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Steroid Sparing Treatment of Asthma

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https://www.readbyqxmd.com/read/29680938/diagnosis-and-novel-approaches-to-the-treatment-of-hypereosinophilic-syndromes
#1
REVIEW
Melanie C Dispenza, Bruce S Bochner
PURPOSE OF REVIEW: Hypereosinophilic syndrome (HES) is characterized by persistent hypereosinophilia associated with end-organ damage. As our understanding of the pathogenesis of various forms of HES broadens, so does our ability to tailor steroid-sparing therapies for each subtype. The purpose of this review is to summarize recent literature related to the etiology, diagnosis, and management of HES. RECENT FINDINGS: Mutations involved in subsets of HES can guide the choice of tyrosine kinase inhibitors beyond just imatinib...
April 21, 2018: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/29552874/allergic-conjunctivitis-current-concepts-on-pathogenesis-and-management
#2
M Sacchetti, I Abicca, A Bruscolini, C Cavaliere, M Nebbioso, A Lambiase
Allergic conjunctivitis (AC) includes a wide spectrum of clinical entities characterized by different incidence, age of onset, natural course, clinical outcome and response to treatment. Taken together, they represent one of the most frequent ocular surface diseases affecting more than 30% of the young-adult population and show an increasing incidence over the years. Moreover, comorbidities with other systemic atopic conditions such as asthma, atopic dermatitis and rhinitis require a multidisciplinary approach...
January 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29332144/long-acting-%C3%AE-2-agonists-in-asthma-enantioselective-safety-studies-are-needed
#3
Glenn A Jacobson, Sharanne Raidal, Morten Hostrup, Luigino Calzetta, Richard Wood-Baker, Mark O Farber, Clive P Page, E Haydn Walters
Long-acting β2-agonists (LABAs) such as formoterol and salmeterol are used for prolonged bronchodilatation in asthma, usually in combination with inhaled corticosteroids (ICSs). Unexplained paradoxical asthma exacerbations and deaths have been associated with LABAs, particularly when used without ICS. LABAs clearly demonstrate effective bronchodilatation and steroid-sparing activity, but long-term treatment can lead to tolerance of their bronchodilator effects. There are also concerns with regard to the effects of LABAs on bronchial hyperresponsiveness (BHR), where long-term use is associated with increased BHR and loss of bronchoprotection...
January 13, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29031617/steroid-sparing-effects-of-doxofylline
#4
Yanira Riffo-Vasquez, Radhakrishnan Venkatasamy, Clive P Page
Glucocorticosteroids are widely used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). However, there are growing concerns about the side effect profile of this class of drug, particularly an increased risk of pneumonia. Over the last two decades there have been many attempts to find drugs to allow a reduction of glucocorticosteroids, including xanthines such as theophylline. Use of xanthines has been shown to lead to a reduction in the requirement for glucocorticosteroids, although xanthines also have a narrow therapeutic window limiting their wider use...
February 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28876537/steroid-phobia-chinese-medicine-and-asthma-control
#5
Ka Ian Ip, Kam Lun Hon, Kathy Yin Ching Tsang, Theresa Ngan Ho Leung
BACKGROUND: Inhaled corticosteroids (ICS) are the mainstay of treatment for asthma. Corticosteroid (CS) phobia and fears are prevalent, and these may influence therapeutic efficacy and asthma control. AIM: The aim of this study was to evaluate if CS fear is associated with asthma control in children. METHODS: Patients aged >4 years with asthma at a pediatric outpatient clinic were surveyed, and the Asthma Control Test (ACT) was used for the assessment of asthma control...
September 6, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28736267/gamma-tocopherol-enriched-supplement-reduces-sputum-eosinophilia-and-endotoxin-induced-sputum-neutrophilia-in-volunteers-with-asthma
#6
Allison J Burbank, Charity G Duran, Yinghao Pan, Patricia Burns, Susan Jones, Qing Jiang, Chao Yang, Sha'Leema Jenkins, Heather Wells, Neil Alexis, Mehmet Kesimer, William D Bennett, Haibo Zhou, David B Peden, Michelle L Hernandez
BACKGROUND: We and others have shown that the gamma tocopherol (γT) isoform of vitamin E has multiple anti-inflammatory and antioxidant actions and that γT supplementation reduces eosinophilic and endotoxin (LPS)-induced neutrophilic airway inflammation in animal models and healthy human volunteers. OBJECTIVE: We sought to determine whether γT supplementation reduces eosinophilic airway inflammation and acute neutrophilic response to inhaled LPS challenge in volunteers with asthma...
