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Oral steroid asthma

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https://www.readbyqxmd.com/read/27923549/assessing-the-value-of-mepolizumab-for-severe-eosinophilic-asthma-a-cost-effectiveness-analysis
#1
Melanie D Whittington, R Brett McQueen, Daniel A Ollendorf, Jeffrey A Tice, Richard H Chapman, Steven D Pearson, Jonathan D Campbell
BACKGROUND: Adding mepolizumab to standard treatment with inhaled corticosteroids and controller medications could decrease asthma exacerbations and use of long-term oral steroids in patients with severe disease and increased eosinophils; however, mepolizumab is costly and its cost effectiveness is unknown. OBJECTIVE: To estimate the cost effectiveness of mepolizumab. METHODS: A Markov model was used to determine the incremental cost per quality-adjusted life year (QALY) gained for mepolizumab plus standard of care (SoC) and for SoC alone...
December 3, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27912982/should-recommendations-about-starting-inhaled-corticosteroid-treatment-for-mild-asthma-be-based-on-symptom-frequency-a-post-hoc-efficacy-analysis-of-the-start-study
#2
Helen K Reddel, William W Busse, Søren Pedersen, Wan C Tan, Yu-Zhi Chen, Carin Jorup, Dan Lythgoe, Paul M O'Byrne
BACKGROUND: Low-dose inhaled corticosteroids (ICS) are highly effective for reducing asthma exacerbations and mortality. Conventionally, ICS treatment is recommended for patients with symptoms on more than 2 days per week, but this criterion has scant evidence. We aimed to assess the validity of the previous symptom-based cutoff for starting ICS by establishing whether there was a differential response to budesonide versus placebo for severe asthma exacerbations, lung function, and asthma symptom control across subgroups identified by baseline asthma symptom frequency...
November 29, 2016: Lancet
https://www.readbyqxmd.com/read/27909980/omalizumab-in-severe-refractory-vernal-keratoconjunctivitis-in-children-case-series-and-review-of-the-literature
#3
Serge Doan, Flore Amat, Eric Gabison, Sarah Saf, Isabelle Cochereau, Jocelyne Just
INTRODUCTION: Vernal keratoconjunctivis (VKC) is a severe form of pediatric ocular allergy, characterized by acute and chronic corneoconjunctival inflammation that may lead to visual sequelae. Although topical immunosuppressive drugs such as cyclosporine are usually effective, some severe forms may be refractory and require prolonged steroid therapy. Very few papers report the use of omalizumab in VKC in the literature. In the present study, we describe our clinical experience with omalizumab in severe VKC children...
December 1, 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27889361/adult-bronchiectasis-patients-a-first-look-at-the-united-states-bronchiectasis-research-registry
#4
Timothy R Aksamit, Anne E O'Donnell, Alan Barker, Kenneth N Olivier, Kevin L Winthrop, M Leigh Anne Daniels, Margaret Johnson, Edward Eden, David Griffith, Michael Knowles, Mark Metersky, Matthias Salathe, Byron Thomashow, Gregory Tino, Gerard Turino, Betsy Carretta, Charles L Daley
OBJECTIVE: We sought to describe the characteristics of adult bronchiectasis patients enrolled in the United States Bronchiectasis Research Registry (BRR). METHODS: The BRR is a database of non-cystic fibrosis bronchiectasis (NCFB) patients enrolled at 13 sites within the United States. Baseline demographic, spirometric, imaging, microbiologic, and therapeutic data were entered into a central web-based database. Patients were subsequently analyzed by the presence NTM...
