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management of exacerbation of asthma

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https://www.readbyqxmd.com/read/28645995/mepolizumab-for-the-treatment-of-severe-eosinophilic-asthma
#1
REVIEW
Mara N Poulakos, Shawna M Cargill, Melissa F Waineo, Allen L Wolford
PURPOSE: Published data on the pharmacology, pharmacokinetics and pharmacodynamics, and clinical efficacy and safety of the interleukin-5 antagonist mepolizumab are reviewed. SUMMARY: Asthma of the eosinophilic phenotype is characterized by persistent eosinophilic airway inflammation promoted primarily by T-helper type 2 cytokines, the key regulator of eosinophils. Patients with severe eosinophilic asthma are burdened by the need to administer high doses of corticosteroids to help manage their symptoms...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28636411/asthma-and-influenza-vaccination-in-elderly-hospitalized-patients-matched-case-control-study-in-spain
#2
María Morales Suárez-Varela, Agustin Llopis, Estrella Fernandez-Fabrellas, Francisco Sanz, M Jose Perez-Lozano, Vicente Martin, Jenaro Astray, Jesús Castilla, Mikel Egurrola, Luis Force, Diana Toledo, Àngela Domínguez
OBJECTIVES: Influenza infection is an exacerbating factor for asthma, and its prevention is critical in managing asthmatic patients. We investigated the effect of influenza vaccination on asthmatic and non-asthmatic patients hospitalized with laboratory-confirmed influenza in Spain. METHODS: We made a matched case-control study to assess the frequency of hospitalization for influenza in people aged ≥65 years. Hospitalized patients with unplanned hospital admissions were recruited from 20 hospitals representing seven Spanish regions...
June 21, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28635549/a-missed-primary-care-appointment-correlates-with-a-subsequent-emergency-department-visit-among-children-with-asthma
#3
Colleen Marie McGovern, Margaret Redmond, Kimberly Arcoleo, David R Stukus
OBJECTIVE: Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits...
March 2, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#4
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28631599/efficacy-and-safety-of-omalizumab-in-children-and-adolescents-with-moderate-to-severe-asthma-a-systematic-literature-review
#5
J Corren, A Kavati, B Ortiz, J A Colby, K Ruiz, B A Maiese, S M Cadarette, R A Panettieri
BACKGROUND: There are limited pediatric data about the use of omalizumab, especially the effectiveness and safety ofomalizumab in the real-world management of allergic asthma. OBJECTIVE: The objective of this study was to summarize the safety and efficacy of omalizumab in both randomized clinicaltrials (RCT) used for U.S. Food and Drug Administration registration and real-world studies (RWS) based on clinical care of children with moderate-to-severe asthma. METHODS: Studies that evaluated omalizumab use in patients < 18 years old and with asthma, published between January2003 and October 2016, were retrieved from medical literature data bases...
June 19, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28619649/the-school-inner-city-asthma-intervention-study-design-rationale-methods-and-lessons-learned
#6
Wanda Phipatanakul, Petros Koutrakis, Brent A Coull, Choong-Min Kang, Jack M Wolfson, Stephen T Ferguson, Carter R Petty, Mihail Samnaliev, Amparito Cunningham, William J Sheehan, Jonathan M Gaffin, Sachin N Baxi, Peggy S Lai, Perdita Permaul, Liming Liang, Peter S Thorne, Gary Adamkiewicz, Kasey J Brennan, Andrea A Baccarelli, Diane R Gold
Asthma is the most common chronic disease of childhood in the United States, causes significant morbidity, particularly in the inner-city, and accounts for billions of dollars in health care utilization. Home environments are established sources of exposure that exacerbate symptoms and home-based interventions are effective. However, elementary school children spend 7 to 12h a day in school, primarily in one classroom. From the observational School Inner-City Asthma Study we learned that student classroom-specific exposures are associated with worsening asthma symptoms and decline in lung function...
