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https://www.readbyqxmd.com/read/29156455/-the-overrated-impact-of-inhaled-substances-laba-lama-ics-on-exacerbation-rates-in-copd
#1
D Köhler, D Dellweg
Numerous studies have shown that exacerbation rates in COPD can be significantly reduced by long acting beta-2-agonists (LABA), long acting anticholinergic agents (LAMA) and inhaled steroids (ICS). Elaborate and extensive investigations however failed to prove that the reduction in exacerbation rates leads to life prolongation. As opposed to this, numerous studies have shown a reduction in life expectancy with increasing number and severity of exacerbations.This review aimed at comparing these studies and to elaborate the relevance and reduction of exacerbations rates by LABA, LAMA and ICS application through effect size calculation by means of Cohens' d...
November 20, 2017: Pneumologie
https://www.readbyqxmd.com/read/29115880/treatment-response-heterogeneity-in-asthma-the-role-of-genetic-variation
#2
Susanne J H Vijverberg, Niloufar Farzan, Elise M A Slob, Anne H Neerincx, Anke H Maitland-van der Zee
Asthmatic patients show a large heterogeneity in response to asthma medication. Rapidly evolving genotyping technologies have led to the identification of various genetic variants associated with treatment outcomes. Areas covered: This review focuses on the current knowledge of genetic variants influencing treatment response to the most commonly used asthma medicines: short- and long-acting beta-2 agonists (SABA/LABA), inhaled corticosteroids (ICS) and leukotriene modifiers. This review shows that various genetic variants have been identified, but none are currently used to guide asthma treatment...
November 8, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29110790/long-term-management-of-patients-with-end-stage-lung-diseases
#3
REVIEW
Domenica Federica Briganti, Frank D'Ovidio
Long-term management of end-stage lung disease differs from interstitial lung disease to chronic obstructive pulmonary disease to cystic fibrosis to pulmonary vascular disease. The management includes pharmacological therapy that is disease specific such as antibiotic therapy for cystic fibrosis, antifibrotic drugs in idiopathic pulmonary fibrosis; long-acting beta-agonists, long-acting muscarinic antagonist, and inhaled corticosteroids in chronic obstructive pulmonary disease; and vasodilators in pulmonary arterial hypertension...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29108533/a-review-of-the-efficacy-and-safety-of-once-daily-tiotropium-respimat-2-5-micrograms-in-adults-and-adolescents-with-asthma
#4
(no author information available yet)
BACKGROUND: Despite current guidelines, many patients with asthma remain symptomatic, particularly those intolerant of,unresponsive to, or uncontrolled by long-acting beta 2-agonists (LABAs). Tiotropium bromide, delivered through the Respimatsoft-mist inhaler in 2 puffs of 1.25 micrograms each, is approved for the long-term, maintenance treatment of asthma in patients aged greater than or equal to 6 years. OBJECTIVE: An overview of the use of once-daily tiotropium Respimat 2...
November 6, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29102337/application-for-authorization-for-therapeutic-use-of-beta-adrenergic-agonists-and-inhaled-corticosteroids-in-athletes-with-asthma
#5
Franchek Drobnic, Jesús Blanco-Alfaro
No abstract text is available yet for this article.