November 23, 2016: Chest
https://www.readbyqxmd.com/read/27888916/refractory-chronic-rhinosinusitis-with-nasal-polyposis
#5
REVIEW
Benjamin P Hull, Rakesh K Chandra
Chronic rhinosinusitis with nasal polyposis (CRSwNP) represents a subset of chronic sinusitis with various causes. Some forms of the disease are driven by allergy, often in association with asthma. Refractory CRSwNP can be associated with cystic fibrosis and other clinical syndromes. More recent literature is presented regarding roles of innate immunity and superantigens. Effective treatment of CRSwNP requires careful endoscopic sinus surgery followed by an individualized treatment plan that often includes oral and topical steroids...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27852427/monitoring-the-hospital-management-of-acute-asthma-the-italian-pediatric-network-experience
#6
A G Martelli, R Bianchi, B Boldrighini, M Bosoni, A De Vuono, A Flores D'Arcais, G Gargantini, R Longhi, M T Ortisi, E Racchi, L Parola
BACKGROUND: The Study Group on Accreditation and Quality Improvement of the Italian Society of Pediatrics has developed an observational study about the hospital management of pediatric patients affected by severe asthma, in order to evaluate how the Guidelines for severe asthma in childhood are applied in the daily practice. METHODS: This study included patients between 2 and 17 years, hospitalized or under short intensive observation for acute asthma. The data collection was carried out through the compilation of on-line forms...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27849653/the-role-of-aspirin-desensitization-in-the-management-of-aspirin-exacerbated-respiratory-disease
#7
Bobby A Tajudeen, Joseph S Schwartz, John V Bosso
PURPOSE OF REVIEW: Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27834175/severe-asthma-anti-ige-or-anti-il-5
#8
REVIEW
Evgenia Papathanassiou, Stelios Loukides, Petros Bakakos
Severe asthma is a discrete clinical entity characterised by recurrent exacerbations, reduced quality of life and poor asthma control as ordinary treatment regimens remain inadequate. Difficulty in managing severe asthma derives partly from the multiple existing phenotypes and our inability to recognise them. Though the exact pathogenetic pathway of severe allergic asthma remains unclear, it is known that numerous inflammatory cells and cytokines are involved, and eosinophils represent a key inflammatory cell mediator...
2016: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27826703/leukotriene-receptor-antagonists-and-antiallergy-drugs
#9
Tsutomu Tamada, Masakazu Ichinose
As one of the candidates of the therapeutic strategy for asthma in addition to inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRAs) are known to be useful for long-term management of asthma patients complicated by allergic rhinitis (AR) or exercise-induced asthma (EIA). Currently available LTRAs are pranlukast hydrate, zafirlukast, and montelukast. These LTRAs have a bronchodilator action and inhibit airway inflammation, resulting in a significant improvement of asthma symptoms, respiratory function, inhalation frequency of as-needed inhaled β2-agonist, airway inflammation, airway hyperresponsiveness, dosage of ICSs, asthma exacerbations, and patients' QOL...
November 9, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27815524/staar-a-randomised-controlled-trial-of-electronic-adherence-monitoring-with-reminder-alarms-and-feedback-to-improve-clinical-outcomes-for-children-with-asthma
#10
Robert W Morton, Heather E Elphick, Alan S Rigby, William J Daw, David A King, Laurie J Smith, Mark L Everard
BACKGROUND: Suboptimal adherence to inhaled steroids is common in children with asthma and is associated with poor disease control, reduced quality of life and even death. Previous studies using feedback of electronically monitored adherence data have demonstrated improved adherence, but have not demonstrated a significant impact on clinical outcomes. The aim of this study was to determine whether introduction of this approach into routine practice would result in improved clinical outcomes...
November 4, 2016: Thorax
https://www.readbyqxmd.com/read/27813670/results-from-a-pragmatic-prospective-cohort-study-shared-decision-making-improves-outcomes-for-children-with-asthma
#11
Hazel Tapp, Lindsay Shade, Rohan Mahabaleshwarkar, Yhenneko J Taylor, Thomas Ludden, Michael F Dulin
OBJECTIVE: Patient/provider shared decision making (SDM) improves asthma control in a pragmatic clinical trial setting. This study evaluated the impact of an evidence-based SDM toolkit on outcomes for patients with asthma implemented by providers in a real world setting. We hypothesized that these patients with asthma would demonstrate improved outcomes such as reduced emergency department (ED) visits, hospitalizations, and oral steroid use in the 12 months following a SDM visit compared to those who did not receive the intervention...
