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management of exacerbation of asthma

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https://www.readbyqxmd.com/read/28530840/oral-glucocorticoid-sparing-effect-of-benralizumab-in-severe-asthma
#1
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...
May 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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28484598/the-evidence-on-tiotropium-bromide-in-asthma-from-the-rationale-to-the-bedside
#7
REVIEW
Dejan Radovanovic, Pierachille Santus, Francesco Blasi, Marco Mantero
Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28479021/what-keeps-children-with-cystic-fibrosis-awake-at-night
#8
Moya Vandeleur, Lisa M Walter, David S Armstrong, Philip Robinson, Gillian M Nixon, Rosemary S C Horne
BACKGROUND: Sleep disturbance is common in children with cystic fibrosis (CF) however there are limited studies investigating the causes for poor sleep quality. In a cross sectional observational study we aimed to evaluate the clinical correlates of sleep disturbance in this population. METHODS: Children with CF (7-18years) free from pulmonary exacerbation completed medical review, overnight oximetry, the OSA-18 and 14days of actigraphy recordings with a sleep diary...
May 4, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28469716/allergic-bronchopulmonary-aspergillosis-in-patients-with-cystic-fibrosis
#9
REVIEW
Ibrahim Ahmed Janahi, Abdul Rehman, Amal Rashid Al-Naimi
Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disorder that often occurs in patients with asthma or cystic fibrosis (CF) and is characterized by a hypersensitivity response to the allergens of the fungus Aspergillus fumigatus. In patients with CF, growth of A. fumigatus hyphae within the bronchial lumen triggers an immunoglobulin E (IgE)-mediated hypersensitivity response that results in airway inflammation, bronchospasm, and bronchiectasis. In most published studies, the prevalence of ABPA is about 8...
April 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28461300/addressing-unmet-needs-in-understanding-asthma-mechanisms-from-the-european-asthma-research-and-innovation-partnership-earip-work-package-wp-2-collaborators
#10
REVIEW
Michael R Edwards, Sejal Saglani, Jurgen Schwarze, Chrysanthi Skevaki, Jaclyn A Smith, Ben Ainsworth, Mark Almond, Evangelos Andreakos, Maria G Belvisi, Kian Fan Chung, William Cookson, Paul Cullinan, Catherine Hawrylowicz, Marek Lommatzsch, David Jackson, Rene Lutter, Benjamin Marsland, Miriam Moffatt, Mike Thomas, J Christian Virchow, Georgina Xanthou, Jessica Edwards, Samantha Walker, Sebastian L Johnston
Asthma is a heterogeneous, complex disease with clinical phenotypes that incorporate persistent symptoms and acute exacerbations. It affects many millions of Europeans throughout their education and working lives and puts a heavy cost on European productivity. There is a wide spectrum of disease severity and control. Therapeutic advances have been slow despite greater understanding of basic mechanisms and the lack of satisfactory preventative and disease modifying management for asthma constitutes a significant unmet clinical need...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28461294/asthma-and-smoking-induced-airway-disease-without-spirometric-copd
#11
REVIEW
Neil C Thomson
Due to the high prevalence rates of cigarette smoking and asthma, current and ex-smokers frequently develop chronic airway disease without spirometric evidence of chronic obstructive pulmonary disease (COPD), either alone or associated with asthma. This review considers the classification, clinical outcomes, inflammatory and imaging variables, phenotypes, and management of current and ex-smokers with airway disease without COPD, focusing on overlaps in those with and without asthma. These individuals have more respiratory symptoms, worse quality of life, increased exacerbation rates, reduced lung function and more comorbidities than never-smokers with asthma or healthy never-smokers...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28449686/the-frequency-of-asthma-exacerbations-and-healthcare-utilization-in-patients-with-asthma-from-the-uk-and-usa
#12
Robert Y Suruki, Jonas B Daugherty, Nada Boudiaf, Frank C Albers
BACKGROUND: Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK. METHODS: Patients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date)...
April 27, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28441001/-mexican-asthma-guidelines-guima-2017
#13
Désirée Larenas-Linnemann, Jorge Salas-Hernández, Juan Carlos Vázquez-García, Ignacio Ortiz-Aldana, Margarita Fernández-Vega, Blanca Estela Del Río-Navarro, María Del Carmen Cano-Salas, Jorge Agustín Luna-Pech, José Antonio Ortega-Martell, Jade Romero-Lombard, Erika Del Carmen López-Estrada, Jimena Villaverde-Rosas, José Luis Mayorga-Butrón, Mario Humberto Vargas-Becerra, Martín Bedolla-Barajas, Noel Rodríguez-Pérez, Ambrocio Aguilar-Aranda, Carlos Adrián Jiménez-González, Carlos García-Bolaños, Claudia Garrido-Galindo, David Alejandro Mendoza-Hernández, Enrique Mendoza-López, Gerardo López-Pérez, Guillermo Hideo Wakida-Kuzonoki, Héctor Hernán Ruiz-Gutiérrez, Héctor León-Molina, Héctor Martínez-De la Lanza, Héctor Stone-Aguilar, Javier Gómez-Vera, Jorge Olvera-Salinas, José Joel Oyoqui-Flores, José Luis Gálvez-Romero, José Santos Lozano-Sáenz, Juan Ignacio Salgado-Gama, Marcos Alejandro Jiménez-Chobillon, Martha Angélica García-Avilés, Martha Patricia Guinto-Balanzar, Miguel Alejandro Medina-Ávalos, Robert Camargo-Angeles, Rogelio García-Torrentera, Saraí Toral-Freyre, Gabriel Montes-Narváez, Héctor Solorio-Gómez, Juan Rosas-Peña, Sergio Jesús Romero-Tapia, Adela Reyes-Herrera, Francisco Cuevas-Schacht, Joaquín Esquer-Flores, José Antonio Sacre-Hazouri, Lorenzo Compean-Martínez, Pablo Julián Medina-Sánchez, Sergio Garza-Salinas, Carlos Báez-Loyola, Iraís Romero-Alvarado, José Luis Miguel-Reyes, Laura Elizabeth Huerta-Espinosa, Manuel Ángel Correa-Flores, Ricardo Castro-Martínez
BACKGROUND: The need for a national guideline, with a broad basis among specialists and primary care physicians was felt in Mexico, to try unifying asthma management. As several high-quality asthma guidelines exist worldwide, it was decided to select the best three for transculturation. METHODS: Following the internationally recommended methodology for guideline transculturation, ADAPTE, a literature search for asthma guidelines, published 1-1-2007 through 31-12-2015 was conducted...
