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Severe persistent asthma

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https://www.readbyqxmd.com/read/28331346/control-of-moderate-to-severe-asthma-with-randomized-ciclesonide-doses-of-160-320-and-640-%C3%AE-g-day
#1
Søren E Pedersen, Niyati Prasad, Udo-Michael Goehring, Henrik Andersson, Dirkje S Postma
BACKGROUND: The inhaled corticoteroid (ICS) ciclesonide (Cic), controls asthma symptoms in the majority of patients at the recommended dose of 160 µg/day. However, the relationship between the level of asthma control and increasing doses of Cic is unknown. This study investigated whether long-term treatment with higher doses of Cic would further improve asthma symptoms in patients with uncontrolled asthma despite ICS use. PATIENTS AND METHODS: In a double-blind, randomized, parallel-group study, 367 patients were allocated to one of three treatment arms (Cic 160, 320 and 640 µg/day)...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28301050/addition-of-anti-leukotriene-agents-to-inhaled-corticosteroids-for-adults-and-adolescents-with-persistent-asthma
#2
REVIEW
Bhupendrasinh F Chauhan, Maya M Jeyaraman, Amrinder Singh Mann, Justin Lys, Ahmed M Abou-Setta, Ryan Zarychanski, Francine M Ducharme
BACKGROUND: Asthma management guidelines recommend low-dose inhaled corticosteroids (ICS) as first-line therapy for adults and adolescents with persistent asthma. The addition of anti-leukotriene agents to ICS offers a therapeutic option in cases of suboptimal control with daily ICS. OBJECTIVES: To assess the efficacy and safety of anti-leukotriene agents added to ICS compared with the same dose, an increased dose or a tapering dose of ICS (in both arms) for adults and adolescents 12 years of age and older with persistent asthma...
March 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28295424/long-term-future-risk-of-severe-exacerbations-distinct-5-year-trajectories-of-problematic-asthma
#3
Anthony C A Yii, Jessica H Y Tan, Therese S Lapperre, Adrian K W Chan, Su Y Low, Thun H Ong, Keng L Tan, Sanjay H Chotirmall, Peter J Sterk, Mariko S Koh
BACKGROUND: Assessing future risk of exacerbations is an important component of asthma management. Existing studies have investigated short-, but not long-term risk. Problematic asthma patients with unfavorable long-term disease trajectory and persistently frequent severe exacerbations need to be identified early to guide treatment. METHODS: Severe exacerbation rates over five years for 177 "problematic asthma" patients presenting to a specialist asthma clinic were tracked...
March 11, 2017: Allergy
https://www.readbyqxmd.com/read/28294591/letter-to-the-editor-can-dog-allergen-immunotherapy-reduce-concomitant-allergic-sensitization-to-other-furry-animals-a-preliminary-experience
#4
G Liccardi, L Calzetta, A Salzillo, L Billeri, G Lucà, P Rogliani
It has been shown that allergen immunotherapy (AIT) is effective in reducing symptoms of allergic asthma and rhinitis. Data on the efficacy are less convincing with regard to AIT for allergens of common pets (cats/dogs). We describe a case of dog allergy in which we explored if dog AIT (DAI) could reduce a concomitant allergic sensitization to other allergens of furry animals. Our case demonstrates the efficacy of sublingual DAI on SPTs, symptom score, and spirometric responses despite persistent exposure to dog allergens at home in a patient sensitized, but not exposed, to several other furry animals...
