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https://www.readbyqxmd.com/read/28643237/small-airway-absorption-and-microdosimetry-of-inhaled-corticosteroid-particles-after-deposition
#1
P Worth Longest, Michael Hindle
PURPOSE: To predict the cellular-level epithelial absorbed dose from deposited inhaled corticosteroid (ICS) particles in a model of an expanding and contracting small airway segment for different particle forms. METHODS: A computational fluid dynamics (CFD)-based model of drug dissolution, absorption and clearance occurring in the surface liquid of a representative small airway generation (G13) was developed and used to evaluate epithelial dose for the same deposited drug mass of conventional microparticles, nanoaggregates and a true nanoaerosol...
June 22, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28639542/fluticasone-propionate-and-fluticasone-propionate-salmeterol-multidose-dry-powder-inhalers-compared-with-placebo-for-persistent-asthma
#2
L D Sher, G Yiu, A Sakov, S Liu, C F Caracta
BACKGROUND: A novel, inhalation-driven, multidose dry powder inhaler (MDPI) has been developed, which allows for lowerdoses of fluticasone propionate (Fp) and Fp/salmeterol (FS) for the treatment of patients with asthma. OBJECTIVE: This phase III, multicenter, double-blind, parallel-group study (NCT02141854) evaluated the efficacy and safetyof Fp MDPI and FS MDPI versus placebo MDPI. METHODS: Patients aged greater than or equal to 12 years with persistent asthma who previously took an inhaled corticosteroid with or without a long-acting beta-agonist entered a 14- to 21-day run-in period, during which they received single-blind, low-dose Fp MDPI 50 microgram (1 inhalation twice daily [b...
June 21, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28626983/comparison-of-systemic-pharmacodynamic-effects-of-two-combination-pressurised-metered-dose-inhalers-that-deliver-salmeterol-and-fluticasone-propionate
#3
Lester I Harrison, Victoria Sessions, Christopher J Wiggenhorn, David Chalmers, Pui Leung, John Efthimiou
AIM: The aim was to test the systemic pharmacodynamic effects of the salmeterol component of two pressurized metered dose inhalers that delivered a combination of salmeterol and fluticasone propionate (SM/FP). METHODS: This was a six-way crossover study in 43 adult subjects, using a single blind design (subject blinded to product and clinical assessor blinded for all measurements). Each subject received single doses of 2, 6, and 12 inhalations from test and reference products that delivered SM/FP as 25/125 mcg per inhalation...
June 19, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28626506/impact-of-nonadherence-to-inhaled-corticosteroid-laba-therapy-on-copd-exacerbation-rates-and-healthcare-costs-in-a-commercially-insured-us-population
#4
Jill R Davis, Bingcao Wu, David M Kern, Ozgur Tunceli, Kathleen M Fox, John Horton, Randall F Legg, Frank Trudo
BACKGROUND: Evidence of poor patient adherence to medications for chronic obstructive pulmonary disease (COPD) is well-documented, but its impact on disease exacerbation rates and associated healthcare costs remains unclear. OBJECTIVE: To assess the association between adherence levels to different inhaled corticosteroid/long-acting ß2-adrenergic agonist (LABA) and COPD exacerbation rates and costs in a commercially insured population. METHODS: In this observational cohort study, patients with COPD (aged ≥40 years) who were treatment-naïve to inhaled corticosteroid/LABA and were initiating budesonide plus formoterol or fluticasone plus salmeterol between March 1, 2009, and January 31, 2014, were identified in a national representative claims database and were followed for up to 12 months...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28619778/in-patients-with-severe-uncontrolled-asthma-does-knowledge-of-adherence-and-inhaler-technique-using-electronic-monitoring-improve-clinical-decision-making-a-protocol-for-a-randomised-controlled-trial
#5
Matshediso C Mokoka, Lorna Lombard, Elaine M MacHale, Joanne Walsh, Breda Cushen, Imran Sulaiman, Damien Mc Carthy, Fiona Boland, Frank Doyle, Eoin Hunt, Desmond M Murphy, John Faul, Marcus Butler, Kathy Hetherington, J Mark FitzGerald, Job Fm van Boven, Liam G Heaney, Richard B Reilly, Richard W Costello
INTRODUCTION: Many patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28617814/risk-of-pneumonia-in-obstructive-lung-disease-a-real-life-study-comparing-extra-fine-and-fine-particle-inhaled-corticosteroids
#6
Samatha Sonnappa, Richard Martin, Elliot Israel, Dirkje Postma, Wim van Aalderen, Annie Burden, Omar S Usmani, David B Price
BACKGROUND: Regular use of inhaled corticosteroids (ICS) in patients with obstructive lung diseases has been associated with a higher risk of pneumonia, particularly in COPD. The risk of pneumonia has not been previously evaluated in relation to ICS particle size and dose used. METHODS: Historical cohort, UK database study of 23,013 patients with obstructive lung disease aged 12-80 years prescribed extra-fine or fine-particle ICS. The endpoints assessed during the outcome year were diagnosis of pneumonia, acute exacerbations and acute respiratory events in relation to ICS dose...
