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https://www.readbyqxmd.com/read/28334727/discovering-the-relative-efficacy-of-inhaled-medications-for-chronic-obstructive-pulmonary-disease-multiple-treatment-comparisons
#1
Ying Zhu, Tong Zhang, Haiyan Li, Yang Yang, Qiong Chen, Lei Kong, Bo Tai
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is managed by three major classes of inhaled medications: inhaled corticosteroids (ICS), long-acting Beta 2-agonist (LABA), long-acting muscarinic antagonist (LAMA). Single inhaled medication is usually replaced by combined inhaled medications for efficacy enhancement. However, this practice should be supported by clinical evidence for large-scale implementations. METHODS: The relative efficacy of inhaled medications is determined by three endpoints: changes in the trough forced expiratory volume in 1 second (tFEV1), changes in the St George's Respiratory Questionnaire (SGRQ) score and the proportion of SGRQ responders which represents a reduction in SGRQ total score at week 24 of ≥4...
March 27, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28327480/pharmacotherapy-of-patients-with-stable-bronchial-asthma
#2
REVIEW
Ashutosh Nath Aggarwal
Several reliever and controller medications are available for managing patients with stable asthma. Inhaled corticosteroids (ICS) are the mainstay of treatment, and can be combined with long-acting beta-agonists (LABA) for patients with moderate or severe disease. An ICS-LABA combination is best administered as a single inhaler used for both maintenance and emergency use. A stepwise approach to therapy has recently been proposed as part of Indian guidelines for management of asthma. Clinicians should advise proper use of inhaled medications, and step up or step down treatment based on adequacy of asthma control...
November 2016: National Medical Journal of India
https://www.readbyqxmd.com/read/28302544/can-the-response-to-omalizumab-be-influenced-by-treatment-duration-a-real-life-study
#3
Bruno Sposato, Marco Scalese, Manuela Latorre, Federica Novelli, Nicola Scichilone, Manlio Milanese, Carmela Olivieri, Antonio Perrella, Pierluigi Paggiaro
OBJECTIVE: It is unknown whether Omalizumab effectiveness changes over the course of time. Our retrospective real-life study tried to analyze whether Omalizumab response may be influenced by treatment duration. METHODS: 340 severe asthmatics treated with Omalizumab for different periods of time were recruited. They were subdivided into 4 groups according to the Omalizumab treatment length: <12, between 12 and 24, between 24 and 60 and >60 months. Omalizumab treatment results (FEV1, exacerbations, ACT, SABA use, asthma control levels, medications used e and ICS doses) were compared...
March 13, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28293106/inhaled-treatment-of-copd-a-delphi-consensus-statement
#4
Vincent Ninane, Jean-Louis Corhay, Paul Germonpré, Wim Janssens, Guy F Joos, Giuseppe Liistro, Walter Vincken, Sandra Gurdain, Evelyne Vanvlasselaer, An Lehouck
BACKGROUND: Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. OBJECTIVES: To evaluate the level of medical experts' consensus on their preferred first-choice treatment within different COPD categories. METHODS: A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28270657/the-impact-of-poor-asthma-control-among-asthma-patients-treated-with-inhaled-corticosteroids-plus-long-acting-%C3%AE-2-agonists-in-the-united-kingdom-a-cross-sectional-analysis
#5
Ian D Pavord, Nicola Mathieson, Anna Scowcroft, Riccardo Pedersini, Gina Isherwood, David Price
There are several new treatment options for patients whose asthma remains uncontrolled on free-dose and fixed-dose combinations of inhaled corticosteroids plus long-acting β2-agonists (ICS+LABA). In order to evaluate the likely impact of these treatments, we assessed the effect of uncontrolled asthma on healthcare and patient burden within the UK among adult patients treated with ICS+LABA. Data obtained from 2010-2011 UK National Health and Wellness Surveys identified 701 patients treated with ICS+LABA. Patients with not well-controlled asthma (Asthma Control Test™ score <20) were compared with well-controlled asthma (score ≥ 20) patients on multiple measures...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28258535/routine-use-of-budesonide-formoterol-fixed-dose-combination-in-elderly-asthmatic-patients-practical-considerations
#6
Nicola Scichilone, Fulvio Braido, Federico Lavorini, Mark L Levy, Omar S Usmani
Asthma has been demonstrated to be as common in the elderly as in younger age groups. Although no specific recommendations exist to manage the disease differently in older individuals, functional features and clinical presentations may be affected by age per se, and by age-related conditions, such as comorbidities and polypharmacy. In this review article, we aimed to explore the efficacy and safety in elderly asthmatic patients of one of the most currently used inhaled treatments for asthma, that is, the fixed-dose combination of budesonide/formoterol...
