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JOURNAL ARTICLE
Meredith A Case, Eric P Boorman, Elizabeth Ruvalcaba, Michael T Vest, Nadia N Hansel, Nirupama Putcha, Michelle N Eakin
BACKGROUND: Provider adherence to clinical treatment guidelines in COPD is low. However, for patients to receive guideline-aligned care, providers not only must prescribe guideline-aligned care, but also must communicate that regimen successfully to patients to ensure medication concordance. The rate of medication concordance between patients and providers and its impact on clinical management is unknown in COPD. RESEARCH QUESTION: To examine rates of guideline alignment and medication concordance and to identify patient-level factors that place patients at risk for these types of poor disease management outcomes...
March 2024: CHEST Pulm
#2
JOURNAL ARTICLE
Mei Sheng Duh, Melissa H Roberts, Kieran J Rothnie, Wendy Y Cheng, Philippe Thompson-Leduc, Shiyuan Zhang, Alexandrosz Czira, David Slade, Alexandra Greatsinger, Adina Zhang, Douglas Mapel
INTRODUCTION: Despite adherence to inhaled corticosteroid/long-acting β2 -agonist (ICS/LABA) therapy, many patients with asthma experience moderate exacerbations. Data on the impact of moderate exacerbations on the healthcare system are limited. This study assessed the frequency and economic burden of moderate exacerbations in patients receiving ICS/LABA. METHODS: Retrospective, longitudinal study analyzed data from Optum's de-identified Clinformatics® Data Mart Database recorded between October 1, 2015, and December 31, 2019...
April 7, 2024: Respiratory Medicine
#3
JOURNAL ARTICLE
Rachael Mountain, Kevin I Duan, Kate Johnson
Rationale: Reducing the risk of exacerbation is a fundamental goal in managing stable COPD. Guidelines recommend triple therapy (inhaled corticosteroids, long-acting muscarinic antagonists, and long-acting beta-agonists [ICS/LAMA/LABA]) only as a step-up from dual therapy (LAMA/LABA) for patients at continued high risk of exacerbation, due to the trade-off of an increased risk of pneumonia associated with ICS-containing therapies. However, there is little evidence on the optimum timing of initiating triple therapy...
April 5, 2024: Annals of the American Thoracic Society
#4
JOURNAL ARTICLE
Manuela Latorre, Angela Rizzi, Pierluigi Paggiaro, Ilaria Baiardini, Diego Bagnasco, Stefano DelGiacco, Carlo Lombardi, Vincenzo Patella, Eleonora Nucera, Roberta Parente, Giovanni Paoletti, Laura Pini, Erminia Ridolo, Gianenrico Senna, Francesco Blasi, Giorgio Walter Canonica, Arianna Aruanno, Carmen Ballacchino, Marco Bonavia, Cecilia Calabrese, Marco Caminati, Monica Carbonara, Cristina Cardini, Cristiano Caruso, Luciano Cattani, Maria Angiola Crivellaro, Alessandra Diana, Eugenia Durante, Elisabetta Favero, Maria Pia Foschino Barbaro, Sandra Frateiacci, Gabriella Guarnieri, Alessia Lofaro, Francesca Losa, Nadia Magarò, Francesco Menzella, Luisa Ricciardi, Giulia Scioscia, Elisa Testino, Francesca Torracca
OBJECTIVE: Patients' perceptions of asthma symptoms, and attitudes regarding diagnosis and management, can affect their ability to reach good asthma control. The aim of the study was to explore patients' perceptions of asthma management, with focus on treatment with oral corticosteroids (OCS). METHODS: A DOXAPHARMA survey was conducted. A questionnaire with 46 multiple choice questions was completed by 50 patients with severe uncontrolled asthma, and 258 with mild-moderate controlled or partly controlled asthma...