November 1, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29083972/inhaled-corticosteroid-containing-treatment-escalation-and-outcomes-for-patients-with-asthma-in-a-u-s-health-care-organization
#6
Lindsay G S Bengtson, Yanni Yu, Weijia Wang, Feng Cao, Erin M Hulbert, Ryan Wolbeck, Caitlin A Elliott, Ami R Buikema
BACKGROUND: Asthma is a common disorder that affects approximately 8% of the U.S. POPULATION: Treatment guidelines indicate inhaled corticosteroids (ICS) as the mainstay treatment, yet poor asthma control is common among ICS-treated patients. Treatment escalation (ICS dose increase and other controller therapy add-ons) is used to manage symptoms. Real-world studies of postescalation outcomes may inform treatment decisions. OBJECTIVES: To (a) describe characteristics and treatment patterns among asthma patients who escalated treatment and (b) assess outcomes (exacerbations, uncontrolled asthma, and health care resource utilization [HCRU]) after escalation...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29071080/description-of-the-protocol-for-the-practical-study-a-randomised-controlled-trial-of-the-efficacy-and-safety-of-ics-laba-reliever-therapy-in-asthma
#7
James Fingleton, Jo Hardy, Christina Baggott, Janine Pilcher, Andrew Corin, Robert J Hancox, Matire Harwood, Mark Holliday, Helen K Reddel, Philippa Shirtcliffe, Suzanne Snively, Mark Weatherall, Richard Beasley
INTRODUCTION: In adult asthma, combination inhaled corticosteroid (ICS)/fast-onset long-acting beta agonist (LABA) used solely as reliever therapy may represent an effective and safe alternative to ICS maintenance and short-acting beta agonist (SABA) reliever therapy. OBJECTIVE: To compare the efficacy and safety of ICS/fast-onset LABA reliever therapy with ICS maintenance and SABA reliever therapy in adults with asthma. METHODS AND ANALYSIS: A 52-week, open-label, parallel group, multicentre, phase III randomised controlled trial with 1:1 randomisation to either budesonide/formoterol Turbuhaler 200/6 µg, one actuation as required for symptom relief, or budesonide Turbuhaler 200 µg, one actuation twice daily and terbutaline Turbuhaler 250 µg, two actuations as required for symptom relief...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29030687/tolerability-of-bisoprolol-on-domiciliary-spirometry-in-copd
#8
Sunny Jabbal, Brian J Lipworth
We investigated if serial domiciliary measures of spirometry were sensitive at detecting subtle effects of beta-2 blockade associated with bisoprolol in (n = 17) patients with COPD. After a two-week run in on inhaled corticosteroid (ICS) and long acting beta-2 agonist (LABA): beclometasone/formoterol 100/6 µg, patients' started additional a long acting muscarinic receptor antagonist: (LAMA) Tiotropium 18 µg, with concomitant weekly dose titration of bisoprolol: 1.25-2.5-5 mg. After a further week of bisoprolol 5 mg, they were stepped back down to (ICS/LABA) for one week...
October 14, 2017: Lung
https://www.readbyqxmd.com/read/29025008/cardiopulmonary-interactions-with-beta-blockers-and-inhaled-therapy-in-copd
#9
S Jabbal, W Anderson, P Short, A Morrison, A Manoharan, B J Lipworth
Background: Beta-blockers remain underused in patients with chronic obstructive pulmonary disease (COPD) and cardiovascular disease. Aim: We compared how different inhaled therapies affect tolerability of bisoprolol and carvedilol in moderate to severe COPD. Design: A randomized, open label, cross-over study. Methods: We compared the cardiopulmonary interactions of bisoprolol 5 mg qd or carvedilol 12.5 mg bid for 6 weeks in conjunction with: (i) triple: inhaled corticosteroid/long acting beta-agonist/long acting muscarinic antagonist (ICS + LABA + LAMA), (ii) dual: ICS + LABA and (iii) ICS alone...
July 24, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28974349/step-down-therapy-for-asthma-well-controlled-on-inhaled-corticosteroid-and-long-acting-beta-agonist-a-randomized-clinical-trial
#10
Linda Rogers, Elizabeth A Sugar, Kathryn Blake, Mario Castro, Emily Dimango, Nicola A Hanania, Kyle I Happel, Stephen P Peters, Joan Reibman, Joy Saams, W Gerald Teague, Robert A Wise, Janet T Holbrook
BACKGROUND: Stepping down therapy when asthma is well controlled on combination inhaled corticosteroids (ICSs) and long-acting beta-agonists (LABAs) is recommended, but it is not known whether lowering the ICS dose or stopping LABA is superior. OBJECTIVE: To evaluate whether step-down therapy with LABA is superior to one without; and, secondarily, to evaluate whether reducing the ICS dose while maintaining LABA is noninferior to remaining on stable-ICS/LABA. METHODS: The study was a randomized, double-masked 3-arm parallel group trial in participants aged 12 years or older...
