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Asthma controller withdrawal

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https://www.readbyqxmd.com/read/29079610/duration-of-the-efficacy-of-omalizumab-after-treatment-discontinuation-in-real-life-severe-asthma
#1
Maria Del Carmen Vennera, Carlos Sabadell, Cesar Picado
Efficacy of omalizumab in severe asthma is well documented; however, the optimal duration of the treatment remains unclear. In an open prospective study, we sought to assess the persistence of response in subjects withdrawing from omalizumab treatment. We evaluated 49 patients who voluntarily accepted to discontinue omalizumab treatment after 6 years of therapy. Asthma relapse was defined as any severe asthma exacerbation associated with loss of asthma control. Twelve patients relapsed in the first year of follow-up, and 7 within 13 and 48 months...
October 27, 2017: Thorax
https://www.readbyqxmd.com/read/29058249/a-2-year-step-down-withdrawal-from-inhaled-corticosteroids-in-asthmatic-children-receiving-immunotherapy
#2
Chun-Hui He, Xing Li, Jun-Hong Lin, Qiang Xiao, Jia-Lu Yu, Ying-Fen Liu, Wen-Hui Jiang, Chen Chen, Li Deng, Jie Zhou
BACKGROUND: Inhaled corticosteroids (ICSs) for treating asthma are controversial because of their negative effects on the growth of asthmatic children and without clearly defined withdrawal strategy. A 2-year ICS step-down and withdrawal strategy has been developed for asthmatic children receiving 3-year subcutaneous immunotherapy (SCIT). METHODS: Eleven children were included into the SCIT group and 13 children into the ICS group. ICSs were discontinued when children met the following criteria: requiring only 1 puffper day, with good control, for at least 6 months; having a forced expiratory volume in 1 second (FEV1)/forced vital capacity ≥80%; and SCIT discontinued for ≥24 months...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28933516/anti-il5-therapies-for-asthma
#3
REVIEW
Hugo A Farne, Amanda Wilson, Colin Powell, Lynne Bax, Stephen J Milan
BACKGROUND: This review is the first update of a previously published review in The Cochrane Library (Issue 7, 2015). Interleukin-5 (IL-5) is the main cytokine involved in the activation of eosinophils, which cause airway inflammation and are a classic feature of asthma. Monoclonal antibodies targeting IL-5 or its receptor (IL-5R) have been developed, with recent studies suggesting that they reduce asthma exacerbations, improve health-related quality of life (HRQoL) and lung function...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28853952/perceptions-of-asthma-and-exercise-in-adolescents-with-and-without-asthma
#4
Winn Con, Mackintosh Ka, Eddolls Wtb, Stratton G, Wilson Am, Rance Jy, Doull Ijm, Mcnarry Ma, Davies Ga
OBJECTIVE: To elicit the views of adolescents, with and without asthma, about exercise and asthma, and the perceived benefits of and barriers to participation. The adolescent views elicited would subsequently inform the design of a high-intensity exercise intervention to improve asthma control. METHODS: Fifty-four adolescents (age 13.1±0.9years; 26 with asthma) participated in twelve semi-structured group interviews. Questions were structured around knowledge, attitudes and beliefs towards asthma and its impact on exercise participation and lifestyle...
August 30, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28692145/efficacy-and-safety-of-tiotropium-in-school-age-children-with-moderate-to-severe-symptomatic-asthma-a-systematic-review
#5
Gustavo J Rodrigo, Hugo Neffen
BACKGROUND: Recently published data support the benefits and safety of the once-daily (OD) long-acting anticholinergic tiotropium bromide bronchodilator for the treatment of uncontrolled moderate-to-severe asthma in adults and adolescents. However, its role for the treatment of school-age asthmatics has not yet been clearly defined. The aim of this systematic review was to assess the efficacy and safety of tiotropium Respimat(®) in children aged 6-11 years with moderate-to-severe symptomatic asthma...
