Read by QxMD icon Read

Steroid Sparing Treatment of Asthma

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
Amit D Parulekar, Zuzana Diamant, Nicola A Hanania
PURPOSE OF REVIEW: Severe asthma is a heterogeneous syndrome that can be classified into distinct phenotypes and endotypes. In the type 2 (T2)-high endotype, multiple cytokines are produced that lead to eosinophilic inflammation. These cytokines and their receptors are targets for biologic therapies in patients with severe asthma who do not respond well to standard therapy with inhaled corticosteroids. RECENT FINDINGS: In the last decade, an increasing number of biologic therapies have been developed targeting T2 inflammation...
January 2017: Current Opinion in Pulmonary Medicine
Antonino Tuttolomondo, Irene Simonetta, Domenico Di Raimondo, Tiziana Di Chiara, Roberta Conigliaro, Francesca Corpora, Valerio Vassallo, Antonio Pinto
BACKGROUND: IgG4-related disease is a rare, clinical and pathologic disease entity of unknown etiology. Its main features are increased serum concentrations of IgG4 > 1,35 g/l, lymphocyte and IgG4+plasma-cell infiltration within tissues, fibrosis or sclerosis. The classical presentation of IgG4-RSD is pancreatitis which is combined with the involvement of biliary ducts in 74 percent of patients. Extrapancreatic manifestations include: abdominal or mediastinal lymphadenopathy; the involvement of salivary glands and lacrimal glands, kidneys, lung, retroperitoneum...
2016: Current Pharmaceutical Design
Maxime Luu, Marc Bardou, Philippe Bonniaud, Françoise Goirand
Omalizumab is a subcutaneously administrated monoclonal anti-IgE antibody indicated in adults, adolescents and children 6 years of age and older with moderate to severe allergic asthma uncontrolled by conventional pharmacological treatments and sensitization to at least one perennial allergen. Area covered: This drug evaluation summarizes published data on pharmacokinetic and pharmacodynamic properties of omalizumab, on clinical efficacy and safety, including real-world evidence, and provides a medico-economic evaluation of the drug...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
Ayfer Yukselen
Allergen-specific immunotherapy (AIT) is the only curative way that can change the immunologic response to allergens and thus can modify the natural progression of allergic diseases. There are some important criteria which contributes significantly on efficacy of AIT, such as the allergen extract used for treatment, the dose and protocol, patient selection in addition to the severity and control of asthma. The initiation of AIT in allergic asthma should be considered in intermittent, mild and moderate cases which coexisting with other allergic diseases such as allergic rhinitis, and in case of unacceptable adverse effects of medications...
July 2016: Asia Pacific Allergy
Antonino Tuttolomondo, Irene Simonetta, Domenico Di Raimondo, Roberta Conigliaro, Francesca Corpora, Valerio Vassallo, Antonio Pinto
BACKGROUND: IgG4-related disease is a rare, clinical and pathologic disease entity of unknown etiology. Its main features are increased serum concentrations of IgG4 > 1,35 g/l, lymphocyte and IgG4+plasma-cell infiltration within tissues, fibrosis or sclerosis. The classical presentation of IgG4-RSD is pancreatitis which is combined with the involvement of biliary ducts in 74 percent of patients. Extrapancreatic manifestations include: abdominal or mediastinal lymphadenopathy; the involvement of salivary glands and lacrimal glands, kidneys, lung, retroperitoneum...
May 10, 2016: Current Pharmaceutical Design
R Sehmi, S G Smith, M Kjarsgaard, K Radford, L-P Boulet, C Lemiere, C M Prazma, H Ortega, J G Martin, P Nair
BACKGROUND: In severe asthmatics with persistent airway eosinophilia, blockade of interleukin-5 has significant steroid-sparing effects and attenuates blood and sputum eosinophilia. The contribution of local maturational processes of progenitors within the airways relative to the recruitment of mature cells from the peripheral circulation to the development of airway eosinophilia is not known. We hypothesize that local eosinophilopoiesis may be the predominant process that drives persistent airway eosinophilia and corticosteroid requirement in severe asthmatics...