September 30, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28968051/gps-have-key-role-in-improving-outcomes-in-acute-asthma
#11
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/28891349/next-generation-beta-adrenoreceptor-agonists-for-the-treatment-of-asthma
#12
Ernesto Crisafulli, Annalisa Frizzelli, Alberto Fantin, Alessandra Manco, Angelo Mangia, Giovanna Pisi, Valentina Fainardi, Veronica Alfieri, Marina Aiello, Giuseppina Bertorelli, Alfredo Chetta
A fixed-dose inhalation of a long-acting β-agonist (LABA) and inhaled corticosteroids (ICS) is commonly recommended for moderate to severe asthmatic patients not adequately controlled by an ICS only. In order to improve the patients' adherence and the control of disease there is a noteworthy interest for the next generation inhaled β adrenoreceptor agonists maintaining an over 24 hours bronchodilatation and used once-daily (ultra-LABAs). This review focuses on the currently available evidences on the clinical role of any single ultra-LABAs in the treatment of asthmatic patients...
October 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28889900/a-62-year-old-woman-with-wheezing-respiratory-failure-and-an-abnormal-ct%C3%A2-scan
#13
Peter Hountras, Hector Cajigas
A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspnea. She presented to an urgent care facility and was diagnosed with community-acquired pneumonia. She received a 5-day course of azithromycin, with partial improvement of her symptoms. The patient returned home 1 week prior to admission, reporting worsening dyspnea, chest pressure, cough, and fever...
September 2017: Chest
https://www.readbyqxmd.com/read/28881155/seasonal-patterns-of-asthma-medication-fills-among-diverse-populations-of-the-united-states
#14
Kedir N Turi, Tebeb Gebretsadik, Rees L Lee, Tina V Hartert, Amber M Evans, Cosby Stone, Nicholas M Sicignano, Ann C Wu, Carlos Iribarren, Melissa G Butler, Edward Mitchel, James Morrow, Emma K Larkin, Pingsheng Wu
OBJECTIVE: Nonadherence to controller and overuse of reliever asthma medications are associated with exacerbations. We aimed to determine patterns of seasonal asthma medication use and to identify time period(s) during which interventions to improve medication adherence could reduce asthma morbidity. METHODS: We conducted a retrospective cohort study of asthmatics 4-50 years of age and enrolled in three diverse health insurance plans. Seasonal patterns of medications were reported by monthly prescription fill rates per 1000 individuals with asthma from 1998 to 2013, and stratified by healthcare plan, sex, and age...
September 7, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28877011/tezepelumab-in-adults-with-uncontrolled-asthma
#15
RANDOMIZED CONTROLLED TRIAL
Jonathan Corren, Jane R Parnes, Liangwei Wang, May Mo, Stephanie L Roseti, Janet M Griffiths, René van der Merwe
BACKGROUND: In some patients with moderate-to-severe asthma, particularly those with noneosinophilic inflammation, the disease remains uncontrolled. This trial evaluated the efficacy and safety of tezepelumab (AMG 157/MEDI9929), a human monoclonal antibody specific for the epithelial-cell-derived cytokine thymic stromal lymphopoietin (TSLP), in patients whose asthma remained uncontrolled despite treatment with long-acting beta-agonists and medium-to-high doses of inhaled glucocorticoids...
