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https://www.readbyqxmd.com/read/29332144/long-acting-%C3%AE-2-agonists-in-asthma-enantioselective-safety-studies-are-needed
#1
Glenn A Jacobson, Sharanne Raidal, Morten Hostrup, Luigino Calzetta, Richard Wood-Baker, Mark O Farber, Clive P Page, E Haydn Walters
Long-acting β2-agonists (LABAs) such as formoterol and salmeterol are used for prolonged bronchodilatation in asthma, usually in combination with inhaled corticosteroids (ICSs). Unexplained paradoxical asthma exacerbations and deaths have been associated with LABAs, particularly when used without ICS. LABAs clearly demonstrate effective bronchodilatation and steroid-sparing activity, but long-term treatment can lead to tolerance of their bronchodilator effects. There are also concerns with regard to the effects of LABAs on bronchial hyperresponsiveness (BHR), where long-term use is associated with increased BHR and loss of bronchoprotection...
January 13, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29325305/-evaluation-of-asthma-management-from-the-surveys-in-30-provinces-of-china-in-2015-2016
#2
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: To evaluate the general level of asthma management in urban areas of China and further promote the national asthma management plan. Methods: A multi-center, cross-sectional survey was carried out in 30 provinces of China (except for Tibet) during Oct 2015 to May 2016. It's a questionnaire-based face-to-face survey which included asthma management using peak flow meter (PFM) and pulmonary function test, medication choice of maintenance therapy and asthma education. Results: A total of 3 875 asthmatic outpatients were recruited including 2 347(60...
January 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29279056/a-review-of-the-efficacy-and-safety-of-once-daily-tiotropium-respimat-2-5-micrograms-in-adults-and-adolescents-with-asthma
#3
Eli O Meltzer, William E Berger
BACKGROUND: Despite current guidelines, many patients with asthma remain symptomatic, particularly those intolerant of, unresponsive to, or uncontrolled by long-acting beta 2-agonists (LABAs). Tiotropium bromide, delivered through the Respimat soft-mist inhaler in 2 puffs of 1.25 micrograms each, is approved for the long-term, maintenance treatment of asthma in patients aged ≥6 years. OBJECTIVE: An overview of the use of once-daily tiotropium Respimat 2.5 micrograms in adults and adolescents with varying degrees of asthma severity...
January 6, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29237699/single-inhaler-triple-therapy-for-copd
#4
(no author information available yet)
The European Medicines Agency (EMA) has granted marketing authorisation for a pressurised metered dose inhaler (pMDI) containing beclometasone dipropionate, formoterol fumarate dihydrate and glycopyrronium bromide (Trimbow - Chiesi Pharmaceuticals) for the treatment of chronic obstructive pulmonary disease (COPD) in patients not adequately treated with a combination of an inhaled corticosteroid (ICS) and a long-acting beta2 agonist (LABA).1-3 The manufacturer claims that this is a significant treatment advance for COPD patients, and that the use of one inhaler should simplify therapy and, therefore, may improve adherence...
December 2017: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/29230274/factors-influencing-pharmacological-treatment-in-copd-a-comparison-of-2005-and-2014
#5
Josefin Sundh, Joakim Åberg, Mikael Hasselgren, Scott Montgomery, Björn Ställberg, Karin Lisspers, Christer Janson
Introduction: The aim was to investigate how the pattern of pharmacological treatment in Swedish patients with chronic obstructive pulmonary disease (COPD) has changed over a decade, and to identify factors associated with treatment. Methods: Data on patient characteristics and pharmacological treatment were collected using questionnaires from two separate cohorts of randomly selected primary and secondary care patients with a doctor's diagnosis of COPD in central Sweden, in 2005 (n = 1111) and 2014 (n = 1329)...
2017: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29216852/access-to-affordable-medicines-and-diagnostic-tests-for-asthma-and-copd-in-sub-saharan-africa-the-ugandan-perspective
#6
Davis Kibirige, Leaticia Kampiire, David Atuhe, Raymond Mwebaze, Winceslaus Katagira, Winters Muttamba, Rebecca Nantanda, William Worodria, Bruce Kirenga
BACKGROUND: Equitable access to affordable medicines and diagnostic tests is an integral component of optimal clinical care of patients with asthma and chronic obstructive pulmonary disease (COPD). In Uganda, we lack contemporary data about the availability, cost and affordability of medicines and diagnostic tests essential in asthma and COPD management. METHODS: Data on the availability, cost and affordability of 17 medicines and 2 diagnostic tests essential in asthma and COPD management were collected from 22 public hospitals, 23 private and 85 private pharmacies...