September 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28626990/exhaled-breath-profiles-in-the-monitoring-of-loss-of-control-and-clinical-recovery-in-asthma
#6
P Brinkman, M A van de Pol, M G Gerritsen, L D Bos, T Dekker, B S Smids, A Sinha, C J Majoor, M M Sneeboer, H H Knobel, T J Vink, F H de Jongh, R Lutter, P J Sterk, N Fens
BACKGROUND: Asthma is a chronic inflammatory airway disease, associated with episodes of exacerbations. Therapy with inhaled corticosteroids (ICS) targets airway inflammation, which aims to maintain and restore asthma control. Clinical features are only modestly associated with airways inflammation. Therefore, we hypothesized that exhaled volatile metabolites identify longitudinal changes between clinically stable episodes and loss of asthma control. OBJECTIVES: To determine whether exhaled volatile organic compounds (VOCs) as measured by gas-chromatography/mass-spectrometry (GC/MS) and electronic nose (eNose) technology discriminate between clinically stable and unstable episodes of asthma...
June 19, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28301050/addition-of-anti-leukotriene-agents-to-inhaled-corticosteroids-for-adults-and-adolescents-with-persistent-asthma
#7
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/28203072/-real-life-inhaled-corticosteroid-withdrawal-in-copd-a-subgroup-analysis-of-daccord
#8
MULTICENTER STUDY
Claus Vogelmeier, Heinrich Worth, Roland Buhl, Carl-Peter Criée, Nadine S Lossi, Claudia Mailänder, Peter Kardos
Many patients with chronic obstructive pulmonary disease (COPD) receive inhaled corticosteroids (ICSs) without a clear indication, and thus, the impact of ICS withdrawal on disease control is of great interest. DACCORD is a prospective, noninterventional 2-year study in the primary and secondary care throughout Germany. A subgroup of patients were taking ICS prior to entry - 1,022 patients continued to receive ICS for 2 years; physicians withdrew ICS on entry in 236 patients. Data from these two subgroups were analyzed to evaluate the impact of ICS withdrawal...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27966207/partial-retraction-of-lawrence-chd-chen-iyd-the-effect-of-scuba-diving-on-airflow-obstruction-in-divers-with-asthma-diving-and-hyperbaric-medicine-2016-march-46-1-11-14
#9
Christopher Hd Lawrence, Isobel Yd Chen
Consistent with the Committee on Publication Ethics guidelines, we the above authors are initiating a partial retraction of our paper: Lawrence CHD, Chen IYD. The effect of scuba diving on airflow obstruction in divers with asthma. Diving and Hyperbaric Medicine. 2016 March;46(1):11-14. We wish to make the following statement: "Following independent statistical review of our paper we would like to withdraw the following: all subgroup statistical analysis including Table 1 and the statement "∗ P 〈 0.05, non-asthmatic controls vs Group A3 asthmatics" in the legend of Figure 2; the discussion statement: "We hope that these data will provide practitioners assessing and risk stratifying people with asthma prior to diving with a modest evidence basis on which to advise them of their relative risk of airflow obstruction compared to the normal population...
December 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27937064/safety-efficacy-and-dose-response-of-fluticasone-propionate-delivered-via-the-novel-mdpi-in-patients-with-severe-asthma-a-randomized-controlled-dose-ranging-study
#10
RANDOMIZED CONTROLLED TRIAL
David I Bernstein, Michael Gillespie, Sharon Song, Jonathan Steinfeld
OBJECTIVE: Evaluate fluticasone propionate (Fp) using a novel, inhalation-driven, multidose dry powder inhaler (MDPI) in patients with severe persistent asthma, versus placebo MDPI and Fp dry powder inhaler (DPI). METHODS: Patients with persistent asthma despite use of high-dose inhaled corticosteroids were randomized to Fp MDPI 50, 100, 200, or 400 mcg; Fp DPI 250 mcg; or placebo MDPI twice daily for 12 weeks. The primary outcome measure was change from baseline in trough forced expiratory volume in 1 second (FEV1) over the 12-week period, compared with placebo; secondary measures included change from baseline in peak expiratory flow (PEF), rescue inhaler use, and time to withdrawal due to meeting stopping criteria...
August 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27826098/a-randomized-multicenter-study-evaluating-xolair-persistence-of-response-after-long-term-therapy
#11
RANDOMIZED CONTROLLED TRIAL
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: We sought to evaluate the benefit and persistence 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...
July 2017: 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
#12
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
#13
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
#14
REVIEW
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...
August 25, 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
#15
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
#16
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
#17
RANDOMIZED CONTROLLED TRIAL
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...
April 28, 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
#18
RANDOMIZED CONTROLLED TRIAL
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
#19
RANDOMIZED CONTROLLED TRIAL
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
#20
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
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