November 4, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27805264/identification-of-phenotypic-clusters-of-nonsteroidal-anti-inflammatory-drugs-exacerbated-respiratory-disease
#12
H Y Lee, Y M Ye, S H Kim, G Y Ban, S C Kim, J H Kim, Y S Shin, H S Park
BACKGROUND: Clinical presentation of nonsteroidal anti-inflammatory drugs exacerbated respiratory disease (NERD) is found to be heterogeneous. This study classified phenotypic clusters to determine NERD subtypes. METHODS: We performed two-step cluster analysis using urticaria, chronic rhinosinusitis (CRS), and atopy, in a NERD cohort comprising 302 patients. Asthma exacerbation was defined as receiving at least one burst of intravenous steroid treatment and/or at least two bursts of oral steroid use (≥ 45 mg/3 days) per year...
November 2, 2016: Allergy
https://www.readbyqxmd.com/read/27766109/adrenal-suppression-in-children-treated-with-swallowed-fluticasone-and-oral-viscous-budesonide-for-eosinophilic-esophagitis
#13
Alexandra Ahmet, Eric I Benchimol, Ellen B Goldbloom, Janice L Barkey
BACKGROUND: Adrenal suppression (AS), a glucocorticoid (GC) side effect associated with significant morbidity, is well described related to inhaled corticosteroid therapy for asthma. Swallowed topical glucocorticoid therapy is the main pharmacotherapy treatment for eosinophilic esophagitis (EoE) and therefore children with EoE are potentially at increased risk of AS. METHODS: In this prospective cohort study, we included children and youth <18 years diagnosed with EoE and treated with swallowed fluticasone or oral viscous budesonide for more than 1 month...
2016: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/27758759/nasal-ketorolac-challenge-using-an-acoustic-rhinomether-in-patients-with-aspirin-exacerbated-respiratory-disease
#14
J Quiralte-Castillo, M Del Robledo Ávila-Castellano, S Cimbollek, P Benaixa, S Leguisamo, K Baynova, M Labella, J Quiralte
BACKGROUND: Safer and less time consuming alternatives to single-blind placebo-controlled oral challenge (SBPCOC) in order to diagnose aspirin-exacerbated respiratory disease (AERD) have been searched for. Nasal challenges with different non-steroidal anti-inflammatory drugs and assessment methods have been developed. OBJECTIVE: Our objective was to evaluate the utility and safety of nasal ketorolac challenge (NKC) using an acoustic rhinomether in patients with suspected AERD Methods: Thirty-six patients with suspected AERD were included in the study...
October 19, 2016: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/27737713/fourfold-asthma-study-fast-a-study-protocol-for-a-randomised-controlled-trial-evaluating-the-clinical-cost-effectiveness-of-temporarily-quadrupling-the-dose-of-inhaled-steroid-to-prevent-asthma-exacerbations
#15
Andrew Skeggs, Tricia McKeever, Lelia Duley, Eleanor Mitchell, Lucy Bradshaw, Kevin Mortimer, Samantha Walker, Steve Parrott, Andrew Wilson, Ian Pavord, Chris Brightling, Mike Thomas, David Price, Graham Devereux, Bernard Higgins, Tim Harrison, Rebecca Haydock
BACKGROUND: Asthma is one of the commonest chronic diseases in the UK. Acute exacerbations of asthma are unpredictable, disruptive and frightening. They cause considerable morbidity and account for a large component of the health service costs of asthma. The widespread use of an asthma self-management plan, designed to encourage disease monitoring and timely intervention, can reduce exacerbations and is, therefore, recommended for all patients with asthma. Unfortunately, the majority of patients are not provided with such a plan...
