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Asthma controller withdrawal

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https://www.readbyqxmd.com/read/27826098/a-randomized-multicenter-study-evaluating-xolair%C3%A2-persistency-of-response-after-long-term-therapy-xport
#1
Dennis Ledford, William Busse, Benjamin Trzaskoma, Theodore A Omachi, Karin Rosén, Bradley E Chipps, Allan T Luskin, Paul G Solari
BACKGROUND: Few data are available to assist clinicians with decisions regarding long-term use of asthma therapies, including omalizumab. OBJECTIVE: To evaluate the benefit and persistency of response in subjects continuing or withdrawing from long-term omalizumab treatment. METHODS: Evaluating the Xolair® Persistency Of Response After Long-Term Therapy (XPORT) was a randomized, double-blind, placebo-controlled withdrawal study that included subjects with moderate-to-severe persistent asthma receiving long-term omalizumab...
November 5, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27817819/efficacy-and-safety-comparison-fluticasone-furoate-and-fluticasone-propionate-after-step-down-from-fluticasone-furoate-vilanterol-in-japanese-patients-with-well-controlled-asthma-a-randomized-trial
#2
Mitsuru Adachi, Caroline Goldfrad, Loretta Jacques, Yoshie Nishimura
BACKGROUND: For patients with well-controlled asthma, 'step down' of therapy is recommended. We evaluated Japanese patients switching from inhaled corticosteroid (ICS)/long-acting beta2-agonists (LABA; equivalent to fluticasone propionate [FP]/salmeterol [SAL] 250/50 μg twice daily [BD]) to fluticasone furoate (FF)/vilanterol (VI) 100/25 μg, then stepping down to ICS alone. METHODS: This phase III trial had two treatment periods (P): P1, patients with well-controlled asthma on FP/SAL 250/50 μg BD equivalent stepped across to once daily (OD) FF/VI 100/25 μg (open-label, eight weeks); P2, patients remaining 'well controlled' after P1 stepped down to FF 100 μg OD/FP 100 μg BD/FP 250 μg BD (randomized 1:1:1, double-blind, 12 weeks)...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27692128/step-down-treatment-from-medium-dosage-of-budesonide-formoterol-in-controlled-asthma
#3
Kazutaka Mori, Tomoyuki Fujisawa, Naoki Inui, Dai Hashimoto, Noriyuki Enomoto, Yutaro Nakamura, Shigeki Kuroishi, Koshi Yokomura, Mikio Toyoshima, Shiro Imokawa, Takashi Yamada, Toshihiro Shirai, Masafumi Masuda, Hiroshi Hayakawa, Kingo Chida, Takafumi Suda
BACKGROUND: The stepping down of asthma treatment can be considered when asthma symptoms have been well controlled with inhaled corticosteroids (ICSs)/long-acting β2 adrenergic agonists (LABAs). However, few data are available comparing the efficacy between two step-down strategies, to reduce ICS/LABA dose or to withdraw LABA continuing ICS, in well-controlled asthmatics. METHODS: This was a prospective multicentre randomized, two-arm, controlled study. Ninety-one asthmatic patients controlled by budesonide/formoterol combination (BFC) 320/9 μg twice daily were assigned to 2 stepping-down treatments as follows: the BFC group; BUD/FM 160/4...
October 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27562427/drop-out-rate-among-patients-treated-with-omalizumab-for-severe-asthma-literature-review-and-real-life-experience
#4
M Caminati, G Senna, G Stefanizzi, R Bellamoli, S Longhi, F Chieco-Bianchi, G Guarnieri, S Tognella, M Olivieri, C Micheletto, G Festi, E Bertocco, M Mazza, A Rossi, A Vianello
BACKGROUND: In patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies...
2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27519578/real-life-effect-of-long-acting-%C3%AE-2-agonist-withdrawal-in-patients-with-controlled-step-3-asthma
#5
Sunny Jabbal, Arvind Manoharan, William Anderson, Joseph Lipworth, Brian Lipworth
No abstract text is available yet for this article.