April 5, 2024: Journal of Asthma
#5
JOURNAL ARTICLE
Frederik Trinkmann
BACKGROUND: Diagnostic and therapeutic options for asthma have improved with asthma control and remission being of central importance. The RELEVANT study aimed for a nationwide snapshot of current asthma diagnosis and treatment in general practice and specialty care for identification of further aspects for optimization. METHOD: RELEVANT is a nationwide cross-sectional study using a structured questionnaire. This comprised 14 questions on asthma-related topics covering diagnostics and therapy...
April 2024: MMW Fortschritte der Medizin
#6
Bianca Oprescu, Oana Raduna, Stefan Mihaicuta, Stefan Frent
Background and Objectives : Severe adult-onset eosinophilic asthma and COPD with eosinophilic inflammation are two entities with a similar clinical course and are sometimes difficult to differentiate in clinical practice, especially in patients with a history of smoking. Anti-IL-5 or -IL-5R biological therapy has been shown to be highly effective in severe eosinophilic asthma but has not demonstrated significant benefit in patients with COPD with the eosinophilic phenotype. Our aim was to illustrate this issue in the form of a case report...
February 25, 2024: Medicina
#7
JOURNAL ARTICLE
Sangmin Lee, Erin Hetherington, Richard Leigh, Kaylee Ramage, Amy Metcalfe
BACKGROUND: Asthma affects 5% to 13% of pregnant women, and many require daily pharmacotherapy to achieve asthma control; however, adherence to medication during pregnancy often decreases. OBJECTIVE: To understand the association between the use of or adherence to asthma medication with asthma exacerbation and maternal/neonatal outcomes. METHODS: Using linked population-based administrative databases from Alberta, Canada (2012-2018), pregnant women with asthma were categorized based on asthma medication use 1 year before pregnancy: short-acting β-agonists (SABA), inhaled corticosteroids (ICS), and ICS with long-acting β-agonists (ICS+LABA)...
March 7, 2024: Journal of Allergy and Clinical Immunology in Practice
#8
JOURNAL ARTICLE
Hnin Ww Aung, Claire E Boddy, Eleanor Hampson, Mark Bell, Lauren A Parnell, Kumaran Balasundaram, Anna C Murphy, Shamsa Naveed, Peter Bradding
BACKGROUND: 65% of people with severe asthma and a FeNO ≥45 ppb are non-adherent to inhaled corticosteroids (ICS). Digital devices recording both time-of-use and inhaler technique identify non-adherence and ICS responsiveness but are not widely available. As the NEXThaler™ dose counter only activates at an inspiratory flow of 35 L/min, this may provide an alternative to identifying ICS responsiveness. OBJECTIVE: To assess ICS adherence and responsiveness in severe asthma using beclometasone/formoterol (200/6 mcg) NEXThaler™ (BFN) dose-counting...
March 20, 2024: Journal of Allergy and Clinical Immunology in Practice
#9
JOURNAL ARTICLE
Hyun Woo Lee, Jiyu Sun, Hyo-Jin Lee, Jung-Kyu Lee, Tae Yeon Park, Eun Young Heo, Chin Kook Rhee, Deog Kyeom Kim
BACKGROUND: Roflumilast is effective in reducing acute exacerbation in patients with chronic obstructive pulmonary disease (COPD) at high risk of severe exacerbation. Clinical traits related to the benefits of roflumilast need to be evaluated in patients with COPD. METHODS: A longitudinal observational study in patients newly diagnosed with COPD was conducted using claims data from the Health Insurance Review and Assessment Service in South Korea from 2012-2020 after a 2-year washout period...
February 29, 2024: Journal of Thoracic Disease
#10
JOURNAL ARTICLE
Rayan Alsuwaigh, Anthony Yii, Chee Hong Loh, Xiaomeng Xu, Priti Bahety, Aldo A Navarro Rojas, Dominique Milea, Augustine Tee
BACKGROUND: In 2019 and 2023, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) provided updated strategies for modifying the therapy of patients with chronic obstructive pulmonary disease (COPD) and high exacerbation risk. A key update since the 2019 guidelines recommends considering blood eosinophil count to guide decisions on inhaled corticosteroid (ICS) treatment. To evaluate the potential impact of these updated recommendations, this study aimed to assess how extensively future practice would diverge from contemporaneous prescribing practices at a single center in Singapore, assuming adherence to the 2019 and 2023 GOLD guidelines...