October 13, 2016: Trials
https://www.readbyqxmd.com/read/27650241/allergy-medications-during-pregnancy
#16
REVIEW
Alexei Gonzalez-Estrada, Stephen A Geraci
Allergic diseases are common in women of childbearing age. Both asthma and atopic conditions may worsen, improve or remain the same during pregnancy. Primary care physicians commonly encounter women receiving multiple medications for pre-existing atopic conditions, who then become pregnant and require medication changes to avoid potential fetal injury or congenital malformations. Each medication should be evaluated; intranasal and inhaled steroids are relatively safe to continue during pregnancy (budesonide is the drug of choice), second-generation antihistamines of choice are cetirizine and loratadine, leukotriene receptor antagonists are safe, sparing use of oral decongestants during the first trimester and omalizumab may be used for both uncontrolled asthma and for antihistamine-resistant urticaria...
September 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27649894/cognitive-behavioural-therapy-cbt-for-adults-and-adolescents-with-asthma
#17
Kayleigh M Kew, Marina Nashed, Valdeep Dulay, Janelle Yorke
BACKGROUND: People with asthma have a higher prevalence of anxiety and depression than the general population. This is associated with poorer asthma control, medication adherence, and health outcomes. Cognitive behavioural therapy (CBT) may be a way to improve the quality of life of people with asthma by addressing associated psychological issues, which may lead to a lower risk of exacerbations and better asthma control. OBJECTIVES: To assess the efficacy of CBT for asthma compared with usual care...
September 21, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27611495/asthma-chronic-obstructive-pulmonary-disease-overlap-syndrome-associated-with-risk-of-pulmonary-embolism
#18
Jun-Jun Yeh, Yu-Chiao Wang, Chia-Hung Kao
PURPOSE: We conducted a cohort study to clarify this relationship between asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE). METHODS: From the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876)...
2016: PloS One
https://www.readbyqxmd.com/read/27578470/effects-of-older-age-and-age-of-asthma-onset-on-clinical-and-inflammatory-variables-in-severe-refractory-asthma
#19
Rekha Chaudhuri, Charles McSharry, Liam G Heaney, Robert Niven, Christopher E Brightling, Andrew N Menzies-Gow, Christine Bucknall, Adel H Mansur, Waiting Lee, Malcolm Shepherd, Mark Spears, Douglas C Cowan, Holger Husi, Neil C Thomson
BACKGROUND: Asthma in the elderly as well as asthma of adult-onset has been associated with increased morbidity, but little is known specifically about the effects of age on clinical and inflammatory outcomes in severe refractory asthma. The aims of the study were to examine the effects of age [<65 versus ≥65 years] and age of onset of asthma [childhood-onset, <18 versus adult-onset, ≥18 years] on clinical and inflammatory variables in patients with severe asthma. METHODS: In 1042 subjects with refractory asthma recruited to the British Thoracic Society Severe Asthma Registry, we compared patient demographics, disease characteristics and biomarkers of inflammation in patients aged <65 years (n = 896) versus ≥65 years (n = 146) and onset at age <18 years (n = 430) versus ≥18 years (n = 526)...
September 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27544712/predictive-properties-of-the-asthma-control-test-and-its-component-questions-for-severe-asthma-exacerbations
#20
Sonia Cajigal, Karen E Wells, Edward L Peterson, Brian K Ahmedani, James J Yang, Rajesh Kumar, Esteban G Burchard, L Keoki Williams
BACKGROUND: Current US guidelines recommend the Asthma Control Test (ACT) for assessing disease control and selecting treatment. OBJECTIVE: The goal of this study was to prospectively assess the ACT and its component questions for their utility in predicting the risk of severe asthma exacerbations. METHODS: Individuals were participants in the Study of Asthma Phenotypes and Pharmacogenomic Interactions by Race-Ethnicity, and those included in the current analysis had the following characteristics: age 18 years or more, physician-diagnosed asthma, and longitudinal care received at a large health system in southeastern Michigan...
August 17, 2016: Journal of Allergy and Clinical Immunology in Practice
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