteroids (ICSs), leukotriene modifiers, short-acting β2-agonists, oral corticosteroids, other bronchodilators, and no medications were measured on a monthly basis, and the changes were evaluated by using interrupted time series with segmented regression analysis...
March 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/26606079/emerging-role-of-long-acting-anticholinergics-in-children-with-asthma
#16
REVIEW
Christian Vogelberg
PURPOSE OF REVIEW: Although the use of inhaled anticholinergics in obstructive airway disease has been established for several years, the clinical experience using these medications in treating patients with asthma is limited. Only few studies so far have included pediatric patients with asthma, but these studies demonstrate relevant therapeutic effects. This review will explore the pharmacological effects of inhaled anticholinergics, provide an overview about current adult and pediatric asthma studies using tiotropium, and describe future research needs...
January 2016: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/26594816/addition-of-long-acting-beta2-agonists-to-inhaled-corticosteroids-for-chronic-asthma-in-children
#17
REVIEW
Bhupendrasinh F Chauhan, Caroline Chartrand, Muireann Ni Chroinin, Stephen J Milan, Francine M Ducharme
BACKGROUND: Long-acting beta2-agonists (LABA) in combination with inhaled corticosteroids (ICS) are increasingly prescribed for children with asthma. OBJECTIVES: To assess the safety and efficacy of adding a LABA to an ICS in children and adolescents with asthma. To determine whether the benefit of LABA was influenced by baseline severity of airway obstruction, the dose of ICS to which it was added or with which it was compared, the type of LABA used, the number of devices used to deliver combination therapy and trial duration...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26171905/interventions-for-bronchiectasis-an-overview-of-cochrane-systematic-reviews
#18
REVIEW
Emma J Welsh, David J Evans, Stephen J Fowler, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal dilatation of the bronchi, and presents typically with a chronic productive cough (or chronic wet cough in children) and recurrent infective exacerbations. It significantly impacts daily activities and quality of life, and can lead to recurrent hospitalisations, severe lung function impairment, respiratory failure and even death. OBJECTIVES: To provide an overview of the efficacy and safety of interventions for adults and children with bronchiectasis from Cochrane reviews...
July 14, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26097789/safety-tolerability-pharmacokinetics-and-pharmacodynamics-of-vilanterol-a-novel-inhaled-long-acting-%C3%AE-agonist-in-children-aged-5-11-years-with-persistent-asthma-a-randomized-trial
#19
Amanda Oliver, Sandi VanBuren, Ann Allen, Melanie Hamilton, Lee Tombs, Rodger Kempsford, Paul Qaqundah
This multi-center, randomized, double-blind, placebo-controlled, two-way crossover study was designed to characterize the safety, tolerability, pharmacokinetic, and pharmacodynamic profile of single and once-daily repeat doses of vilanterol 25 µg in children aged 5-11 years. Twenty-eight children with persistent asthma received a single inhaled dose of vilanterol 25 µg or placebo via the ELLIPTA™ dry powder inhaler (DPI) on Day 1, followed 7 days later by once-daily treatment for 7 days. Nine (33%) subjects reported adverse events (AEs) with vilanterol 25 µg and 6 (23%) with placebo...
May 2014: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/26068328/initial-step-up-treatment-changes-in-asthmatic-children-already-prescribed-inhaled-corticosteroids-a-historical-cohort-study
#20
Steve W Turner, Kathryn Richardson, Annie Burden, Mike Thomas, Clare Murray, David Price
BACKGROUND: When standard doses of inhaled corticosteroids (ICS) fail to control symptoms in children aged >4 years, guidelines recommend the addition of a long-acting β2-agonist (LABA), with other treatment options being available if symptoms persist. AIMS: To determine the proportion of initial 'step-up' episodes where LABAs were prescribed and to describe characteristics of individuals not stepped up with LABA. METHODS: Between 1999 and 2011, initial step-up episodes from ICS monotherapy were identified in children aged 5-12 years with asthma and in receipt of ICS...
2015: NPJ Primary Care Respiratory Medicine
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