June 12, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28590992/montelukast-treatment-of-acute-asthma-exacerbations-in-children-aged-2-to-5-years-a-randomized-double-blind-placebo-controlled-trial
#7
Xiuping Wang, Jinfang Zhou, Xin Zhao, Xiongxiong Yi
BACKGROUND: Although montelukast has an established role in the management of chronic asthma in children, its efficacy in acute asthma exacerbations (AAEs) in children aged 2 to 5 years is not fully known. This study aimed to evaluate the effectiveness and safety of montelukast for treating AAE in children aged 2 to 5 years in China. METHODS: In total, 120 Chinese children with AAE, aged 2 to 5 years, were randomly divided into 2 groups, each with 60 patients. All patients received either montelukast or placebo along with standard therapy for acute asthma between January 2011 and December 2015...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28583396/a-novel-endpoint-for-exacerbations-in-asthma-to-accelerate-clinical-development-a-post-hoc-analysis-of-randomised-controlled-trials
#8
Anne L Fuhlbrigge, Thomas Bengtsson, Stefan Peterson, Alexandra Jauhiainen, Göran Eriksson, Carla A Da Silva, Anthony Johnson, Tariq Sethi, Nicholas Locantore, Ruth Tal-Singer, Malin Fagerås
BACKGROUND: Occurrence of severe asthma exacerbations are the cornerstone of the evaluation of asthma management, but severe asthma exacerbations are rare events. Therefore, trials that assess drug efficacy on exacerbations are done late in clinical development programmes. We aimed to establish an endpoint capturing clinically relevant deteriorations (diary events) that, when combined with severe exacerbations, create a composite outcome (CompEx). CompEx needs to strongly mirror results seen with the severe exacerbation-validated outcome, to allow the design of clinical trials of shorter duration and that include fewer patients than trials assessing severe exacerbations...
June 2, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28583260/the-case-for-impulse-oscillometry-in-the-management-of-asthma-in-children-and-adults
#9
REVIEW
Stanley P Galant, Hirsh D Komarow, Hye-Won Shin, Salman Siddiqui, Brian J Lipworth
OBJECTIVE: To provide a clinical rationale for including impulse oscillometry (IOS) as a part of standard office-based asthma assessment. DATA SOURCES: PubMed and Google search, limited to English language and human disease, with the keywords IOS and asthma. STUDY SELECTIONS: Articles included in this review were based on the expert opinion and previous publications by the authors. RESULTS: In children, IOS was more useful than spirometry in identifying asthma and uncontrolled asthma and predicting loss of control and exacerbations...
June 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28580744/management-of-severe-asthma-targeting-the-airways-comorbidities-and-risk-factors
#10
Peter G Gibson, Vanessa M McDonald
Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple comorbidities and risk factors. In mild to moderate asthma, the burden of disease can be minimised by inhaled corticosteroids, bronchodilators and self-management education. In severe asthma, however, management is more complex. When patients with asthma continue to experience symptoms and exacerbations despite optimal management, severe refractory asthma (SRA) should be suspected and confirmed, and other aetiologies ruled out...