October 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27503237/fevipiprant-a-prostaglandin-d2-receptor-2-antagonist-in-patients-with-persistent-eosinophilic-asthma-a-single-centre-randomised-double-blind-parallel-group-placebo-controlled-trial
#6
Sherif Gonem, Rachid Berair, Amisha Singapuri, Ruth Hartley, Marie F M Laurencin, Gerald Bacher, Björn Holzhauer, Michelle Bourne, Vijay Mistry, Ian D Pavord, Adel H Mansur, Andrew J Wardlaw, Salman H Siddiqui, Richard A Kay, Christopher E Brightling
BACKGROUND: Eosinophilic airway inflammation is often present in asthma, and reduction of such inflammation results in improved clinical outcomes. We hypothesised that fevipiprant (QAW039), an antagonist of prostaglandin D2 receptor 2, might reduce eosinophilic airway inflammation in patients with moderate-to-severe eosinophilic asthma. METHODS: We performed a single-centre, randomised, double-blind, parallel-group, placebo-controlled trial at Glenfield Hospital (Leicester, UK)...
September 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27125779/modelling-variable-dropout-in-randomised-controlled-trials-with-longitudinal-outcomes-application-to-the-magnetic-study
#7
Ruwanthi Kolamunnage-Dona, Colin Powell, Paula Ruth Williamson
BACKGROUND: Clinical trials with longitudinally measured outcomes are often plagued by missing data due to patients withdrawing or dropping out from the trial before completing the measurement schedule. The reasons for dropout are sometimes clearly known and recorded during the trial, but in many instances these reasons are unknown or unclear. Often such reasons for dropout are non-ignorable. However, the standard methods for analysing longitudinal outcome data assume that missingness is non-informative and ignore the reasons for dropout, which could result in a biased comparison between the treatment groups...
2016: Trials
https://www.readbyqxmd.com/read/27050801/impact-of-the-arg-16-allele-of-the-b2ar-gene-on-the-effect-of-withdrawal-of-laba-in-patients-with-moderate-to-severe-asthma
#8
Marjorie Slankard, Mary Ann Michelis, Mahesh Mansukhani, Barbara McGoey, Amy Paige, Howard Andrews, David Lederer, Stephen Canfield, Emily DiMango
INTRODUCTION: Long-acting beta agonists (LABAs) are effective for controlling asthma, however questions about their safety have led to concerns over use. Genetic polymorphisms at the 16 amino acid position of the beta-2 adrenergic receptor gene (B2AR) may be associated with increased risk. METHODS: A randomized, double blind study was conducted in patients with moderate to severe asthma being treated with combined inhaled corticosteroids/LABA (ICS/LABA), comparing the effect of LABA continuation versus withdrawal on asthma outcomes among patients stratified by B2AR genotype (Arg/Arg vs...
October 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27039236/assessment-of-consistency-of-fixed-airflow-obstruction-status-during-budesonide-formoterol-treatment-and-its-effects-on-treatment-outcomes-in-patients-with-asthma
#9
Donald P Tashkin, Gary E Moore, Frank Trudo, Michael DePietro, Bradley E Chipps
BACKGROUND: The consistency of fixed airflow limitation status during treatment in patients with asthma is unknown. OBJECTIVE: The objective of this study was to determine the consistency of fixed airflow obstruction (FAO) status during treatment and effects on treatment response. METHODS: This post hoc analysis from a 12-week study (NCT00652002) assessed patients aged 12 years or more with moderate-to-severe asthma randomized to twice-daily budesonide/formoterol (BUD/FM) via pressurized metered-dose inhaler (pMDI) 320/9 μg, BUD pMDI 320 μg, FM 9 μg via dry-powder inhaler, or placebo...
July 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/26870702/effect-of-abstinence-on-audio-visual-reaction-time-in-chronic-smokers-pursuing-a-professional-course
#10
Aditya Lal Vallath, Anuradha Rajiv Joshi, Savita Madhukar Vaidya
INTRODUCTION: It has now been proven that tobacco abuse is the leading cause for various carcinomas such as oral, lung and oesophageal. It also leads to atherosclerosis of major vessels, development of hypertension, autoimmune disorders, COPD, bronchitis, asthma, bronchiectasis, etc. Most smokers are dependent on nicotine and abstinence from smoking results in tobacco withdrawal and craving. It also affects cognitive skills and reaction time. Many students in professional college have the habit of smoking...
