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Inhaled corticosteroid

Augustine Tee, Wai Leng Chow, Colin Burke, Guruprasad Basavarajaiah
INTRODUCTION: In light of the growing evidence base for better clinical results with the use of the dual bronchodilator indacaterol/glycopyrronium (IND/GLY) over inhaled corticosteroid-containing salmeterol/fluticasone combination (SFC), this study aimed to evaluate the cost-effectiveness of IND/GLY over SFC in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) who are at low risk of exacerbations in the Singapore healthcare setting. METHODS: A previously published patient-level simulation model was adapted for use in Singapore by applying local unit costs...
March 16, 2018: Singapore Medical Journal
Catia Cilloniz, Miquel Ferrer, Adamanthia Liapikou, Carolina Garcia-Vidal, Albert Gabarrus, Adrian Ceccato, Jorge Puig de La Bellacasa, Francesco Blasi, Antoni Torres
Question: To assess the incidence, characteristics, aetiology, risk factors and mortality of acute respiratory distress syndrome (ARDS) in ICU patients with community-acquired pneumonia (CAP) using the Berlin definition. Methods: We prospectively enrolled consecutive mechanically-ventilated ICU adults with CAP over 20 years, compared with mechanically-ventilated patients without ARDS. The main outcome was 30-day mortality. Results: Among 5,334 patients hospitalized with CAP, 930 (17%) were admitted to the ICU, and 432 required mechanical ventilation; 125 (29%) cases met the Berlin ARDS criteria...
March 15, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
A Sicras-Mainar, S Traseira-Lugilde, T Fernández-Sánchez, R Navarro-Artieda
OBJECTIVE: To determine the persistence, exacerbations, and use of resources in patients who use inhaler treatment with fluticasone propionate/formoterol (PF/Form) in relation with other combinations of inhaled corticosteroid/long-acting β-adrenergic (ICS/LABA) at fixed doses, for the treatment of asthma in real-life practice. MATERIAL AND METHODS: Observational study conducted by reviewing medical records. The study included subjects ≥18 years of age who started treatment with ICS/LABA and who met certain inclusion/exclusion criteria...
March 12, 2018: Semergen
Patrick Darken, Paolo DePetrillo, Colin Reisner, Earl St Rose, Paul Dorinsky
The budesonide/glycopyrronium/formoterol fumarate dihydrate metered dose inhaler (BGF MDI) is an inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β2 -agonist fixed-dose combination formulated with innovative co-suspension delivery technology that is in clinical development for the treatment of chronic obstructive pulmonary disease (COPD). This randomized, Phase I, single-dose, six-treatment, four-period, crossover study (NCT01980615) examined the pharmacokinetic (PK) and safety profile of three doses of BGF MDI (320/14...
March 12, 2018: Pulmonary Pharmacology & Therapeutics
Christian Viniol, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Mario Malerba, Matteo Nardin, Giuseppe Santini, Nadia Mores, Alessandro Radaeli, Paolo Montuschi
Maintenance pharmacological treatment for stable chronic obstructive pulmonary disease (COPD) is based on inhaled drugs, including long-acting muscarinic receptor antagonists (LAMA), long-acting β2 -adrenoceptor agonists (LABA) and inhaled corticosteroids (ICS). Inhaled pharmacological treatment can improve patients' daily symptoms and reduce decline of pulmonary function and acute exacerbation rate. Treatment with all three inhaled drug classes is reserved for selected, more severe, patients with COPD when symptoms are not sufficiently controlled by dual LABA/LAMA therapy and exacerbations are frequent...
January 2018: Therapeutic Advances in Respiratory Disease
B Xing, J T Lin, H P Tang, L Yang, Y D Yuan, Y H Gu, P Chen, X J Liu, J Zhang, H G Liu, C Z Wang, W Zhou, D J Sun, Y Q Chen, Z C Chen, M Huang, Q C Lin, C P Hu, X H Yang, J M Huo, X W Ye, X Zhou, P Jiang, W Zhang, Y J Huang, L M Dai, R Y Liu, S X Cai, J Y Xu, J Y Zhou
Objective: To study the treatment of patients hospitalized for asthma exacerbation in China. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during Jan 2013 to Dec 2014. Information of the demographic features, the severity of the exacerbation, the medicine prescribed during the hospitalization and the use of mechanical ventilation were collected and analyzed. Results: During the study period, there were 3 240 patients hospitalized for asthma exacerbation, and 1 369(42...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Michael C Peters, Sheena Kerr, Eleanor M Dunican, Prescott G Woodruff, Merritt L Fajt, Bruce D Levy, Elliot Israel, Brenda R Phillips, David T Mauger, Suzy A Comhair, Serpil C Erzurum, Mats W Johansson, Nizar N Jarjour, Andrea M Coverstone, Mario Castro, Annette T Hastie, Eugene R Bleecker, Sally E Wenzel, John V Fahy
BACKGROUND: Airway type 2 inflammation is usually corticosteroid sensitive, but the role of type 2 inflammation as a mechanism of asthma in patients on high dose inhaled corticosteroids (ICS) is uncertain. OBJECTIVE: To determine if airway type 2 inflammation persists in patients treated with ICS and to evaluate the clinical features of patients with steroid resistant airway type-2 inflammation. METHODS: We used qPCR to generate a composite metric of type-2 cytokine gene expression (type 2 Gene Mean, "T2GM") in induced sputum cells from healthy controls, severe asthma patients on ICS (n=174), and non-severe asthma patients on ICS (n=85)...