June 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Kayleigh M Kew, Krishna Undela, Ioanna Kotortsi, Giovanni Ferrara
BACKGROUND: Asthma is a chronic disease in which inflammation of the airways causes symptomatic coughing, wheezing, and difficult breathing. The inflammation may have different underlying causes, including a reaction to infection in the lungs. Macrolides are antibiotics with antimicrobial and antiinflammatory activities that have been used long-term to control asthma symptoms. OBJECTIVES: To assess the effects of macrolides for managing chronic asthma. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register up to April 2015...
September 15, 2015: Cochrane Database of Systematic Reviews
Ayfer Yukselen, Seval Guneser Kendirli
Allergen-specific immunotherapy (SIT) induces clinical and immunological tolerance as defined by persistence of clinical benefit and associated long-term immunological parameters after cessation of treatment. Although the efficacy of SIT has been shown in terms of reducing symptoms, medication consumption and ameliorating quality of life in both allergic rhinitis and asthma, there has long been some controversies about effectiveness of SIT in the treatment of allergic asthma. The type of allergen, the dose and protocol of immunotherapy, patient selection criteria, the severity and control of asthma, all are significant contributors to the power of efficacy in allergic asthma...
December 16, 2014: World Journal of Clinical Cases
Claus Vogelmeier, Peter Kardos, Thomas Hofmann, Sebastian Canisius, Gerhard Scheuch, Bernhard Muellinger, Karlheinz Nocker, Guenter Menz, Klaus F Rabe
This phase 2/3 randomised, parallel-group, placebo-controlled trial investigated oral corticosteroid (OCS)-sparing efficacy, safety and tolerability of nebulised budesonide (Bud) administered with a novel computer-controlled, compressor-driven inhalation system (AKITA) as add-on therapy to Global Initiative for Asthma step 5. Patients (18-65 years) with OCS-dependent asthma were randomised (2:1:1:1) to receive 18-week, twice-daily, double-blind treatment with AKITA inhaled corticosteroid (AICS)-Bud 1 mg, AICS-Bud 0...
May 2015: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Claudio Sorino, Sergio Agati, Giuseppe Milani, Annarosa Maspero
We present a case of a 49-year-old man, with a 10-year history of bronchial asthma and nasal polyposis, who developed acutely painful paraplegia and paresthesias. Laboratory data showed elevated blood creatine kinase levels and myoglobinuria, which were diagnostic for rhabdomyolysis but only partially explained the neurological deficit. Electrophysiological studies revealed a sensorimotor neuropathy of multiple mononeuritis type. The patient also had leucocytosis with marked eosinophilia and antineutrophil cytoplasmic autoantibodies...
June 30, 2014: BMJ Case Reports
Rebecca Normansell, Samantha Walker, Stephen J Milan, E Haydn Walters, Parameswaran Nair
BACKGROUND: Asthma is a respiratory (airway) condition that affects an estimated 300 million people worldwide and is associated with significant morbidity and mortality. Omalizumab is a monoclonal antibody that binds and inhibits free serum immunoglobulin E (IgE). It is called an 'anti-IgE' drug. IgE is an immune mediator involved in clinical manifestations of asthma. A recent update of National Institute for Health and Care Excellence (NICE) guidance in 2013 recommends omalizumab for use as add-on therapy in adults and children over six years of age with inadequately controlled severe persistent allergic IgE-mediated asthma who require continuous or frequent treatment with oral corticosteroids...
2014: Cochrane Database of Systematic Reviews
Enrico Compalati, Fulvio Braido, Giorgio W Canonica
PURPOSE OF REVIEW: The aim is to review recent literature up to July 2013 concerning the effect of allergen-specific immunotherapy (AIT) on asthma. AIT, effective in combined allergic rhinitis and asthma, was previously described as a convenient approach able to improve clinical outcomes and reduce bronchial hyperresponsiveness. In addition, long-term and preventive effects on the onset of new sensitizations and progression from allergic rhinitis to asthma have been shown. RECENT FINDINGS: Recent investigations, mainly based on observational or small open trials, confirmed previous findings, showing improvement in asthma control, symptoms and medication usage and steroid-sparing effects, sometimes inconsistent with changes in lung function...
January 2014: Current Opinion in Pulmonary Medicine
Derrica Y Walker, Krystal L Edwards
PURPOSE: Current evidence on statin agents as potential alternatives or adjuncts to corticosteroid therapy for asthma is reviewed. SUMMARY: Research showing antiinflammatory and antioxidant effects of statins in animal models suggested that the cholesterol-lowering drugs might be useful in mitigating the adverse effects of long-term corticosteroid therapy in patients with asthma, but studies in humans have yielded mixed results. Two small placebo-controlled clinical trials indicated that statins were not effective in combating asthmatic inflammatory processes, and trials of statins as adjunctive therapy have indicated minimal steroid-sparing benefits...