December 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29206637/effects-of-inhaled-corticosteroids-long-acting-agonists-in-a-single-inhaler-versus-inhaled-corticosteroids-alone-on-all-cause-mortality-pneumonia-and-fracture-in-chronic-obstructive-pulmonary-disease-a-nationwide-cohort-study-2002-2013
#7
Kyoung Hee Cho, Young Sam Kim, John A Linton, Chung Mo Nam, Young Choi, Eun-Cheol Park
BACKGROUND: Both inhaled corticosteroids (ICS) and long-acting ?-agonists (LABA) have been recommended for the treatment of severe/moderate chronic obstructive pulmonary disease (COPD), but mild COPD has not been frequently studied. METHODS: We performed a prospective cohort study to compare the effect of inhaled corticosteroid (ICS) and ICS/long-acting ?-agonist (LABA) in a single inhaler on all-cause mortality and adverse events, such as pneumonia and fracture, in patients with newly diagnosed chronic obstructive pulmonary disease (COPD)...
September 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29197099/identification-of-patterns-of-factors-preceding-severe-or-life-threating-asthma-exacerbations-in-a-nationwide-study
#8
H Tanaka, E Nakatani, Y Fukutom, K Sekiya, H Kaneda, M Iikura, M Yoshida, K Takahashi, K Tomii, M Nishikawa, N Kaneko, Y Sugino, M Shinkai, T Ueda, Y Tanikawa, T Shirai, M Hirabayashi, T Aoki, T Kato, K Iizuka, M Fujii, M Taniguchi
BACKGROUND: Reducing near-fatal asthma exacerbations is a critical problem in asthma management. OBJECTIVES: To determine patterns of factors preceding asthma exacerbations in a real-world setting. METHODS: In a nationwide prospective study of 190 patients who had experienced near-fatal asthma exacerbation, cluster analysis was performed using asthma symptoms over the two-week period before admission. RESULTS: Three distinct clusters of symptoms were defined employing the self-reporting of a visual analogue scale...
December 1, 2017: Allergy
https://www.readbyqxmd.com/read/29181828/influence-of-inhaled-corticosteroids-on-bronchial-inflammation-and-pulmonary-function-in-chronic-obstructive-pulmonary-disease-with-moderate-obstruction
#9
Iza Toczyska, Ewa Zwolińska, Andrzej Chcialowski
Inflammation in the bronchial respiratory tract and lung parenchyma underlies the pathogenesis of chronic obstructive pulmonary disease (COPD). It consists of effector cell infiltration, changes in reticular basement membrane (RBM) thickness, and the content of inflammatory mediators. The aim of this study was to assess the influence of inhaled corticosteroids (ICS) on the number of inflammatory cells and RBM thickness in bronchial biopsies, and pulmonary function in patients with moderate COPD. Twenty four patients with newly diagnosed COPD were included into the study...
November 28, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29178871/efficacy-and-safety-of-tiotropium-and-olodaterol-in-copd-a-systematic-review-and-meta-analysis
#10
Marc Miravitlles, Gerard Urrutia, Alexander G Mathioudakis, Julio Ancochea
BACKGROUND: Long-acting bronchodilators are the cornerstone of pharmacologic treatment of COPD. The new combination of long-acting muscarinic antagonist (LAMA) tiotropium (TIO) and long acting beta-agonists (LABA) olodaterol (OLO) has been introduced as fist line therapy for COPD. This article analyses the evidence of efficacy and safety of the TIO/OLO combination. METHODS: A systematic review and metaanalysis of randomized controlled trials (RCT) with a period of treatment of at least 6 weeks, in patients with COPD confirmed by spirometry, comparing combined treatment with TIO/OLO (approved doses only), with any of the mono-components or any other active comparator administered as an inhalator...