June 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28561247/asthma-during-pregnancy-exacerbations-management-and-health-outcomes-for-mother-and-infant
#11
Vanessa E Murphy, Megan E Jensen, Peter G Gibson
One in 10 pregnant women worldwide has asthma and of these, 10% will have a severe exacerbation requiring oral corticosteroids (OCSs) in pregnancy. This review of recent publications in the field will describe the effects of exacerbation on maternal and neonatal health, the use of asthma medications during pregnancy, and will suggest novel management approaches for asthma in pregnancy. Pregnancy results in unpredictable changes in the disease; therefore, regular monitoring of symptoms is recommended. Uncontrolled asthma is frequently described in cohorts of pregnant women with asthma, and some recent studies show associations with adverse perinatal outcomes, as previously demonstrated with exacerbations...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28557753/oral-corticosteroid-prescribing-for-children-with-asthma-in-a-medicaid-managed-care-program
#12
Harold J Farber, Edwin A Silveira, Douglas R Vicere, Viral D Kothari, Angelo P Giardino
BACKGROUND AND OBJECTIVE: Short courses of oral corticosteroid (OCS) medication are recommended for treatment of moderate to severe asthma exacerbations. Concern has been raised about OCS overuse. Our objective is to describe rates of OCS dispensing among children with asthma and factors associated with variation in OCS dispensing. METHODS: Claims data for children 1 to <18 years of age with an asthma diagnosis between January 2011 and January 2016 were extracted from the computerized databases of Texas Children's Health Plan...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28552257/-allergic-bronchopulmonary-aspergillosis-evaluation-of-a-maintenance-therapy-with-nebulized-ambisome-%C3%A2
#13
C Godet, F Couturaud, S Ragot, F Laurent, A L Brun, A Bergeron, J Cadranel
BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) affects 3-13% of patients with asthma. Its natural history includes possibly life-threatening exacerbations and evolution towards fixed obstructive ventilatory disorders or even irreversible lung fibrosis lesions. ABPA prognosis is directly associated with exacerbation control and the main objective of the treatment is to decrease their frequency and duration. Recommendations regarding dosage and duration of treatment are not very precise...
May 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28551030/excessive-gestational-weight-gain-in-first-trimester-is-a-risk-factor-for-exacerbation-of-asthma-during-pregnancy-a%C3%A2-prospective-study-of-1283-pregnancies
#14
Zarqa Ali, Lisbeth Nilas, Charlotte Suppli Ulrik
BACKGROUND: Acute exacerbation during pregnancy is the most important risk factor for an unfavorable outcome of pregnancy in women with asthma. OBJECTIVE: We sought to identify pregnancy-related risk factors for acute exacerbations of asthma during pregnancy. METHODS: Since 2007, all pregnant women referred to give birth at Hvidovre Hospital, Denmark, have been offered participation in the prospective Management of Asthma during Pregnancy (MAP) program...
May 24, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28530840/oral-glucocorticoid-sparing-effect-of-benralizumab-in-severe-asthma
#15
Parameswaran Nair, Sally Wenzel, Klaus F Rabe, Arnaud Bourdin, Njira L Lugogo, Piotr Kuna, Peter Barker, Stephanie Sproule, Sandhia Ponnarambil, Mitchell Goldman
Background Many patients with severe asthma rely on oral glucocorticoids to manage their disease. We investigated whether benralizumab, a monoclonal antibody directed against the alpha subunit of the interleukin-5 receptor that significantly reduces the incidence of asthma exacerbations, was also effective as an oral glucocorticoid-sparing therapy in patients relying on oral glucocorticoids to manage severe asthma associated with eosinophilia. Methods In a 28-week randomized, controlled trial, we assessed the effects of benralizumab (at a dose of 30 mg administered subcutaneously either every 4 weeks or every 8 weeks [with the first three doses administered every 4 weeks]) versus placebo on the reduction in the oral glucocorticoid dose while asthma control was maintained in adult patients with severe asthma...