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28875459/once-daily-triple-therapy-in-patients-with-advanced-copd-healthcare-resource-utilization-data-and-associated-costs-from-the-fulfil-trial
#16
Afisi S Ismaila, Ruby Birk, Dhvani Shah, Shiyuan Zhang, Noushin Brealey, Nancy A Risebrough, Maggie Tabberer, Chang-Qing Zhu, David A Lipson
INTRODUCTION: Chronic obstructive pulmonary disease is associated with a high healthcare resource and cost burden. Healthcare resource utilization was analyzed in patients with symptomatic chronic obstructive pulmonary disease at risk of exacerbations in the FULFIL study. Patients received either once-daily, single inhaler triple therapy (fluticasone furoate/umeclidinium/vilanterol) 100 µg/62.5 µg/25 µg or twice-daily dual inhaled corticosteroid/long-acting beta agonist therapy (budesonide/formoterol) 400 µg/12 µg...
September 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28868931/emerging-inhaled-long-acting-beta-2-adrenoceptor-agonists-for-the-treatment-of-copd
#17
REVIEW
Thomas J Monaco, Nicola A Hanania
Chronic obstructive pulmonary disease (COPD), characterized by persistent and partially reversible airflow obstruction, is a leading cause of morbidity and mortality worldwide. Long-acting inhaled bronchodilators form the backbone for the maintenance therapy for this disease. The ultra-long-acting β2-agonists (ultra-LABAs) represent novel pharmacologic agents with interesting potential benefits as stand-alone therapy or in combination with other therapies for the treatment of COPD. Areas covered: In this review, we will focus newly developed ultra-LABAs, describing currently available evidence of their clinical effect and safety, their comparison relative to older long-acting β2-agonists, and their potential niche in the maintenance treatment of COPD...
September 2017: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/28864055/tracheobronchopathy-from-inhaled-corticosteroids
#18
REVIEW
Bryan C Husta, Suhail Raoof, Serpil Erzurum, Atul C Mehta
Inhaled corticosteroids (ICSs) have become the mainstay of asthma control. They are also recommended as an add-on therapy to long-acting beta agonists and anticholinergics in moderate to severe COPD with recurrent exacerbations. Ultimately this clinical practice has led to the widespread use of ICSs, which are supported by a more favorable side effect profile than that of systemic steroids.
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28859263/response-to-omalizumab-using-patient-enrichment-criteria-from-trials-of-novel-biologics-in-asthma
#19
T B Casale, B E Chipps, K Rosén, B Trzaskoma, T Haselkorn, T A Omachi, S Greenberg, N A Hanania
BACKGROUND: Recent efficacy studies of asthma biologics have included highly enriched patient populations. Using a similar approach, we examined factors that predict response to omalizumab to facilitate selection of patients most likely to derive the greatest clinical benefit from therapy. METHODS: Data from two phase III clinical trials of omalizumab in patients with allergic asthma were examined. Differences in rates of asthma exacerbations between omalizumab and placebo groups during the 16-week inhaled corticosteroid (ICS) dose-stable phase were evaluated with respect to baseline blood eosinophil counts (eosinophils <300/μL [low] vs ≥300/μL [high]) and baseline markers of asthma severity (emergency asthma treatment in prior year, asthma hospitalization in prior year, forced expiratory volume in 1 second [FEV1 ; FEV1 <65% vs ≥65% predicted], inhaled beclomethasone dipropionate dose [<600 vs ≥600 μg/day], and long-acting beta-agonist [LABA] use [yes/no])...
August 31, 2017: Allergy
https://www.readbyqxmd.com/read/28840400/therapeutic-effects-of-the-combination-of-inhaled-beta2-agonists-and-beta-blockers-in-copd-patients-with-cardiovascular-disease
#20
REVIEW
Vasiliki Petta, Fotis Perlikos, Stelios Loukides, Petros Bakakos, Athanasios Chalkias, Nicoletta Iacovidou, Theodoros Xanthos, Dorothea Tsekoura, Georgios Hillas
Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide, with co-morbidities contributing to the overall severity and mortality of the disease. The incidence and prevalence of cardiovascular disease among COPD patients are high. Both disorders often co-exist, mainly due to smoking, but they also share common underlying risk factors, such as aging and low-grade systemic inflammation. The therapeutic approach is based on agents, whose pharmacological properties are completely opposed...
November 2017: Heart Failure Reviews
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