March 7, 2018: Journal of Allergy and Clinical Immunology
Matthew Morten, Adam Collison, Vanessa E Murphy, Daniel Barker, Christopher Oldmeadow, John Attia, Joseph Meredith, Heather Powell, Paul D Robinson, Peter D Sly, Peter G Gibson, Joerg Mattes
BACKGROUND: The single-centre double-blind, randomised controlled Managing Asthma in Pregnancy (MAP) trial in Newcastle, Australia, compared a treatment algorithm using the fraction of exhaled nitric oxide (FeNO) in combination with asthma symptoms (FeNO group) against a treatment algorithm using clinical symptoms only (clinical group) in pregnant asthmatic women (ANZ Clinical Trials Registry, number 12607000561482). The primary outcome was a 50% reduction in asthma exacerbations during pregnancy in the FeNO group...
March 7, 2018: Journal of Allergy and Clinical Immunology
Antonio Anzueto, Marc Miravitlles
Chronic obstructive pulmonary disease (COPD) is often misdiagnosed and inappropriately treated in many patients. COPD is a distinct disease from adult-onset asthma; however, some patients with COPD may present with several forms of airway disease described as asthma-COPD overlap (ACO). Bronchodilators and inhaled corticosteroids (ICS) both have a place in standard maintenance treatment of COPD and asthma; however, recommendations for use differ widely. In patients with COPD, long-acting bronchodilators are effective initial monotherapy treatment, while ICS monotherapy is recommended as initial treatment in patients with asthma...
March 7, 2018: Chest
Abhishek Biswas, Hiren J Mehta, Michael A Jantz
A 62-year-old Hispanic woman, a resident of Puerto Rico, presented with symptoms of chronic cough and shortness of breath for the past 2 years that were slowly and progressively getting worse. She received a diagnosis of asthma on the basis of her history of symptomatic "wheezing" and had been on treatment with inhaled bronchodilators and corticosteroids with minimal symptomatic improvement. The peculiarity of her symptoms was that her dyspnea was worse when she was reclining in bed and she would often hear a "whistling" noise in her throat during those times...
March 2018: Chest
J T Lin, W Q Wang, X Zhou, K S Yin, C T Liu, C Z Wang, M Huang, P Chen, Y D Yuan, S X Cai, C G Wu, J Li, Q C Lin, J Y Zhou, H G Liu, Y H Gu, X G Huang, D J Sun, X H Yang, L Yang, J M Huo, Z C Chen, W Zhou, P Jiang, H P Tang, R Y Liu, W Zhang, Y Q Chen, Y J Huang, X J Liu, L M Dai, X W Ye, C P Hu, J Zhang, J Y Xu
Objective: To evaluate the changes of asthma control, disease management and perception in recent years in China. Methods: We conducted 2 multi-center, cross-sectional surveys. Outpatient asthmatic patients from 10 cities in mainland China (2007-2008) and 30 central cities from 30 provinces in China (except Tibet)(2015-2016) were recruited respectively. Data of asthma control, disease management and perception from the 2 surveys were compared for 10 cities which took part in both of the 2 surveys. Chi-square test was used for comparison between groups...
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Katharine C Pike, Melika Akhbari, Dylan Kneale, Katherine M Harris
BACKGROUND: Asthma exacerbations in school-aged children peak in autumn, shortly after children return to school following the summer holiday. This might reflect a combination of risk factors, including poor treatment adherence, increased allergen and viral exposure, and altered immune tolerance. Since this peak is predictable, interventions targeting modifiable risk factors might reduce exacerbation-associated morbidity and strain upon health resources. The peak occurs in September in the Northern Hemisphere and in February in the Southern Hemisphere...
March 8, 2018: Cochrane Database of Systematic Reviews
Paulo Camargos, Alessandra Affonso, Geralda Calazans, Lidiana Ramalho, Marisa L Ribeiro, Nulma Jentzsch, Simone Senna, Renato T Stein
Background: Daily inhaled corticosteroids are widely recommended for mild persistent asthma. This study aimed to assess the efficacy of the intermittent use of beclomethasone as an alternative treatment for mild persistent asthma. Methods: In this 16-week trial, children aged 6-18 years were evaluated. Subjects in the continuous treatment arm of the study received 500 μg/day of beclomethasone, whereas the intermittent ones were given 1000 μg/day (250 μg every 6 h) in combination with albuterol for 7 days upon exacerbations or worsening of symptoms...