March 4, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28226405/comparative-effectiveness-of-long-acting-beta2-agonist-combined-with-a-long-acting-muscarinic-antagonist-or-inhaled-corticosteroid-in-chronic-obstructive-pulmonary-disease
#7
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
INTRODUCTION: Several dual bronchodilator fixed dose inhaler medications were recently approved for the treatment of chronic obstructive pulmonary disease (COPD). These products combine a long-acting beta2 -agonist (LABA) and long-acting muscarinic antagonist (LAMA). In clinical trials, the separate mechanisms of the bronchodilators resulted in improved lung function. COPD treatment guidelines currently recommend combination LABA/LAMA as alternative therapy to combination LABA/ inhaled corticosteroid (ICS)...
February 22, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28220767/asthma-control-in-adult-patients-treated-with-a-combination-of-inhaled-corticosteroids-and-long%C3%A2-acting-%C3%AE-2%C3%A2-agonists-a-prospective-observational-study
#8
Barbara Rogala, Paweł Majak, Joanna Glück, Tomasz Dębowski
INTRODUCTION    Asthma is a highly prevalent disease that often requires maintenance therapy. Combined inhaled corticosteroid (ICS) and long‑acting β2‑agonist (LABA) inhalers are one of the available maintenance treatment options. OBJECTIVES    This prospective observational study aimed to assess asthma control in patients treated with ICS/LABA inhalers and to identify factors related to optimal asthma control. PATIENTS AND METHODS    The study included 5789 asthmatic patients from Poland, treated with one of the following ICS/LABA inhalers at clinically appropriate doses: beclomethasone/formoterol, fluticasone/ salmeterol, or budesonide/formoterol...
January 18, 2017: Pol Arch Intern Med
https://www.readbyqxmd.com/read/28194189/day-time-variation-of-serum-periostin-in-asthmatic-adults-treated-with-ics-laba-and-adults-without-asthma
#9
Rachel Caswell-Smith, Terrianne Cripps, Thom Charles, Alexander Hosking, Meghana Handigol, Cecile Holweg, John Matthews, Mark Holliday, Corentin Maillot, James Fingleton, Mark Weatherall, Richard Beasley, Irene Braithwaite
BACKGROUND: We aimed to determine the effect of sampling time during the day on serum periostin levels in adult participants with and without asthma. METHODS: Serum periostin was measured at 2-h intervals from 0800 to 1800 h in 16 adult participants with stable asthma prescribed inhaled corticosteroid and long-acting beta-agonist therapy, and in 16 otherwise healthy participants without asthma. Mixed linear models were used to compare time zero (08:00 h) with subsequent measurement time for serum periostin for both groups...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28185242/long-acting-muscarinic-antagonist-lama-plus-long-acting-beta-agonist-laba-versus-laba-plus-inhaled-corticosteroid-ics-for-stable-chronic-obstructive-pulmonary-disease-copd
#10
REVIEW
Nobuyuki Horita, Atsushi Goto, Yuji Shibata, Erika Ota, Kentaro Nakashima, Kenjiro Nagai, Takeshi Kaneko
BACKGROUND: Three classes of inhaler medications are used to manage chronic obstructive pulmonary disease (COPD): long-acting beta-agonists (LABA), long-acting muscarinic antagonists (LAMA), and inhaled corticosteroids (ICS). When two classes of medications are required, LAMA plus LABA (LAMA+LABA) and LABA plus ICS (LABA+ICS) are often selected because these combinations can be administered via a single medication device. The previous Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidance recommended LABA+ICS as the first-line treatment for managing stable COPD in high-risk people of categories C and D...
