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S A van Nederveen-Bendien, S R J van Oord-Bosselaar, A H Feitsma, J H Kappen
- Asthma during pregnancy is associated with an increased risk of preterm delivery, low birth weight and pre-eclampsia.- This condition may be undertreated due to insufficient knowledge and, in particular, concerns about teratogenic effects of asthma medication among treating healthcare professionals and pregnant women.- The risk of teratogenic effects of inhaled medications (ICS, SABA and LABA) is small. These agents have been used by large groups of patients for many years.- Well-controlled asthma with pharmacological therapy during pregnancy is safer and leads to fewer complications then accepting asthma symptoms and exacerbations...
2018: Nederlands Tijdschrift Voor Geneeskunde
Zahra Alizadeh, Marzieh Mazinani, Esmaeil Mortaz, Mohammad Reza Fazlollahi, Ian Adcock, Mostafa Moein
Different phenotypes of asthma from mild to severe are categorized based on diverse clinical features. A guideline for the recognition and treatment of asthma has been provided by Global Initiative for Asthma (GINA). To control symptoms and prevent asthma exacerbation in most patients combinational therapy with inhaled corticosteroids (ICS) and a long acting B2-adrenreceptor agonist (LABA) are recommended. Understanding asthma phenotypes would be helpful to improve asthma diagnosis and treatment. The aim of this study was to verify glucocorticoid receptor glcococorticoid receptor (GR) nuclear translocation in CD4 T cells treated with fluticasone furoate (FF), vilanterol (V) and FF/V combination in severe asthmatic patients compare to patients with moderate asthma and healthy controls using Immunocytochemistry (ICC)...
February 2018: Iranian Journal of Allergy, Asthma, and Immunology
Maria Gabriella Matera, Luigino Calzetta, Ermanno Puxeddu, Paola Rogliani, Mario Cazzola
LABA+LAMA and LABA+ICS combinations are key pharmacological approaches to the treatment of COPD. However, both combination types can induce adverse events (AEs). Areas covered: Current literature on LABA+LAMA and LABA+ICS combinations has been reviewed with a specific focus on their safety profile in the treatment of COPD. Expert opinion: Several meta-analyses have compared the pooled safety data from randomized clinical trials (RCTs) of LABA+LAMA combinations with LABA+ICS combinations. LABA+LAMA caused significantly less AEs and SAEs...
March 5, 2018: Expert Opinion on Drug Safety
Cedric Van Holsbeke, Jan De Backer, Wim Vos, Jonathan Marshall
BACKGROUND: Functional respiratory imaging (FRI) uses three-dimensional models of human lungs and computational fluid dynamics to simulate functional changes within airways and predict the deposition of inhaled drugs. This study used FRI to model the effects of different patient inhalation and drug formulation factors on lung deposition of an inhaled corticosteroid/long-acting β2 -agonist (ICS/LABA) combination, administered by a pressurized metered-dose inhaler. METHODS: Three-dimensional models of the lungs of six patients with asthma (mean forced expiratory volume in 1 s, 83%), treated with an ICS/LABA, were included...
January 2018: Therapeutic Advances in Respiratory Disease
D Köhler, D Dellweg
No abstract text is available yet for this article.
February 2018: Pneumologie
Jadwiga A Wedzicha, Fernando J Martinez
No abstract text is available yet for this article.
February 16, 2018: American Journal of Respiratory and Critical Care Medicine
Amanda Wilson
The mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and healthcare professionals who deliver, lead or research nursing care. The CNCF produces Cochrane Corner columns, summaries of recent nursing-care-relevant Cochrane Reviews that are regularly published in collaborating nursing-related journals. Information on the processes CNCF has developed can be accessed at: cncf...
February 14, 2018: Nursing Standard
Francesco Patalano, Konstantinos Kostikas, Caterina Brindicci
Both asthma and COPD are complex, heterogeneous conditions comprising a wide range of phenotypes, some of which are refractory to currently available treatments. Elucidation of these phenotypes and identification of biomarkers with which to recognize them and guide appropriate treatment remains a priority. This review describes the utility of blood eosinophils as a surrogate biomarker of eosinophilic airway inflammation, a common feature of specific asthma and COPD phenotypes. The role of blood eosinophils in airway disease is described, as is their relevance in reflecting airway eosinophilia...