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28526665/the-sensor-study-protocol-for-a-mixed-methods-study-of-self-management-checks-to-predict-exacerbations-of-pseudomonas-aeruginosa-in-patients-with-long-term-respiratory-conditions
#16
Claire Roberts, Thomas L Jones, Samal Gunatilake, Will Storrar, Scott Elliott, Sharon Glaysher, Ben Green, Steven Rule, Carole Fogg, Ann Dewey, Kevin A Auton, Anoop J Chauhan
BACKGROUND: There are an estimated three million people in the United Kingdom with chronic obstructive pulmonary disease (COPD), and the incidence of bronchiectasis is estimated at around 0.1% but is more common in COPD and severe asthma. Both COPD and bronchiectasis are characterized by exacerbations in which bacteria play a central role. Pseudomonas aeruginosa is isolated from sputum samples from 4% to 15% of adults with COPD and is more likely to be isolated from patients with severe disease...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28506728/-the-effects-of-inhaled-steroids-withdrawal-in-copd
#17
G Jebrak, I Honore, P Serrier, J Dumoulin, P Terrioux, F Soyez, C Maurer, G Mangiapan, M Febvre, L-J Couderc, J-M Braun, T Chinet
The key pathophysiological feature of chronic obstructive pulmonary disease (COPD) is an abnormal inflammatory bronchial reaction after inhalation of toxic substances. The priority is the avoidance of such toxic inhalations, but the use of anti-inflammatory drugs also seems appropriate, especially corticosteroids that are the sole anti-inflammatory drug available for this purpose in France. The risks associated with the prolonged use of these parenteral drugs are well known. Inhalation is therefore the optimal route, but inhaled drugs may also lead to adverse consequences...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28502823/niaid-niehs-nhlbi-mcan-workshop-report-the-indoor-environment-and-childhood-asthma-implications-for-home-environmental-intervention-in-asthma-prevention-and-management
#18
Diane R Gold, Gary Adamkiewicz, Syed Hasan Arshad, Juan C Celedón, Martin D Chapman, Ginger L Chew, Donald N Cook, Adnan Custovic, Ulrike Gehring, James E Gern, Christine C Johnson, Suzanne Kennedy, Petros Koutrakis, Brian Leaderer, Herman Mitchell, Augusto A Litonjua, Geoffrey A Mueller, George T O'Connor, Dennis Ownby, Wanda Phipatanakul, Victoria Persky, Matthew S Perzanowski, Clare D Ramsey, Päivi M Salo, Julie M Schwaninger, Joanne E Sordillo, Avrum Spira, Shakira F Suglia, Alkis Togias, Darryl C Zeldin, Elizabeth C Matsui
Environmental exposures have been recognized as critical in the initiation and exacerbation of asthma, one of the most common chronic childhood diseases. The National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Environmental Health Sciences (NIEHS), National Heart, Lung, and Blood Institute (NHLBI), and Merck Childhood Asthma Network (MCAN) sponsored a joint workshop to discuss the current state of the science with respect to the indoor environment and its effects on the development and morbidity of childhood asthma...
May 10, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28496564/in-flight-allergic-emergencies
#19
REVIEW
Mario Sánchez-Borges, Victoria Cardona, Margitta Worm, Richard F Lockey, Aziz Sheikh, Paul A Greenberger, Ignacio J Ansotegui, Motohiro Ebisawa, Yehia El-Gamal, Stanley Fineman, Mario Geller, Alexei Gonzalez-Estrada, Luciana Tanno, Bernard Y Thong
Allergic and hypersensitivity reactions such as anaphylaxis and asthma exacerbations may occur during air travel. Although the exact incidence of in-flight asthma and allergic emergencies is not known, we have concerns that this subject has not received the attention it warrants. There is a need to provide passengers at risk and airlines with the necessary measures to prevent and manage these emergencies. A review of the epidemiology, management and approaches to prevention of allergic and asthma emergencies during air travel is presented with the goal of increasing awareness about these important, potentially preventable medical events...
2017: World Allergy Organization Journal
https://www.readbyqxmd.com/read/28487836/allergic-conjunctivitis-in-asia
#20
REVIEW
Bernard Yu-Hor Thong
Allergic conjunctivitis (AC), which may be acute or chronic, is associated with rhinitis in 30%-70% of affected individuals, hence the term allergic rhinoconjunctivitis (AR/C). Seasonal and perennial AC is generally milder than the more chronic and persistent atopic and vernal keratoconjunctivitis. Natural allergens like house dust mites (HDM), temperate and subtropical grass and tree pollen are important triggers that drive allergic inflammation in AC in the Asia-Pacific region. Climate change, environmental tobacco smoke, pollutants derived from fuel combustion, Asian dust storms originating from central/north Asia and phthalates may also exacerbate AR/C...
April 2017: Asia Pacific Allergy
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