November 25, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29174062/tiotropium-respimat-add-on-is-efficacious-in-symptomatic-asthma-independent-of-t2-phenotype
#11
Thomas B Casale, Eric D Bateman, Mark Vandewalker, J Christian Virchow, Hendrik Schmidt, Michael Engel, Petra Moroni-Zentgraf, Huib A M Kerstjens
BACKGROUND: Adding tiotropium to existing inhaled corticosteroid (ICS) maintenance therapy with or without a long-acting β2-agonist (LABA) has been shown to be beneficial in patients with symptomatic asthma. OBJECTIVE: To assess whether responses to tiotropium Respimat add-on therapy were influenced by patients' T2 status. METHODS: In this exploratory study, data from 4 phase III trials were analyzed: once-daily tiotropium 5 μg or placebo as add-on to ICS + LABA (PrimoTinA-asthma; 2 replicate trials; NCT00772538/NCT00776984; n = 912); once-daily tiotropium 5 μg or 2...
November 22, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29156455/-the-overrated-impact-of-inhaled-substances-laba-lama-ics-on-exacerbation-rates-in-copd
#12
D Köhler, D Dellweg
Numerous studies have shown that exacerbation rates in COPD can be significantly reduced by long acting beta-2-agonists (LABA), long acting anticholinergic agents (LAMA) and inhaled steroids (ICS). Elaborate and extensive investigations however failed to prove that the reduction in exacerbation rates leads to life prolongation. As opposed to this, numerous studies have shown a reduction in life expectancy with increasing number and severity of exacerbations.This review aimed at comparing these studies and to elaborate the relevance and reduction of exacerbations rates by LABA, LAMA and ICS application through effect size calculation by means of Cohens' d...
November 20, 2017: Pneumologie
https://www.readbyqxmd.com/read/29138555/the-efficacy-of-extrafine-beclomethasone-dipropionate-formoterol-fumarate-in-copd-patients-who-are-not-frequent-exacerbators-a-post-hoc-analysis-of-the-forward-study
#13
Dave Singh, Stefano Vezzoli, Stefano Petruzzelli, Alberto Papi
The GOLD 2017 strategy document recommends that the pharmacological management of COPD patients be based on the risk of future exacerbations and the severity of symptoms. A threshold of two moderate exacerbations or one hospitalization is used to define high-risk patients. The FORWARD study was a randomized, double-blind, parallel-group trial that compared 48 weeks' treatment with extrafine beclomethasone dipropionate plus formoterol fumarate (BDP-FF) versus FF in severe COPD patients with a history of one or more exacerbations in the previous year...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29128192/efficacy-and-safety-of-benralizumab-in-japanese-patients-with-severe-uncontrolled-eosinophilic-asthma
#14
Ken Ohta, Mitsuru Adachi, Yuji Tohda, Tadashi Kamei, Motokazu Kato, J Mark Fitzgerald, Masayuki Takanuma, Tadahiro Kakuno, Nobuyuki Imai, Yanping Wu, Magnus Aurivillius, Mitchell Goldman
BACKGROUND: In the Phase III CALIMA trial, benralizumab significantly reduced asthma exacerbations, increased lung function, and alleviated symptoms for patients with severe, uncontrolled eosinophilic asthma. The aim of this subgroup analysis was to evaluate the efficacy and safety of benralizumab for Japanese patients in the CALIMA trial. METHODS: CALIMA was a randomised, controlled trial of 1306 patients (aged 12-75 years; registered at ClinicalTrials.gov: NCT01914757) with severe asthma uncontrolled by medium- to high-dosage inhaled corticosteroids and long-acting β2-agonists (ICS/LABA)...
November 8, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/29120273/triple-therapy-in-copd-what-we-know-and-what-we-don-t
#15
Peter M A Calverley, Helgo Magnussen, Marc Miravitlles, Jadwiga A Wedzicha
Triple inhaled therapy for chronic obstructive pulmonary disease (COPD) consists of an inhaled corticosteroid (ICS), a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) taken in combination. Triple therapy is recommended by the Global initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator (preferred initial therapy) or LABA/ICS combination (alternative initial therapy). Although there is evidence for the greater efficacy of triple therapy compared with LABA/ICS and LAMA monotherapy with regards to improved lung function, health status, and exacerbation rate, the efficacy of triple therapy when compared with dual bronchodilation (LABA/LAMA) is as yet unknown...