February 12, 2018: Current Drug Targets
Vincent Yi-Fong Su, Kuang-Yao Yang, Yao-Hsu Yang, Ying-Huang Tsai, Diahn-Warng Perng, Wei-Juin Su, Kun-Ta Chou, Kang-Cheng Su, Yung-Feng Yen, Pau-Chung Chen
BACKGROUND: Based on current guidelines, more research is urgently needed to guide appropriate treatment for patients with asthma-chronic obstructive pulmonary disease (COPD) overlap. OBJECTIVE: The objective of this study was to investigate medication effects on acute exacerbation in patients with coexistent COPD and asthma. METHODS: Using Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to evaluate medication effects in patients with COPD and asthma...
February 10, 2018: Journal of Allergy and Clinical Immunology in Practice
W Q Wang, J T Lin, X Zhou, C Z Wang, M Huang, S X Cai, P Chen, Q C Lin, J Y Zhou, Y H Gu, Y D Yuan, D J Sun, X H Yang, L Yang, J M Huo, Z C Chen, P Jiang, J Zhang, X W Ye, H G Liu, H P Tang, R Y Liu, C T Liu, W Zhang, C P Hu, Y Q Chen, X J Liu, L M Dai, W Zhou, Y J Huang, J Y Xu
Objective: In order to evaluate disease perception of asthma patients in urban China and provide evidence for further specific patient education. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out in 30 general hospitals dispersed in 30 provinces of mainland China (except for Tibet) during Oct 2015 to May 2016. Information of disease perception [Question 1: the disease nature of asthma; Question 2: medication choice of first-line in chronic asthma; Question 3: the occasion of using short-acting aerosols of receptor agonists; Question 4: perception of asthma treatment goal; Question 5: reason for not using peak flow meter (PFM)] were collected from asthma patients of outpatient department...
February 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Kian Fan Chung
Severe therapy-resistant asthma has been defined as "asthma which requires treatment with high dose inhaled corticosteroids (ICSs) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy". Patients who usually present with 'difficult-to-treat asthma' should first be assessed to determine whether he/she has asthma with the exclusion of other diagnoses and if so, whether the asthma can be classified as severe therapy-resistant...
February 2018: Seminars in Respiratory and Critical Care Medicine
Zafar Zafari, Mohsen Sadatsafavi, J Mark FitzGerald
Background: A significant minority of asthma patients remain uncontrolled despite the use of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA). A number of add-on therapies, including monoclonal antibodies (namely omalizumab) and more recently tiotropium bromide have been recommended for this subgroup of patients. The purpose of this study was to assess the cost-effectiveness of tiotropium versus omalizumab as add-on therapies to ICS + LABA for patients with uncontrolled allergic asthma...
2018: Cost Effectiveness and Resource Allocation: C/E
Mona Al-Ahmad, Nermina Arifhodzic, Jasmina Nurkic, Ahmed Maher, Tito Rodriguez-Bouza, Nasser Al-Ahmed, Ali Sadek, Edin Jusufovic
OBJECTIVE: To evaluate the long-term efficacy and safety of omalizumab in asthma in a real-life setting. SUBJECTS AND METHODS: This was a 4-year observational study that included 65 patients treated with omalizumab during clinic visits; treatment response was rated as excellent, good and partial based on modified GETE (mGETE) scale. of emergency room visits (ERV), hospitalization, use of oral corticosteroids, inhaled corticosteroids/ long acting beta-agonist (ICS/LABA) dose, and short acting beta-agonist (SABA) rescue...
February 7, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Bartolome R Celli, Julie A Anderson, Robert Brook, Peter M A Calverley, Courtney Crim, Andrew P Holmes, Fernando J Martinez, David E Newby, Julie Yates, Jørgen Vestbo
No abstract text is available yet for this article.