February 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28176893/indacaterol-glycopyrronium-versus-salmeterol-fluticasone-in-asian-patients-with-copd-at-a-high-risk-of-exacerbations-results-from-the-flame-study
#11
Jadwiga A Wedzicha, Nanshan Zhong, Masakazu Ichinose, Michael Humphries, Robert Fogel, Chau Thach, Francesco Patalano, Donald Banerji
BACKGROUND: The FLAME study demonstrated that indacaterol/glycopyrronium (IND/GLY), the fixed-dose combination of a long-acting β2-agonist (LABA, IND) and a long-acting muscarinic antagonist (LAMA, GLY), was superior to salmeterol/fluticasone combination (SFC) in preventing exacerbations in COPD patients with a high risk of exacerbations. In this study, we report a prespecified analysis of the efficacy and safety of IND/GLY versus SFC in Asian patients from the FLAME study. PATIENTS AND METHODS: Patients from Asian centers with moderate-to-very severe COPD and ≥1 exacerbation in the previous year from the 52-week, randomized FLAME study were included...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28146601/stepping-down-the-dose-of-inhaled-corticosteroids-for-adults-with-asthma
#12
REVIEW
Iain Crossingham, David Jw Evans, Nathan R Halcovitch, Paul A Marsden
BACKGROUND: Asthma is a condition of the airways affecting more than 300 million adults and children worldwide. National and international guidelines recommend titrating up the dose of inhaled corticosteroids (ICS) to gain symptom control at the lowest possible dose because long-term use of higher doses of ICS carries a risk of systemic adverse events. For patients whose asthma symptoms are controlled on moderate or higher doses of ICS, it may be possible to reduce the dose of ICS without compromising symptom control...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28144054/current-trends-of-management-of-respiratory-diseases-by-pulmonologists-results-of-national-conference-of-pulmonary-disease-2015-survey
#13
Sheetu Singh, Nishtha Singh
CONTEXT: Respiratory diseases are a common problem in our country and these are associated with significant morbidity and mortality. AIMS: The aim of the paper was to analyze the pattern of diagnostic tests used and treatment prescribed for common respiratory diseases. SETTINGS AND DESIGN: A total of 1028 pulmonologists, either member of Indian Chest Society or delegate attending the National Conference of Pulmonary Diseases (NAPCON) 2015, participated in the online survey...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28140686/role-of-muscarinic-antagonists-in-asthma-therapy
#14
Mario Cazzola, Josuel Ora, Paola Rogliani, Maria Gabriella Matera
Higher parasympathetic tone has been reported in asthmatics. In general, cholinergic contractile tone is increased by airway inflammation associated with asthma. Nevertheless, the role of muscarinic antagonists for the treatment of asthma has not yet been clearly defined. Areas covered: The use of SAMAs and LAMAs in asthma has been examined and discussed according with the published evidence. Particular attention has been given to the large Phase III clinical trial program designed to evaluate the efficacy and safety of tiotropium respimat added to standard treatment in adults, adolescents and children with persistent asthma across the spectrum of asthma severity...
March 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28119753/is-the-combination-of-ics-and-laba-a-therapeutic-option-for-copd-fading-away
#15
EDITORIAL
Yeon-Mok Oh
No abstract text is available yet for this article.