2017: PloS One
https://www.readbyqxmd.com/read/28617448/diminishing-effectiveness-of-long-term-maintenance-topical-steroid-therapy-in-ppi-non-responsive-eosinophilic-esophagitis
#7
Swathi Eluri, Thomas M Runge, Jason Hansen, Bharati Kochar, Craig C Reed, Benjamin S Robey, John T Woosley, Nicholas J Shaheen, Evan S Dellon
OBJECTIVES: While topical corticosteroids are first-line therapy for eosinophilic esophagitis (EoE), the data regarding long-term effectiveness are lacking. We aimed to determine long-term histologic and endoscopic outcomes of maintenance therapy in EoE steroid responders. METHODS: We performed a retrospective study of adults with EoE at UNC Hospitals who had initial histologic response (<15 eos/hpf) after 8 weeks of topical steroids, and maintained on therapy...
June 15, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28615628/glucocorticoids-ameliorate-tgf-%C3%AE-1-mediated-epithelial-to-mesenchymal-transition-of-airway-epithelium-through-mapk-and-snail-slug-signaling-pathways
#8
Hyun-Woo Yang, Seoung-Ae Lee, Jae-Min Shin, Il-Ho Park, Heung-Man Lee
Chronic rhinosinusitis with nasal polyps (CRSwNP) is closely associated with tissue remodeling. Epithelial-to-mesenchymal transition (EMT), a process of tissue remodeling, can be a therapeutic target of CRSwNP. Glucocorticoids are a type of steroid hormone that is used primarily in medical therapy for patients with CRSwNP; however, their effects on EMT in the airway epithelium remain unknown. To investigate the effects of dexamethasone and fluticasone propionate, a class of glucocorticoids, on transforming growth factor-β1 (TGF-β1) -induced EMT, we used A549 cells, human primary nasal epithelial cells (hPNECs) and ex vivo organ culture of the inferior turbinate...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28612675/formulation-of-novel-dry-powder-inhalation-for-fluticasone-propionate-and-salmeterol-xinafoate-with-capsule-based-device
#9
Kyeong Soo Kim, Jeong Hyun Kim, Sung Giu Jin, Dong Wuk Kim, Jong Oh Kim, Chul Soon Yong, Yu Seok Youn, Kyung Taek Oh, Jong Soo Woo, Han-Gon Choi
The aim of this study was to develop a novel fluticasone propionate (FP) and salmeterol xinafoate (SX)-loaded dry powder inhaler (DPI) system, which was composed of powder formulation and performance. The air flow resistances were determined with various types of DPI device, showing that the modified RS01 device gave the specific resistance similar to the commercial DPI device. The particle properties of fluticasone propionate (FP), salmeterol xinafoate (SX) and inhalation grade lactose particles, such as particle size, size distribution and fine content, were assessed...
June 14, 2017: Pharmaceutical Development and Technology
https://www.readbyqxmd.com/read/28608048/six-food-elimination-diet-and-topical-steroids-are-effective-for-eosinophilic-esophagitis-a-meta-regression
#10
Cary C Cotton, Swathi Eluri, W Asher Wolf, Evan S Dellon
BACKGROUND: Topical corticosteroids or six-food elimination diet is recommended as initial therapy for eosinophilic esophagitis (EoE). AIMS: We aimed to summarize published manuscripts that report outcomes of these therapies for EoE. METHODS: We performed a systematic review in MEDLINE, Web of Science, and Embase of published manuscripts describing topical fluticasone, topical budesonide, and six-food elimination diet as therapies for EoE...