February 7, 2018: American Journal of Respiratory and Critical Care Medicine
Kensuke Fukumitsu, Yoshihiro Kanemitsu, Takamitsu Asano, Norihisa Takeda, Hiroya Ichikawa, Jennifer Maries Go Yap, Satohi Fukuda, Takehiro Uemura, Osamu Takakuwa, Hirotsugu Ohkubo, Ken Maeno, Yutaka Ito, Tetsuya Oguri, Atsushi Nakamura, Masaya Takemura, Akio Niimi
BACKGROUND: Asthmatic cough is often refractory to standard treatments such as inhaled corticosteroids and long-acting β2 agonists (ICS/LABA). Tiotropium may modulate cough reflex sensitivity of acute viral cough, but its efficacy in asthmatic cough remains unknown. OBJECTIVE: To evaluate whether tiotropium improves cough and cough reflex sensitivity in asthmatic patients refractory to ICS/LABA. METHODS: Seventeen consecutive asthmatic patients with chronic cough despite the use of ICS/LABA [13 females; 43...
February 2, 2018: Journal of Allergy and Clinical Immunology in Practice
Jiangtao Lin, Xin Zhou, Changzheng Wang, Chuntao Liu, Shaoxi Cai, Mao Huang
The Global Initiative for Asthma (GINA) annual report summarizes the latest evidence for asthma management. GINA recommends stepwise pharmacological treatment, advocating inhaled corticosteroids (ICS) plus rapid, long-acting β2-agonists (LABA) delivered in a single inhaler for maintenance and relief at Steps 3 (moderate persistent asthma requiring 1-2 controllers plus as-needed reliever), 4 (severe persistent asthma requiring ≥2 controllers plus as-needed reliever), and 5 (higher level care and/or add-on treatment)...
February 5, 2018: Expert Review of Respiratory Medicine
Cristina Longo, Gillian Bartlett, Tibor Schuster, Francine M Ducharme, Brenda MacGibbon, Tracie A Barnett
BACKGROUND: Current evidence regarding the relationship between childhood obesity, decreased response to inhaled corticosteroids (ICS), and poor asthma control is conflicting. OBJECTIVES: We assessed if obesity: i) is associated with time-to-first exacerbation among children with asthma initiating Step-3 maintenance therapies; ii) modifies the effectiveness of Step-3 therapies. METHODS: A retrospective cohort study was conducted from clinical data linked to health and drug administrative databases...
January 27, 2018: Journal of Allergy and Clinical Immunology
Osemeke U Osokogu, Javeed Khan, Swabra Nakato, Daniel Weibel, Maria de Ridder, Miriam C J M Sturkenboom, Katia Verhamme
PURPOSE: To control for confounding by indication in comparative (drug) effectiveness studies, propensity scores (PS) methods may be utilized. Since childhood diseases or outcomes often present as acute events, we compared the effect of using different look back periods in electronic health care data, to construct PSs. This was applied in our research on the effect of a combination of inhaled corticosteroids/long-acting beta-2-agonists (ICS+LABA), either as fixed combination or used as loose combination (2 separate inhaler devices) in the prevention of severe asthma exacerbations...
January 26, 2018: Journal of Clinical Epidemiology
Samy Suissa, Elliot Israel, James Donohue, Scott Evans, James Kemp
The safety of long-acting beta-agonists (LABA) to treat asthma has been a lingering issue for the last 25 years after two large randomized trials reported an increased incidence of asthma death with salmeterol. The current dilemma is whether this risk is also increased when LABAs are given with inhaled corticosteroids (ICS). To address this, the FDA required that manufacturers conduct five large randomized trials comparing ICS-LABA combinations to ICS alone on the incidence of major asthma outcomes. The three trials that have been published to date showed that the risk of a serious asthma-related event, including asthma-related death, intubation or hospitalization, was not increased with the addition of the LABA...
January 22, 2018: American Journal of Respiratory and Critical Care Medicine
E Padrão, D Araújo, A Todo Bom, C Robalo Cordeiro, J Correia de Sousa, J Cardoso, M Morais-Almeida, R Costa, F Pavão, R B Leite, A Marques
INTRODUCTION: The overlap between asthma and chronic obstructive pulmonary disease (COPD) (ACO) has been discussed for many years but clinical recommendations for this entity have been diverse. This study is intended to reach a consensus on diagnosis, treatment and patient orientation for ACO, within the Portuguese medical community. METHODS: This study was conducted by a multidisciplinary panel of experts from three distinct medical specialties (Pulmonology, Family Medicine and Immunoallergology)...
January 12, 2018: Revista Portuguesa de Pneumologia
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