2017: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
https://www.readbyqxmd.com/read/28439076/practice-makes-perfect-self-reported-adherence-a-positive-marker-of-inhaler-technique-maintenance
#14
Elizabeth Azzi, Pamela Srour, Carol Armour, Cynthia Rand, Sinthia Bosnic-Anticevich
Poor inhaler technique and non-adherence to treatment are major problems in the management of asthma. Patients can be taught how to achieve good inhaler technique, however maintenance remains problematic, with 50% of patients unable to demonstrate correct technique. The aim of this study was to determine the clinical, patient-related and/or device-related factors that predict inhaler technique maintenance. Data from a quality-controlled longitudinal community care dataset was utilized. 238 patients using preventer medications where included...
April 24, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28431499/asthma-copd-overlap-syndrome-acos-in-primary-care-of-four-latin-america-countries-the-puma-study
#15
Maria Montes de Oca, Maria Victorina Lopez Varela, Maria E Laucho-Contreras, Alejandro Casas, Eduardo Schiavi, Juan Carlos Mora
BACKGROUND: Asthma-COPD overlap syndrome (ACOS) prevalence varies depending on the studied population and definition criteria. The prevalence and clinical characteristics of ACOS in an at-risk COPD primary care population from Latin America was assessed. METHODS: Patients ≥40 years, current/ex-smokers and/or exposed to biomass, attending routine primary care visits completed a questionnaire and performed spirometry. COPD was defined as post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) < 0...
April 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28427362/efficacy-of-budesonide-formoterol-maintenance-and-reliever-therapy-compared-with-higher-dose-budesonide-as-step-up-from-low-dose-inhaled-corticosteroid-treatment
#16
Christine R Jenkins, Göran Eriksson, Eric D Bateman, Helen K Reddel, Malcolm R Sears, Magnus Lindberg, Paul M O'Byrne
BACKGROUND: Asthma management may involve a step up in treatment when symptoms are not well controlled. We examined whether budesonide/formoterol maintenance and reliever therapy (MRT) is as effective as higher, fixed-dose budesonide plus as-needed terbutaline in patients requiring step-up from Step 2 treatment (low-dose inhaled corticosteroids), stratified by baseline reliever use. METHODS: A post-hoc analysis utilized data from three clinical trials of 6-12 months' duration...
April 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28424767/direct-and-indirect-costs-of-asthma-management-in-greece-an-expert-panel-approach
#17
Kyriakos Souliotis, Hara Kousoulakou, Georgios Hillas, Petros Bakakos, Michalis Toumbis, Stelios Loukides, Theodoros Vassilakopoulos
OBJECTIVE: Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. METHODS: A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28421600/lay-led-and-peer-support-interventions-for-adolescents-with-asthma
#18
REVIEW
Kayleigh M Kew, Robin Carr, Iain Crossingham
BACKGROUND: Adolescents with asthma are at high risk of poor adherence with treatment. This may be compounded by activities that worsen asthma, in particular smoking. Additional support above and beyond routine care has the potential to encourage good self-management. We wanted to find out whether sessions led by their peers or by lay leaders help to reduce these risks and improve asthma outcomes among adolescents. OBJECTIVES: To assess the safety and efficacy of lay-led and peer support interventions for adolescents with asthma...
April 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28407829/-application-of-pulmonary-function-and-fractional-exhaled-nitric-oxide-tests-in-the-standardized-management-of-bronchial-asthma-in-children
#19
Hui-Qin Zhang, Hui-Qin Zhang, Jing-Jing Zhang, Yu-Dong Liu, Yue-Lin Deng, Jian-Feng Luo, Huan-Hong Niu, Xin Sun
OBJECTIVE: To investigate the changes of pulmonary function and fractional exhaled nitric oxide (FeNO) in the standardized treatment of bronchial asthma in children. METHODS: A total of 254 children who were newly diagnosed with acute exacerbation of bronchial asthma were selected as asthma group, and they were divided into two subgroups: asthma with concurrent rhinitis and asthma without concurrent rhinitis. All patients received the standardized management and treatment for one year...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28402017/asthma-education-for-school-staff
#20
REVIEW
Kayleigh M Kew, Robin Carr, Tim Donovan, Morris Gordon
BACKGROUND: Teachers and school staff should be competent in managing asthma in schools. Demonstrated low levels of asthma knowledge mean that staff may not know how best to protect a child with asthma in their care, or may fail to take appropriate action in the event of a serious attack. Education about asthma could help to improve this knowledge and lead to better asthma outcomes for children. OBJECTIVES: To assess the effectiveness and safety of asthma education programmes for school staff, and to identify content and attributes underpinning them...
April 12, 2017: Cochrane Database of Systematic Reviews
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