March 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28284319/longterm-clinical-outcomes-of-omalizumab-therapy-in-severe-allergic-asthma-study-of-efficacy-and-safety
#5
Adel H Mansur, Sapna Srivastava, Verity Mitchell, Julie Sullivan, Ismail Kasujee
Omalizumab has been shown to be an effective add-on therapy for patients with uncontrolled severe persistent allergic asthma. There has been a steady accumulation of evidence on the long-term effectiveness of omalizumab; however, data on real-life outcomes beyond one year of treatment is limited. In this study, we report on long-term outcomes of omalizumab treatment. We collected data from our severe asthma registry on hospitalisations, exacerbations, corticosteroid sparing, asthma control, lung function, biomarkers and side effects, to determine if the benefit was sustained and treatment was safe on the long term...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28278149/-socioeconomic-costs-of-asthma-in-the-european-union-united-states-and-canada-a-systematic-review
#6
REVIEW
Jaume Puig-Junoy, Natàlia Pascual-Argenté
BACKGROUND: Asthma is responsible for a large number of doctor and emergency visits due to exacerbations and inadequate control of the disease, which give rise to very high associated economic costs. The social cost of asthma comprises both the healthcare and non-healthcare costs. The purpose of this study was to analyse up-to-date estimates of the social cost of asthma, with special reference to the influence of level of severity and degree of control. METHODS: A systematic review of original cost-of-illness studies of asthma published in English or Spanish between January 2004 and December 2014 and indexed in PubMed, IBECS or IME was conducted...
March 9, 2017: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/28275486/comparison-of-fluticasone-propionate-with-budesonide-administered-via-nebulizer-a-randomized-controlled-trial-in-patients-with-severe-persistent-asthma
#7
Jiangtao Lin, Ping Chen, Chuntao Liu, Jian Kang, Wei Xiao, Zhengxian Chen, Huaping Tang, Xin Du, Cindy Liu, Linda Luo
BACKGROUND: This study compared the efficacy and safety of fluticasone propionate (FP) inhalation n solution with budesonide (BUD) suspension for inhalation administered via nebulizer, in Chinese adult patients with severe, persistent asthma. METHODS: This was a multicenter, randomized, active-controlled, single-blind, parallel-group study, conducted at 26 clinical sites in China. Participants were randomized 1:1 to FP nebules 1 mg twice daily or BUD 2 mg twice daily via nebulizer for 12 weeks...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28274526/efficacy-of-long-term-omalizumab-therapy-in-patients-with-severe-asthma
#8
Junko Saji, Takahito Yamamoto, Motonaka Arai, Masamichi Mineshita, Teruomi Miyazawa
BACKGROUND: The efficacy of omalizumab, an anti-immunoglobulin E (IgE) antibody, has been studied in patients with severe bronchial asthma. We conducted a study to evaluate, on the basis of both objective and subjective measures, the efficacy of omalizumab as a long-term therapy in patients with severe and persistent asthma. METHODS: Omalizumab was administered subcutaneously every two or four weeks. The results of pulmonary function tests, Asthma Control Test (ACT) and Asthma Health Questionnaire (AHQ)-33 scores, the dosage of methylprednisolone during the 12-month treatment period, and the number of emergency visits prior to the start of treatment with omalizumab were compared in patients pre- and post-treatment with omalizumab...
March 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28272068/rare-disease-heralded-by-pulmonary-manifestations-avoiding-pitfalls-of-an-asthma-label
#9
S Bajaj, M Muranjan, S Karande, D Prabhat
Pulmonary manifestations are seldom recognized as symptoms of storage disorders. The report describes the diagnostic journey in a 30-month-old male infant, born of a third-degree consanguineous marriage referred to our institute as severe persistent asthma. History revealed that the child had progressively worsening breathlessness and persistent dry cough not associated with fever but accompanied by weight loss. On physical examination, there was growth failure, respiratory distress, clubbing, hepatosplenomegaly, and occasional rhonchi...