January 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28110558/tiotropium-for-the-treatment-of-asthma-in-adolescents
#16
REVIEW
Eckard Hamelmann, Christian Vogelberg, Stanley J Szefler
Asthma is a prevalent disease affecting millions of individuals. Despite receiving guideline therapy with inhaled corticosteroids (ICS) with or without a long-acting β2-agonist (LABA), a proportion of patients remain symptomatic or have suboptimal lung function. There is therefore an unmet need for additional therapies to improve asthma control. The long-acting anticholinergic tiotropium, delivered via the Respimat inhaler, is approved for the treatment of asthma in the EU, the USA, and other countries. Phase III investigation in adults has demonstrated that tiotropium improves lung function and asthma control, with a safety profile comparable with that of placebo...
February 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28109164/assessment-of-biological-psychological-and-adherence-factors-in-the-prediction-of-step-down-treatment-for-patients-with-well-controlled-asthma
#17
Norihiro Saito, Akihito Kamata, Masamichi Itoga, Mami Tamaki, Hiroyuki Kayaba, Thomas Ritz
OBJECTIVES: Inhaled corticosteroids (ICS) and inhaled corticosteroids combined with long-acting beta2-agonist (ICS/LABA) are standard treatments for asthma. However, factors that might help reduce medication in well-controlled asthma are unknown. We classified problems of asthma patients into biological, psychological and adherence factors, and investigated factors associated with the indication and failure of a medication step-down treatment. METHODS: Two hundred twenty two well-controlled asthma patients receiving ICS or ICS/LABA were assessed for physical and psychiatric problems and followed up for one year from adjustment of their treatment step...
January 21, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28107494/protective-roles-for-rgs2-in-a-mouse-model-of-house-dust-mite-induced-airway-inflammation
#18
Tresa George, Matthew Bell, Mainak Chakraborty, David P Siderovski, Mark A Giembycz, Robert Newton
The GTPase-accelerating protein, regulator of G-protein signalling 2 (RGS2) reduces signalling from G-protein-coupled receptors (GPCRs) that signal via Gαq. In humans, RGS2 expression is up-regulated by inhaled corticosteroids (ICSs) and long-acting β2-adrenoceptor agonists (LABAs) such that synergy is produced in combination. This may contribute to the superior clinical efficacy of ICS/LABA therapy in asthma relative to ICS alone. In a murine model of house dust mite (HDM)-induced airways inflammation, three weeks of intranasal HDM (25 μg, 3×/week) reduced lung function and induced granulocytic airways inflammation...
2017: PloS One
https://www.readbyqxmd.com/read/28099820/new-and-developing-non-adrenoreceptor-small-molecule-drugs-for-the-treatment-of-asthma
#19
REVIEW
Neil C Thomson
Inhaled corticosteroids (ICS) alone or in combination with an inhaled long-acting beta2-agonist (LABA) are the preferred long-term treatment for adults and adolescents with symptomatic asthma. Additional drugs include leukotriene-receptor antagonists, slow-release theophylline and the long-acting muscarinic antagonist (LAMA) tiotropium (approved in 2015). There is a need for more effective therapies, as many patients continue to have poorly controlled asthma. Areas covered: New and developing long-acting non-adrenoreceptor synthetic drugs for the treatment of symptomatic chronic asthma despite treatment with an ICS alone or combined with a LABA...
February 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28089081/asthma-chronic-obstructive-pulmonary-disease-overlap-syndrome-literature-review-and-contributions-towards-a-portuguese-consensus
#20
D Araújo, E Padrão, M Morais-Almeida, J Cardoso, F Pavão, R B Leite, A C Caldas, A Marques
INTRODUCTION: Phenotypic overlap between the two main chronic airway pulmonary diseases, asthma and chronic obstructive pulmonary disease (COPD), has been the subject of debate for decades, and recently the nomenclature of asthma-COPD overlap syndrome (ACOS) was adopted for this condition. The definition of this entity in the literature is, however, very heterogeneous, it is therefore important to define how it applies to Portugal. METHODS: A literature review of ACOS was made in a first phase resulting in the drawing up of a document that was later submitted for discussion among a panel of chronic lung diseases experts, resulting in reflexions about diagnosis, treatment and clinical guidance for ACOS patients...
January 6, 2017: Revista Portuguesa de Pneumologia
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