2018: Clinical and Translational Allergy
Zahra Alizadeh, Marzieh Mazinani, Esmaeil Mortaz, Mohammad Reza Fazlollahi, Ian Adcock, Mostafa Moein
Different phenotypes of asthma from mild to severe are categorized based on diverse clinical features. A guideline for the recognition and treatment of asthma has been provided by Global Initiative for Asthma (GINA). To control symptoms and prevent asthma exacerbation in most patients combinational therapy with inhaled corticosteroids (ICS) and a long acting B2-adrenreceptor agonist (LABA) are recommended. Understanding asthma phenotypes would be helpful to improve asthma diagnosis and treatment. The aim of this study was to verify glucocorticoid receptor glcococorticoid receptor (GR) nuclear translocation in CD4 T cells treated with fluticasone furoate (FF), vilanterol (V) and FF/V combination in severe asthmatic patients compare to patients with moderate asthma and healthy controls using Immunocytochemistry (ICC)...
February 2018: Iranian Journal of Allergy, Asthma, and Immunology
Anna Sztafińska, Joanna Jerzyńska, Włodzimierz Stelmach, Katarzyna Woicka-Kolejwa, Iwona Stelmach
Introduction: Omalizumab, a monoclonal anti-immunoglobulin E antibody, has been successfully used as a supplementary therapy to improve asthma control in children aged ≥ 6 years with severe persistent allergic asthma. Aim: To demonstrate the quality of life in children with severe asthma and their caregivers, and changes from baseline in forced expiratory volume in 1 s (FEV1 ) and daily inhaled corticosteroids (ICS) dose after 2-year treatment with omalizumab...
October 2017: Postȩpy Dermatologii i Alergologii
Guillaume Chaussé, Tina Kader, Gad Abikhzer, Stephan Probst
A 44-year-old woman was found to have new diffuse lung uptake on a follow-up whole-body I scan 1 year after being treated with surgery and radioactive iodine for papillary thyroid cancer. However, subsequent CT thorax and thyroglobulin levels were both unremarkable. Shortly after, she presented with respiratory symptoms, exhibiting end-expiratory wheezing on auscultation. Metacholine challenge test confirmed asthma. Symptoms improved under inhaled corticosteroids and beta-2 agonists. Resolution of lung uptake was confirmed on a second I imaging 6 months later...
April 2018: Clinical Nuclear Medicine
Yavor Ivanov, Ivan Nikolaev, Imola Nemeth
Introduction: This was the first study designed to prospectively evaluate treatment patterns in chronic obstructive pulmonary disease (COPD) and the degree of adherence with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy recommendations in routine clinical practice in Bulgaria. Methods: The study was conducted in an outpatient setting and enrolled patients of both genders, aged >40 years, who were diagnosed with COPD (as per GOLD 2013)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Giorgio Ciprandi, Irene Schiavetti, Fabio L M Ricciardolo
BACKGROUND: Asthma is characterized by airway inflammation and bronchial hyperreactivity. It is conceived that aging may affect asthma characteristics, but this issue is still not completely clarified in clinical practice. OBJECTIVE: The present study investigated whether aging may affect some clinical and functional factors in outpatients with asthma visited in a real-world setting, such as clinical practice. METHODS: Globally, 391 outpatients (163 males, median age 47 years) with asthma were consecutively evaluated...
March 2018: Respiratory Medicine
Hye Yun Park, Suh-Young Lee, Danbee Kang, Juhee Cho, Hyun Lee, Seong Yong Lim, Ho Il Yoon, Seung Won Ra, Ki Uk Kim, Yeon-Mok Oh, Don D Sin, Sang-Do Lee, Yong Bum Park
BACKGROUND: The recognition of asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) as a distinct phenotype of COPD or asthma has increased. Although ACO has worse clinical features than non-ACO COPD, limited information is available on long-term outcomes of lung function decline for ACO and non-ACO COPD. METHODS: COPD patients with at least 3 years of follow-up were selected from the Korean Obstructive Lung Disease cohort. ACO was defined based on 3 major criteria: 1) airflow limitation in individuals 40 years of age and older, 2) ≥10 pack-years of smoking history, and 3) a history of asthma or bronchodilator response of > 400 mL in forced expiratory volume in 1 s (FEV1 ) at baseline; and at least 1 minor criterion: 1) history of atopy or allergic rhinitis, 2) two separated bronchodilator responses of ≥12% and 200 mL in FEV1 , or 3) peripheral blood eosinophils ≥300 cells/μL...
March 2, 2018: Respiratory Research
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