December 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26594816/addition-of-long-acting-beta2-agonists-to-inhaled-corticosteroids-for-chronic-asthma-in-children
#11
REVIEW
Bhupendrasinh F Chauhan, Caroline Chartrand, Muireann Ni Chroinin, Stephen J Milan, Francine M Ducharme
BACKGROUND: Long-acting beta2-agonists (LABA) in combination with inhaled corticosteroids (ICS) are increasingly prescribed for children with asthma. OBJECTIVES: To assess the safety and efficacy of adding a LABA to an ICS in children and adolescents with asthma. To determine whether the benefit of LABA was influenced by baseline severity of airway obstruction, the dose of ICS to which it was added or with which it was compared, the type of LABA used, the number of devices used to deliver combination therapy and trial duration...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26509255/loss-of-asthma-control-and-activation-of-coagulation-and-fibrinolysis
#12
M M S Sneeboer, N Fens, M A van de Pol, C J Majoor, J C M Meijers, P W Kamphuisen, R Lutter, P J Sterk, E H D Bel
BACKGROUND: Epidemiologic studies have shown that patients with severe asthma have increased risk of pulmonary embolism, in particular patients with frequent asthma exacerbations. Therefore, we hypothesized that asthma exacerbations are associated with increased haemostatic activity. OBJECTIVE: To investigate whether induced loss of asthma control is associated with changes in coagulation and fibrinolytic parameters in peripheral blood. METHODS: We performed a prospective, inhaled steroid withdrawal study in 23 patients with moderate to moderately severe asthma, consisting of a baseline visit and a visit after loss of asthma control...
March 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/26365745/predictive-risk-factors-for-relapse-after-cessation-of-inhaled-corticosteroids-in-well-controlled-childhood-asthma
#13
H Akturk, E Karakoc-Aydiner, A Ozen, S Baris, T Akkoc, N N Bahceciler, I Barlan
AIM: There is limited data for predicting the risk of exacerbations following the cessation of inhaled steroids(ICS) in well controlled childhood asthma. In current study, clinical, functional and inflammatory parameters at the time of ICS withdrawal were investigated in that respect. METHODS: Forty children asymptomatic for at least 3 months on low dose ICS's were enrolled and ICS were discontinued in summer. At enrolment symptom/medication diary, pulmonary function parameters, methacholine provocation testing, peripheral blood eosinophilia, serum total and allergen-specific IgE levels and skin prick testing were performed...
September 10, 2015: Minerva Pediatrica
https://www.readbyqxmd.com/read/26231467/tiotropium-for-the-treatment-of-adolescents-with-moderate-to-severe-symptomatic-asthma-a-systematic-review-with-meta-analysis
#14
REVIEW
Gustavo J Rodrigo, José A Castro-Rodríguez
BACKGROUND: The role of tiotropium for the treatment of adolescents with asthma has not yet been clearly defined. OBJECTIVE: To assess the efficacy and safety of inhaled tiotropium in adolescents with moderate to severe symptomatic asthma. METHODS: Randomized, placebo-controlled trials were included in this systematic review. Primary outcomes were peak and trough forced expiratory volume in 1 second (FEV1). RESULTS: Three studies (approximately 1,000 patients) were included...