March 3, 2017: Journal of Postgraduate Medicine
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
#10
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/28264494/omalizumab-is-equally-effective-in-persistent-allergic-oral-corticosteroid-dependent-asthma-caused-by-either-seasonal-or-perennial-allergens-a-pilot-study
#11
Christian Domingo, Xavier Pomares, Albert Navarro, Núria Rudi, Ana Sogo, Ignacio Dávila, Rosa M Mirapeix
Omalizumab is marketed for chronic severe asthma patients who are allergic to perennial allergens. Our purpose was to investigate whether omalizumab is also effective in persistent severe asthma due to seasonal allergens. Thirty patients with oral corticosteroid-dependent asthma were treated with Omalizumab according to the dosing table. For each patient with asthma due to seasonal allergens, we recruited the next two consecutive patients with asthma due to perennial allergens. The dose of oral methyl prednisolone was tapered at a rate of 2 mg every two weeks after the start of treatment with omalizumab depending on tolerance...
February 28, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28253869/reduced-prf1-enhancer-methylation-in-children-with-a-history-of-severe-rsv-bronchiolitis-in-infancy-an-association-study
#12
Magdeldin Elgizouli, Chad Logan, Ruth Grychtol, Dietrich Rothenbacher, Alexandra Nieters, Andrea Heinzmann
BACKGROUND: Acute lower respiratory tract infection is the commonest disease affecting children under five worldwide. Respiratory syncytial virus (RSV) is among the most common causative pathogens. Epidemiological data suggest an association between severe viral respiratory infections in infancy and increased incidence of childhood wheeze and asthma. DNA methylation is involved in immune cell differentiation and identity. It provides an avenue for environmental influences on the genome and therefore has potential as a marker for sustained effects of infectious insults...
March 3, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28236359/single-nucleotide-polymorphisms-related-to-cystic-fibrosis-in-chronic-rhinositus-a-pilot-study
#13
Benjamin P Hull, Pawina Jiramongkolchai, Justin H Turner, Lana Olson, Rakesh K Chandra
BACKGROUND: The clinical association between cystic fibrosis (CF) and chronic rhinosinusitis (CRS) is well known. Studies have identified several non-CF transmembrane conductance regulator single nucleotide polymorphisms (SNPs) associated with disease severity in CF patients. We hypothesized that prevalence of these SNPs would be different between CRS patients and age/gender-matched non-CRS controls. METHODS: This is a targeted SNP study of 1231 CRS patients identified through a large university hospital database who were compared with 8796 age- and gender-matched controls without a history of rhinitis, sinusitis, allergies, or asthma...
February 25, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28225496/impact-of-nasal-symptoms-on-the-evaluation-of-asthma-control
#14
Chien-Chia Huang, Po-Hung Chang, Pei-Wen Wu, Chun-Hua Wang, Chia-Hsiang Fu, Chi-Che Huang, Hsiao-Jung Tseng, Ta-Jen Lee
The united airways concept suggests that patients with asthma typically exhibit parallel inflammation in the upper airway. The resulting nasal symptoms should reduce quality of life and substantially affect the evaluation of asthma control among these patients. This study aimed to assess the association of nasal symptoms with the evaluation of asthma control.Fifty-eight patients with asthma and persistent nasal symptoms were prospectively recruited for evaluations of their sinonasal symptoms and asthma control in a cross-sectional study from August 2013 to June 2016...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28218986/risk-factors-hindering-asthma-symptoms-control-in-saudi-children-and-adolescents
#15
Rabih Halwani, Alejandro Vazquez-Tello, Nour Horanieh, Said Dulgom, Zohair Al-Aseri, Nouf Al-Khamis, Zubaida Al-Sum, Hamdan Al-Jahdali, Saleh Al-Muhsen
BACKGROUND: Maintaining well control of asthma symptoms can help preventing exacerbations and its associated complications. The Asthma Control Test (ACT) can rapidly assess the effectiveness of asthma management plan and therapy. OBJECTIVE: To identify risk factors associated with uncontrolled asthma symptoms in young Saudi asthmatics (3-17 years-old). METHODS: In this cross-sectional hospital-based survey, the ACT was administered to 297 asthmatic children/adolescents, recruited at the emergency department (ED) of two major hospitals...