February 29, 2024: Journal of Thoracic Disease
#11
Antonio Maiorano, Chiara Lupia, Nicola Montenegro, Giuseppe Neri, Andrea Bruni, Eugenio Garofalo, Federico Longhini, Claudia Crimi, Angelantonio Maglio, Alessandro Vatrella, Girolamo Pelaia, Corrado Pelaia
Beclomethasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G) single inhaler extrafine triple therapy is effective for the treatment of uncontrolled asthma. Nevertheless, there is a lack of data about the use of diaphragmatic ultrasonography to monitor adult asthmatics while they are receiving inhaled treatment. We took into consideration a 78-year-old woman complaining of asthma, treated with inhaled corticosteroid/long-acting β2 -adrenergic agonist (ICS/LABA), characterized by an asthma control questionnaire-5 (ACQ-5) score and a lung function test suggestive of uncontrolled asthma...
2024: Frontiers in Medicine
#12
REVIEW
Maria Gabriella Matera, Barbara Rinaldi, Rosa Annibale, Vito De Novellis, Mario Cazzola
INTRODUCTION: The pharmacotherapy of asthma is a dynamic process that changes as our knowledge of the underlying pathophysiology and treatment of this disease continues to evolve. This implies the need for continuous revision of the recommendations of asthma guidelines and strategies. AREAS COVERED: This review summarizes the latest key practical information on the pharmacological management of asthma in adults. We provide the background to the 2023 update of the GINA strategy report, focusing on changes and discussing areas of uncertainty...
March 20, 2024: Expert Opinion on Pharmacotherapy
#13
JOURNAL ARTICLE
Hiroyuki Nagase, Hayato Oka, Hitomi Uchimura, Yoshifumi Arita, Takehiro Hirai, Naoyuki Makita, Naoki Tashiro, Kazuto Matsunaga
BACKGROUND: Biologics are clinically available for patients with severe asthma, but changes in asthma control over time are unknown. We examined changes in disease burden and treatment in severe asthma patients. METHODS: This retrospective study used a Japanese health insurance database (Cross Fact) and included patients aged ≥16 years treated continuously with an inhaled corticosteroid (ICS) for a diagnosis of asthma in each calendar year from 2015 to 2019...
March 15, 2024: Respiratory Investigation
#14
JOURNAL ARTICLE
Paola Maria Cutroneo, Elena Arzenton, Fabiana Furci, Fabio Scapini, Maria Bulzomì, Nicoletta Luxi, Marco Caminati, Gianenrico Senna, Ugo Moretti, Gianluca Trifirò
BACKGROUND: The management of uncontrolled severe asthma has greatly improved since the advent of novel biologic therapies. Up to August 2022, five biologics have been approved for the type 2 asthma phenotype: anti-IgE (omalizumab), anti-IL5 (mepolizumab, reslizumab, benralizumab), and anti-IL4 (dupilumab) monoclonal antibodies. These drugs are usually well tolerated, although long-term safety information is limited, and some adverse events have not yet been fully characterized. Spontaneous reporting systems represent the cornerstone for the detection of potential signals and evaluation of the real-world safety of all marketed drugs...
March 15, 2024: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
#15
JOURNAL ARTICLE
Jennifer A Zader, Rudolf A Jörres, Imke Mayer, Peter Alter, Robert Bals, Henrik Watz, Pontus Mertsch, Klaus F Rabe, Felix Herth, Franziska C Trudzinski, Tobias Welte, Hans-Ulrich Kauczor, Jürgen Behr, Julia Walter, Claus F Vogelmeier, Kathrin Kahnert
BACKGROUND: Randomized controlled trials described beneficial effects of inhaled triple therapy (LABA/LAMA/ICS) in patients with chronic obstructive pulmonary disease (COPD) and high risk of exacerbations. We studied whether such effects were also detectable under continuous treatment in a retrospective observational setting. METHODS: Data from baseline and 18-month follow-up of the COPD cohort COSYCONET were used, including patients categorized as GOLD groups C/D at both visits (n = 258)...