October 1, 2013: American Journal of Health-system Pharmacy: AJHP
Zahra Aryan, Enrico Comapalati, Giorgio Walter Canonica, Nima Rezaei
Atopic asthma in childhood with the tendency to persist into adult life is an important issue in pediatrics. Allergen-specific immunotherapy (SIT) is the only curative treatment option for these children, being directed to the causes of the disease. The Th2 phenotype is a predominant immunological pattern in atopic asthma and SIT leads to apoptosis/anergy of T cells and induces immune-regulatory responses and immune deviation towards Th1. Many factors can affect the safety and efficacy of SIT, such as pattern of sensitization, allergy vaccine (allergen extracts, adjuvants and conjugated molecules), route of administration (subcutaneous or sublingual) and different treatment schedules...
June 2013: Expert Review of Vaccines
Hasan Yuksel, Ozge Yilmaz, Meral Karaman, H Alper Bagriyanik, Fatih Firinci, Muge Kiray, Ahmet Turkeli, Ozkan Karaman
BACKGROUND: Vascular endothelial growth factor (VEGF) is an important mediator of the neoangiogenesis component of remodeling in asthma. OBJECTIVE: To evaluate the influence of VEGF blockage on airway remodeling, specifically epithelium thickness, subepithelial smooth muscle thickness, number of mast and goblet cells, and basement membrane thickness, in a mouse model of chronic asthma. METHODS: We used 30 BALB/c mice. The control group was not exposed to ovalbumin or any medication (group 1)...
March 2013: Annals of Allergy, Asthma & Immunology
Katie S Adams, Denise K Lowe
OBJECTIVE: To review the literature evaluating the efficacy and steroid-sparing effect of tiotropium for inadequately controlled persistent asthma in adults. DATA SOURCES: Information was obtained through a search of MEDLINE/PubMed (1966-October 2012), using the terms asthma and tiotropium. A further review of reference citations was performed to identify other relevant articles. STUDY SELECTION AND DATA EXTRACTION: English-language case reports and clinical trials were reviewed...
January 2013: Annals of Pharmacotherapy
T Vieira, J F de Oliveira, M da Graça Castel-Branco
BACKGROUND: The impact of severe asthma on patients' quality of life (QoL) has been previously demonstrated, as well the difficulties in controlling the disease. We aimed to evaluate the effect of omalizumab on QoL and asthma control, and its safety and tolerability in real-life conditions in Portugal. METHODS: Prospective and open-label study in 15 adult patients with uncontrolled severe persistent allergic asthma on omalizumab treatment ≥16 weeks (w). The short (at 16w) and long-term (at 1 and 2 years) (y) effects of omalizumab were assessed through the Asthma Life Questionnaire (ALQ) and the Asthma Control Test (ACT)...
January 2014: Allergologia et Immunopathologia
Jennifer Collins, Gabriele Devos, Golda Hudes, David Rosenstreich
BACKGROUND: Current therapy for allergic bronchopulmonary aspergillosis (ABPA) uses oral corticosteroids, exposing patients to the adverse effects of these agents. There are reports of the steroid-sparing effect of anti-IgE therapy with omalizumab for ABPA in patients with cystic fibrosis (CF), but there is little information on its efficacy against ABPA in patients with bronchial asthma without CF. OBJECTIVE: To examine the effects of omalizumab, measured by asthma control, blood eosinophilia, total serum immunoglobulin E (IgE), oral corticosteroid requirements, and forced expiratory volume spirometry in patients with ABPA and bronchial asthma...
2012: Journal of Asthma and Allergy
Aarif O Eifan
Asthma is a heterogeneous disorder with a variable course. It begins very early in life and of different phenotypes. Mainstay treatment for asthma is corticosteroids as controller therapy and guidelines recommends the add-on and step-up or step-down strategies. This review will focus on the studies that enhanced our understandings of the effects of inhaled corticosteroids on the natural course of asthma in regard to symptoms control, protective effect on lung function and potential side effects encountered during the treatment...
2012: Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"