December 2017: COPD
https://www.readbyqxmd.com/read/29116901/use-of-ics-in-copd-from-blockbuster-medicine-to-precision-medicine
#16
Marco Contoli, Angelo G Corsico, Pierachille Santus, Fabiano Di Marco, Fulvio Braido, Paola Rogliani, Luigi Calzetta, Nicola Scichilone
Chronic obstructive pulmonary disease (COPD) is a major cause of mortality worldwide, whose burden is expected to increase in the next decades, because of numerous risk factors, including the aging of the population. COPD is both preventable and treatable by an effective management including risk factor reduction, prevention, assessment, and treatment of acute exacerbations and co-morbidities. The available agents approved for COPD treatment are long-acting or ultra-long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) bronchodilators, as well as inhaled corticosteroids (ICS) in combination with LABAs...
November 8, 2017: COPD
https://www.readbyqxmd.com/read/29115881/a-review-of-current-and-developing-fixed-dose-laba-lama-combinations-for-treating-copd
#17
Chitra Lal, Charlie Strange
The current GOLD (Global Initiative for Chronic Obstructive Lung Disease) recommendations suggest using long acting β2 agonists (LABA) and long acting muscarinic antagonists (LAMA) in combination for group B COPD patients with persistent symptoms, group C COPD patients with further exacerbations on LAMA therapy alone and for group D COPD patients with or without combination with inhaled corticosteroids (ICS). Thus, there is a lot of interest in developing LABA/LAMA combinations for maintenance therapy of chronic stable COPD...
November 15, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29115880/treatment-response-heterogeneity-in-asthma-the-role-of-genetic-variation
#18
Susanne J H Vijverberg, Niloufar Farzan, Elise M A Slob, Anne H Neerincx, Anke H Maitland-van der Zee
Asthmatic patients show a large heterogeneity in response to asthma medication. Rapidly evolving genotyping technologies have led to the identification of various genetic variants associated with treatment outcomes. Areas covered: This review focuses on the current knowledge of genetic variants influencing treatment response to the most commonly used asthma medicines: short- and long-acting beta-2 agonists (SABA/LABA), inhaled corticosteroids (ICS) and leukotriene modifiers. This review shows that various genetic variants have been identified, but none are currently used to guide asthma treatment...
November 8, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29108533/a-review-of-the-efficacy-and-safety-of-once-daily-tiotropium-respimat-2-5-micrograms-in-adults-and-adolescents-with-asthma
#19
(no author information available yet)
BACKGROUND: Despite current guidelines, many patients with asthma remain symptomatic, particularly those intolerant of,unresponsive to, or uncontrolled by long-acting beta 2-agonists (LABAs). Tiotropium bromide, delivered through the Respimatsoft-mist inhaler in 2 puffs of 1.25 micrograms each, is approved for the long-term, maintenance treatment of asthma in patients aged greater than or equal to 6 years. OBJECTIVE: An overview of the use of once-daily tiotropium Respimat 2...
November 6, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29083972/inhaled-corticosteroid-containing-treatment-escalation-and-outcomes-for-patients-with-asthma-in-a-u-s-health-care-organization
#20
Lindsay G S Bengtson, Yanni Yu, Weijia Wang, Feng Cao, Erin M Hulbert, Ryan Wolbeck, Caitlin A Elliott, Ami R Buikema
BACKGROUND: Asthma is a common disorder that affects approximately 8% of the U.S. POPULATION: Treatment guidelines indicate inhaled corticosteroids (ICS) as the mainstay treatment, yet poor asthma control is common among ICS-treated patients. Treatment escalation (ICS dose increase and other controller therapy add-ons) is used to manage symptoms. Real-world studies of postescalation outcomes may inform treatment decisions. OBJECTIVES: To (a) describe characteristics and treatment patterns among asthma patients who escalated treatment and (b) assess outcomes (exacerbations, uncontrolled asthma, and health care resource utilization [HCRU]) after escalation...
November 2017: Journal of Managed Care & Specialty Pharmacy
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