June 12, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28603412/in-vitro-dose-comparison-of-respimat-%C3%A2-inhaler-with-dry-powder-inhalers-for-copd-maintenance-therapy
#11
Anna-Maria Ciciliani, Peter Langguth, Herbert Wachtel
BACKGROUND: Combining in vitro mouth-throat deposition measurements, cascade impactor data and computational fluid dynamics (CFD) simulations, four different inhalers were compared which are indicated for chronic obstructive pulmonary disease (COPD) treatment. METHODS: The Respimat inhaler, the Breezhaler, the Genuair, and the Ellipta were coupled to the idealized Alberta throat model. The modeled dose to the lung (mDTL) was collected downstream of the Alberta throat model using either a filter or a next generation impactor (NGI)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28594587/response-to-indacaterol-glycopyrronium-ind-gly-by-sex-in-patients-with-copd-a-pooled-analysis-from-the-ignite-program
#12
Ioanna Tsiligianni, Karen Mezzi, Sebastian Fucile, Konstantinos Kostikas, Steven Shen, Donald Banerji, Robert Fogel
In this pooled analysis, we compared the effect of indacaterol/glycopyrronium (IND/GLY) by sex versus other commonly used chronic obstructive pulmonary disease (COPD) treatments and placebo. Male and female patients with moderate-to-very-severe COPD who had participated in six randomized controlled trials were included in the analysis. Baseline demographics and disease characteristics were analyzed by sex, and any differences noted. The effects of IND/GLY versus salmeterol/fluticasone (SFC), glycopyrronium, tiotropium and placebo, on lung function and the patient-reported outcomes (health status, dyspnea, rescue medication use and symptoms) were assessed by sex after 26 weeks treatment...
June 8, 2017: COPD
https://www.readbyqxmd.com/read/28587510/effects-of-fluticasone-furoate-nasal-spray-on-parameters-of-eosinophilic-inflammation-in-patients-with-nasal-polyposis-and-perennial-allergic-rhinitis
#13
Cveta Špadijer Mirković, Aleksandar Perić, Biserka Vukomanović Đurđević, Danilo Vojvodić
OBJECTIVES: Regulated on activation normal T cell expressed and secreted (RANTES) and eotaxin-2 have been postulated to be responsible for eosinophilia in chronically inflamed nasal mucosa. This study evaluated mucosal production of RANTES and eotaxin-2 in patients with perennial allergic rhinitis (PAR) and nonallergic and allergic form of chronic rhinosinusitis with nasal polyps (CRSwNP) before and after nasal corticosteroid treatment. METHODS: Twenty patients with PAR, 20 nonallergic and 20 allergic CRSwNP patients, and 20 healthy controls were included...
June 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28583232/effect-of-topical-beclomethasone-on-inflammatory-markers-in-adults-with-eosinophilic-esophagitis-a-pilot-study
#14
Neeti Bhardwaj, Faoud Ishmael, Erik Lehman, Deborah Bethards, Francesca Ruggiero, Gisoo Ghaffari
BACKGROUND: Topical corticosteroids have proven efficacy in the treatment of eosinophilic esophagitis (EoE) and are considered the cornerstone of therapy. OBJECTIVE: To evaluate the effect of topical beclomethasone dipropionate (BDP) therapy on clinical outcomes, esophageal eosinophilia, and other markers of inflammation in patients with EoE. METHODS: Nine subjects with a biopsy-proven diagnosis of EoE were enrolled. In a cross-over design, the subjects were randomly assigned to a sequence of BDP and placebo...
June 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/28568169/effect-of-dexamethasone-and-fluticasone-on-airway-hyperresponsiveness-in-horses-with-inflammatory-airway-disease
#15
R Léguillette, T Tohver, S L Bond, J A Nicol, K J McDonald
BACKGROUND: Airway hyperresponsiveness (AWHR), expressed as hypersensitivity (PC75 RL ) or hyperreactivity (slope of the histamine dose-response curve), is a feature of inflammatory airway disease (IAD) or mild equine asthma in horses. Glucocorticoids are used empirically to treat IAD. OBJECTIVES: To determine whether dexamethasone (DEX) (0.05 mg/kg IM q24h) and inhaled fluticasone (FLUT) (3,000 μg q12h) administered by inhalation are effective in decreasing AWHR, lung inflammation, and clinical signs in horses with IAD...