March 1, 2024: BMC Pulmonary Medicine
#16
Yoshiro Kai, Kentaro Suzuki, Ryosuke Kataoka, Ichiro Sato, Shinji Tamaki, Shigeo Muro
Severe asthma affects approximately 5%-10% of patients with asthma. Herein, we describe a case of non-type 2 asthma that progressively worsened over the years. An 80-year-old woman was diagnosed with asthma 11 years back. She experienced repeated exacerbations requiring treatment with systemic corticosteroid despite therapy with medications including high-dose inhaled corticosteroids/long-acting beta-agonists plus long-acting muscarinic antagonist. The patient presented with non-eosinophilic asthma. Therefore, the patient was initially treated with bronchial thermoplasty, which was effective for 1 year only...
March 2024: Respirology Case Reports
#17
JOURNAL ARTICLE
Maria Gabriella Matera, Barbara Rinaldi, Cecilia Calabrese, Carmela Belardo, Luigino Calzetta, Mario Cazzola, Clive Page
BACKGROUND: Airway epithelial cells (AECs) are a major component of local airway immune responses. Direct effects of type 2 cytokines on AECs are implicated in type 2 asthma, which is driven by epithelial-derived cytokines and leads to airway obstruction. However, evidence suggests that restoring epithelial health may attenuate asthmatic features. METHODS: We investigated the effects of passive sensitisation on IL-5, NF-κB, HDAC-2, ACh, and ChAT in human bronchial epithelial cells (HBEpCs) and the effects of fluticasone furoate (FF) and umeclidinium (UME) alone and in combination on these responses...
February 28, 2024: Respiratory Research
#18
JOURNAL ARTICLE
Lulu Zhang, Zhou Fu, Hua Deng, Qin Xie, Wenjie Wu
BACKGROUND: Asthma is a common respiratory disease. In asthma, the small airways have more intensive inflammation and prominent airway remodelling, compared to the central airways. We aimed to investigate the predictive value of risk factors and the fractional concentration of exhaled nitric oxide (FeNO) for persistent small airway dysfunction (p-SAD), and compare the effects of different treatment modalities. METHODS: This retrospective cohort study included 248 children with asthma (aged 4-11 years)...
February 23, 2024: BMC Pulmonary Medicine
#19
JOURNAL ARTICLE
Zhihua Zhu, Mark Naunton, Reza Mortazavi, Mary Bushell
BACKGROUND: Air pollution can cause numerous health problems and increase the need for medicines to treat and prevent asthma in affected areas. There is limited evidence about the association between airborne particles with a diameter of 2.5 micrometres or smaller (PM2.5 ) and asthma medicine usage. This study examined the potential association between the levels of PM2.5 and the supply of prescription asthma medicines in the Australian Capital Territory (ACT), Australia, during the severe bushfire season between November 2019-January 2020...
February 7, 2024: Healthcare (Basel, Switzerland)
#20
JOURNAL ARTICLE
Javier de Miguel-Díez, Julio Núñez Villota, Salud Santos Pérez, Nicolás Manito Lorite, Bernardino Alcázar Navarrete, Juan Francisco Delgado Jiménez, Juan José Soler-Cataluña, Domingo Pascual Figal, Patricia Sobradillo Ecenarro, Juan José Gómez Doblas
Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) frequently coexist, increasing the prevalence of both entities and impacting on symptoms and prognosis. CVD should be suspected in patients with COPD who have high/very high risk scores on validated scales, frequent exacerbations, precordial pain, disproportionate dyspnea, or palpitations. They should be referred to cardiology if they have palpitations of unknown cause or angina pain. COPD should be suspected in patients with CVD if they have recurrent bronchitis, cough and expectoration, or disproportionate dyspnea...
February 1, 2024: Archivos de Bronconeumología
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