September 2015: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/26197430/intermittent-inhaled-corticosteroid-therapy-versus-placebo-for-persistent-asthma-in-children-and-adults
#15
REVIEW
Jimmy Chong, Cheyaanthan Haran, Bhupendrasinh F Chauhan, Innes Asher
BACKGROUND: International guidelines advocate using daily inhaled corticosteroids (ICS) in the management of children and adults with persistent asthma. However, in real world clinical settings, these medicines are often used at irregular intervals by patients. Recent evidence suggests that the use of intermittent ICS, with treatment initiated at the time of early symptoms, may still have benefits for reducing the severity of an asthma exacerbation. OBJECTIVES: To compare the efficacy and safety of intermittent ICS versus placebo in the management of children and adults diagnosed with, or suspected to have, symptoms of mild persistent asthma...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26143936/focusing-the-mechanism-of-action-to-dissect-the-different-treatments-of-respiratory-allergy
#16
REVIEW
Cristoforo Incorvaia, Philippe Moingeon, Serena Buttafava, Franco Frati
The treatment of respiratory allergy is based on several drugs with different mechanisms of action, which encompass an effect only on symptoms, limited factors of inflammation or the whole process of inflammation. Dissecting the different treatments by their mechanism of action is relevant for the management of allergic patients. Corticosteroids, administered as nasal sprays in rhinitis or by inhalation devices in asthma, and allergen immunotherapy (AIT) are the most effective treatments for respiratory allergy, achieving the control on inflammation by a number of cellular and molecular mechanisms...
2015: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/26089258/stopping-long-acting-beta2-agonists-laba-for-adults-with-asthma-well-controlled-by-laba-and-inhaled-corticosteroids
#17
REVIEW
Shaleen Ahmad, Kayleigh M Kew, Rebecca Normansell
BACKGROUND: Poorly controlled asthma often leads to preventable exacerbations that require additional medications, as well as unscheduled hospital and clinic visits.Long-acting beta2-agonists (LABA) are commonly given to adults with asthma whose symptoms are not well controlled by inhaled corticosteroids (ICS). US and UK regulators have issued warnings for LABA in asthma, and now recommend they be used "for the shortest duration of time required to achieve control of asthma symptoms and discontinued, if possible, once asthma control is achieved"...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26003311/neonatal-urinary-tract-infection-may-increase-the-risk-of-childhood-asthma
#18
C-H Lin, Y-C Wang, W-C Lin, C-H Kao
The aim of this population-based retrospective cohort study was to investigate the onset of urinary tract infection in newborns and the associated risks of childhood asthma. Children with neonatal UTI (n = 3,312) and randomly selected controls (n = 13,243) were enrolled for our analysis. We calculated the follow-up person-years for each participant from the index date until the diagnosis of asthma, the end of 2008, or withdrawal from the insurance system (because of death or loss to follow-up). Furthermore, we compared the risk of asthma between non-UTI and UTI cohorts by using Cox proportional hazards model analysis, the adjusted hazard ratio (aHR), and a 95 % confidence interval (95 % CI)...
September 2015: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/25645133/long-term-efficacy-and-safety-of-omalizumab-in-patients-with-persistent-uncontrolled-allergic-asthma-a-systematic-review-and-meta-analysis
#19
REVIEW
Tianwen Lai, Shaobin Wang, Zhiwei Xu, Chao Zhang, Yun Zhao, Yue Hu, Chao Cao, Songmin Ying, Zhihua Chen, Wen Li, Bin Wu, Huahao Shen
Currently, limited information is available to clinicians regarding the long-term efficacy of omalizumab treatment for allergic asthma. In this report, we aimed to (i) systematically review the evidence regarding the long-term efficacy of omalizumab in patients with persistent uncontrolled allergic asthma, and to (ii) discuss the cost-effectiveness evidence published for omalizumab in this patient population. A comprehensive search for randomized controlled trials (RCTs; ≥52 weeks) was performed, and six studies met our final inclusion criteria (n = 2,749)...
2015: Scientific Reports
https://www.readbyqxmd.com/read/25414582/addition-of-antileukotriene-agents-to-inhaled-corticosteroids-in-children-with-persistent-asthma
#20
Jimmy K Chong, Bhupendrasinh F Chauhan
UNLABELLED: For the current issue of the Journal, we asked Drs Jimmy Chong and Bhupendrasinh Chauhan to comment on and put into context the Cochrane Review on the efficacy and safety of adding antileukotriene agents (LTRAs) to low-dose inhaled corticosteroids (ICS) in children with persistent asthma (1). BACKGROUND: In the treatment of children with mild persistent asthma, low-dose ICS are recommended as the preferred monotherapy (referred to as step 2 of therapy)...
November 2014: Paediatrics & Child Health
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