May 31, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28565813/successful-treatment-of-diffuse-panbronchiolitis-in-a-child-from-western-china-a-case-report
#16
Na-Na Zhao, Hui Cao, Shi-Si Zhang, Guo-Qiang Cao
The present report describes a case of diffuse panbronchiolitis (DPB) in a child from Western China and the favorable outcome associated with early diagnosis. DPB is an uncommon presentation in pediatric patients. A 13-year-old Chinese boy was admitted to the respiratory outpatient department due to recurrent cough and progressive exertional dyspnea that had persisted for 1 year. An initial diagnosis of bronchial asthma was made, and the patient was prescribed inhaled fluticasone combined with salmeterol (50/250 µg, twice daily), and montelukast (4 mg daily)...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28560698/a-biocompatible-synthetic-lung-fluid-based-on-human-respiratory-tract-lining-fluid-composition
#17
Abhinav Kumar, Wachirun Terakosolphan, Mireille Hassoun, Kalliopi-Kelli Vandera, Astrid Novicky, Richard Harvey, Paul G Royall, Elif Melis Bicer, Jonny Eriksson, Katarina Edwards, Dirk Valkenborg, Inge Nelissen, Dave Hassall, Ian S Mudway, Ben Forbes
PURPOSE: To characterise a biorelevant simulated lung fluid (SLF) based on the composition of human respiratory tract lining fluid. SLF was compared to other media which have been utilized as lung fluid simulants in terms of fluid structure, biocompatibility and performance in inhalation biopharmaceutical assays. METHODS: The structure of SLF was investigated using cryo-transmission electron microscopy, photon correlation spectroscopy and Langmuir isotherms. Biocompatibility with A549 alveolar epithelial cells was determined by MTT assay, morphometric observations and transcriptomic analysis...
May 30, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28560037/instant-velocity-and-consistency-of-emitted-cloud-change-by-the-different-levels-of-canister-filling-with-metered-dose-inhalers-mdis-but-not-with-soft-mist-inhalers-smis-a%C3%A2-bench-study
#18
Roberto W Dal Negro, Pietro Longo, Orestepaolo Villanis Ziani, Luca Bonadiman, Paola Turco
BACKGROUND: Inhalation is the preferred route for respiratory drug delivery, but several factors contribute to the variability of the respirable dose fraction. Instant velocity and the dynamic characteristics of the droplet cloud represent crucial factors. Aim was to measure and compare the instant velocity and the consistency of emitted cloud from five different MDIs (A - Salbutamol sulphate 100mcg, GSK; B - Salbutamol sulphate 100mcg, Valeas; C - Salmeterol xinafoate/Fluticasone propionate 25/125mcg, GSK; D - Formoterol fumarate/Bechlomethasone propionate 6/100mcg, Chiesi; E - Formoterol fumarate/Fluticasone dipropionate 5/125mcg, Mundipharma) and one SMI (Tiotropium bromide 5mcg, Boehringer Ingelheim), at different distance from the nozzle and canister filling...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28558147/safety-and-efficacy-of-a-bioabsorbable-fluticasone-propionate-eluting-sinus-dressing-in-postoperative-management-of-endoscopic-sinus-surgery-a-randomized-clinical-trial
#19
Gwijde F J P M Adriaensen, Keng-Hua Lim, Wytske J Fokkens
BACKGROUND: Postoperative wound healing after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS) is an important factor in procedural success. Local steroids and separation of opposing mucosa are commonly implemented to optimize healing. A bioabsorbable, fluticasone propionate (FP)-eluting implant, SinuBand FP, was assessed for its safety and efficacy when used in patients with CRS and nasal polyps, who were indicated for ESS including bilateral anterior and posterior ethmoidectomy...
May 30, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28546282/disease-activity-in-eosinophilic-esophagitis-is-associated-with-impaired-esophageal-barrier-integrity
#20
Marijn J Warners, Bram D van Rhijn, Joanne Verheij, Andreas J P M Smout, Albert J Bredenoord
BACKGROUND: In eosinophilic esophagitis (EoE) the esophageal barrier integrity is impaired. Integrity can be assessed with different techniques. AIMS: To assess the correlations between esophageal eosinophilia and various measures of mucosal integrity, and to evaluate whether endoscopic impedance measurements can predict disease activity. METHODS: Endoscopies and mucosal integrity measurements were performed in adult EoE patients with active disease (≥15 eosinophils/HPF) at baseline (n=32), after fluticasone (n=15) and elemental dietary treatment (n=14) and in controls (n=19)...
May 25, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
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