February 20, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28217433/visual-analogue-scales-vas-measuring-instruments-for-the-documentation-of-symptoms-and-therapy-monitoring-in-cases-of-allergic-rhinitis-in-everyday-health-care-position-paper-of-the-german-society-of-allergology-aeda-and-the-german-society-of-allergy-and-clinical
#16
Ludger Klimek, Karl-Christian Bergmann, Tilo Biedermann, Jean Bousquet, Peter Hellings, Kirsten Jung, Hans Merk, Heidi Olze, Wolfgang Schlenter, Philippe Stock, Johannes Ring, Martin Wagenmann, Wolfgang Wehrmann, Ralph Mösges, Oliver Pfaar
BACKROUND: Visual analogue scales (VAS) are psychometric measuring instruments designed to document the characteristics of disease-related symptom severity in individual patients and use this to achieve a rapid (statistically measurable and reproducible) classification of symptom severity and disease control. VAS can also be used in routine patient history taking and to monitor the course of a chronic disease such as allergic rhinitis (AR). More specifically, the VAS has been used to assess effectiveness of AR therapy in real life, both in intermittent and persistent disease...
2017: Allergo Journal International
https://www.readbyqxmd.com/read/28215604/burden-of-chronic-oral-corticosteroid-use-by-adults-with-persistent-asthma
#17
Robert S Zeiger, Michael Schatz, Qiaowu Li, Wansu Chen, Deepak B Khatry, Trung N Tran
BACKGROUND: Chronic oral corticosteroid (C-OCS) use in asthma is an indicator of disease severity, but its risk factors are largely unknown. OBJECTIVE: To describe patient characteristics and disease burden associated with C-OCS use by adults with persistent asthma. METHODS: We identified 9546 patients aged 18 to 64 years in a large managed care organization who met the Healthcare Effectiveness Data and Information Set 2-year criteria (2009-2010) for persistent asthma...
February 10, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28214106/multicenter-study-of-cigarette-smoking-among-adults-with-asthma-exacerbations-in-the-emergency-department-2011-2012
#18
Robert A Silverman, Kohei Hasegawa, Daniel J Egan, Kirk A Stiffler, Ashley F Sullivan, Carlos A Camargo
INTRODUCTION: Previous studies demonstrated a high prevalence of cigarette smoking in patients presenting to the emergency department (ED) with acute asthma. Despite the clinical and public health importance, there have been no recent multicenter efforts to characterize this patient population. We aimed to update the prevalence of cigarette smoking among ED patients with asthma exacerbations. METHODS: Multicenter chart review study of 48 EDs across 23 US states...
February 7, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28208871/clinical-utility-of-fractional-exhaled-nitric-oxide-feno-as-a-biomarker-to-predict-severity-of-disease-and-response-to-inhaled-corticosteroid-ics-in-asthma-patients
#19
Revathy Neelamegan, Vinodkumar Saka, Kadhiravan Tamilarasu, Manju Rajaram, Sandhiya Selvarajan, Adithan Chandrasekaran
INTRODUCTION: Bronchial asthma is a common chronic inflammatory airway disease diagnosed and is based on symptomatic history and Pulmonary Function Tests (PFT). Fractional exhaled Nitric Oxide (FeNO) is exclusively a non-invasive biomarker of on-going eosinophilic airway inflammation which remains unpredictable only with PFTs. FeNO measurement is recommended in predicting asthma severity and Inhaled Corticosteroid (ICS) response but further research is required to understand its clinical utility and agreement with current recommendations in a specific population...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28196638/japanese-guidelines-for-adult-asthma-2017
#20
REVIEW
Masakazu Ichinose, Hisatoshi Sugiura, Hiroyuki Nagase, Masao Yamaguchi, Hiromasa Inoue, Hironori Sagara, Jun Tamaoki, Yuji Tohda, Mitsuru Munakata, Kohei Yamauchi, Ken Ohta
Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea) and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015). The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and lead a normal life, without any symptoms...
February 11, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
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