April 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28651591/the-cost-of-systemic-corticosteroid-induced-morbidity-in-severe-asthma-a-health-economic-analysis
#7
L E Barry, J Sweeney, C O'Neill, D Price, L G Heaney
BACKGROUND: Treatment of severe asthma may include high dose systemic-steroid therapy which is associated with substantial additional morbidity. This study estimates the additional healthcare costs associated with steroid-induced morbidity by comparing three patients groups: those with severe asthma, moderate asthma and no asthma. METHODS: Patients with severe asthma (n = 808, GINA step 5 treatment) were matched by age and gender with patients with mild/moderate asthma (n = 3,975, GINA step 2 and 3 treatment) and a non-asthma control cohort (with a diagnosis of rhinitis; n = 2,412) from the Optimum Patient Care Research Database (OPCRD), a nationally representative primary care database...
June 26, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28569072/the-role-of-oral-methotrexate-as-a-steroid-sparing-agent-in-refractory-eosinophilic-asthma
#8
David Bilocca, B Hargadon, I D Pavord, R H Green, C E Brightling, P Bradding, A J Wardlaw, N Martin, A C Murphy, S Siddiqui
The use of oral methotrexate for refractory eosinophilic asthma in a tertiary asthma referral centre, Glenfield Hospital, Leicester, was evaluated between January 2006 and December 2014. The patients ( n = 61) were carefully phenotyped at baseline with markers of airway inflammation. In addition, a structured oral methotrexate proforma was utilized to evaluate response to therapy and adverse events. Oral steroid withdrawal was attempted 3 months after commencing treatment. Several outcomes were evaluated at 12 months, including both efficacy and adverse effects; 15% ( n = 9/61) responded by achieving a decrease in daily oral corticosteroid dose (mean 8...
February 2018: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/27834175/severe-asthma-anti-ige-or-anti-il-5
#9
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/27820746/role-of-biologics-targeting-type-2-airway-inflammation-in-asthma-what-have-we-learned-so-far
#10
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
https://www.readbyqxmd.com/read/27790959/igg4-related-syndrome-another-multiorgan-disease-in-the-interest-field-of-internal-medicine
#11
REVIEW
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
https://www.readbyqxmd.com/read/27748630/pharmacokinetics-pharmacodynamics-and-clinical-efficacy-of-omalizumab-for-the-treatment-of-asthma
#12
REVIEW
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
https://www.readbyqxmd.com/read/27489785/allergen-specific-immunotherapy-in-pediatric-allergic-asthma
#13
REVIEW
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
https://www.readbyqxmd.com/read/27160753/a-case-report-of-igg4-related-syndrome-and-literature-review
#14
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
https://www.readbyqxmd.com/read/26685004/role-of-local-eosinophilopoietic-processes-in-the-development-of-airway-eosinophilia-in-prednisone-dependent-severe-asthma
#15
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
https://www.readbyqxmd.com/read/26371536/macrolides-for-chronic-asthma
#16
REVIEW
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
https://www.readbyqxmd.com/read/25516861/role-of-immunotherapy-in-the-treatment-of-allergic-asthma
#17
REVIEW
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
https://www.readbyqxmd.com/read/25504995/nebulised-budesonide-using-a-novel-device-in-patients-with-oral-steroid-dependent-asthma
#18
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/24980994/acute-painful-paraplegia-in-a-49-year-old-man-with-allergic-asthma
#19
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
https://www.readbyqxmd.com/read/24414989/omalizumab-for-asthma-in-adults-and-children
#20
REVIEW
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...
January 13, 2014: Cochrane Database of Systematic Reviews
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