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https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#1
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28687232/reduced-need-for-surgery-in-severe-nasal-polyposis-with-mepolizumab-randomised-trial
#2
Claus Bachert, Ana R Sousa, Valerie J Lund, Glenis K Scadding, Philippe Gevaert, Shuaib Nasser, Stephen R Durham, Marjolein E Cornet, Harsha H Kariyawasam, Jane Gilbert, Daren Austin, Aoife C Maxwell, Richard P Marshall, Wytske J Fokkens
BACKGROUND: Patients with eosinophilic nasal polyposis frequently require surgery, and recurrence rates are high. OBJECTIVE: To assess the efficacy and safety of mepolizumab vs placebo for severe bilateral nasal polyposis. METHODS: This randomised, double-blind, placebo-controlled trial recruited patients aged 18-70 years with recurrent nasal polyposis requiring surgery. Patients received intravenous mepolizumab 750 mg or placebo every 4 weeks for a total of six doses, in addition to daily topical corticosteroid treatment...
July 4, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28687231/mepolizumab-efficacy-in-patients-with-severe-eosinophilic-asthma-receiving-different-controller-therapies
#3
Frank C Albers, Robert G Price, Steven G Smith, Steven W Yancey
This post hoc analysis of the MENSA study demonstrates that mepolizumab reduced the annualized exacerbation rate relative to placebo in patients with severe eosinophilic asthma irrespective of the number or type of background controller therapies.
July 4, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28648630/resolution-of-a-steroid-resistant-hypereosinophilic-immune-diathesis-with-mepolizumab-and-concomitant-amelioration-of-a-mixed-thrombotic-microangiopathy
#4
J Justin Mulvey, Cynthia Magro, Amy Chadburn
The anaphylatoxins produced by an unbridled complement cascade in atypical hemolytic uremic syndrome (aHUS) can alter the leukocyte environment in tissues and peripheral blood, causing clinically significant eosinophilia. While the membrane attack complex and C5a anaphlatoxin can be suppressed with anti-C5 biologics, the production of C3a is still capable of driving a destructive hypereosinophilic syndrome in spite of anticomplement therapy. The side-effects of glucocorticoids in treating hypereosinophilic syndrome limit their therapeutic index in long-term treatment and this behooves the use of alternative strategies...
May 2, 2017: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28645995/mepolizumab-for-the-treatment-of-severe-eosinophilic-asthma
#5
REVIEW
Mara N Poulakos, Shawna M Cargill, Melissa F Waineo, Allen L Wolford
PURPOSE: Published data on the pharmacology, pharmacokinetics and pharmacodynamics, and clinical efficacy and safety of the interleukin-5 antagonist mepolizumab are reviewed. SUMMARY: Asthma of the eosinophilic phenotype is characterized by persistent eosinophilic airway inflammation promoted primarily by T-helper type 2 cytokines, the key regulator of eosinophils. Patients with severe eosinophilic asthma are burdened by the need to administer high doses of corticosteroids to help manage their symptoms...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28622052/biologic-treatment-eligibility-for-real-world-patients-with-severe-asthma-the-ideal-study
#6
Frank C Albers, Hana Müllerová, Necdet B Gunsoy, Ji-Yeon Shin, Linda M Nelsen, Eric S Bradford, Sarah M Cockle, Robert Y Suruki
OBJECTIVES: Severe asthma comprises several distinct phenotypes. Consequently, patients with severe asthma can be eligible for more than one biologic treatment targeting Th2 inflammation, such as anti-interleukin (IL)-5 and anti-immunoglobulin (Ig) E. The objective of this study was to describe treatment eligibility and overlap in treatment eligibility for mepolizumab (anti-IL-5), omalizumab (anti-IgE) and reslizumab (anti-IL-5) in patients with severe asthma, who were recruited from clinical practice...
June 16, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28610668/evaluation-of-the-psychometric-properties-of-the-st-george-s-respiratory-questionnaire-in-patients-with-severe-asthma
#7
Linda M Nelsen, Margaret Vernon, Hector Ortega, Sarah M Cockle, Steven W Yancey, Guy Brusselle, Frank C Albers, Paul W Jones
PURPOSE: Limited data exist on the quantitative validity of the St George's Respiratory Questionnaire (SGRQ) in asthma populations. This study evaluated the psychometric properties of the SGRQ in patients with severe asthma. METHODS: This was a post-hoc analysis of pooled data from MENSA (N = 576; NCT01691508) and SIRIUS (N = 135; NCT01691521), two randomized, placebo controlled trials of mepolizumab in patients with severe asthma. Patients completed the SGRQ at Baseline and Exit (MENSA Week 32; SIRIUS Week 24)...
July 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28583618/new-anti-eosinophil-drugs-for-asthma-and-copd-targeting-the-trait
#8
REVIEW
Elisabeth H Bel, Anneke Ten Brinke
Asthma and chronic obstructive airways disease (COPD) are prevalent chronic inflammatory airway diseases that are responsible for a large global disease burden. Both diseases are complex and heterogeneous, and are increasingly recognized as overlapping syndromes that may share similar pathophysiologic mechanisms and treatable traits. Eosinophilic airway inflammation is considered the most influential treatable trait of chronic airway disease, and over the last decade several monoclonal antibodies and small molecule therapies have been developed to target this trait...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28546236/therapeutic-effect-of-anti-il-5-on-eosinophilic-myocarditis-with-large-pericardial-effusion
#9
Tengyao Song, David Micheal Jones, Yamen Homsi
Eosinophilic myocarditis (EM) is a rare myocardial disease that results from various eosinophilic diseases, such as idiopathic hypereosinophilic syndrome, helminth infection, medications and vasculitis. Patients with EM may present with different severities, ranging from mild symptoms to a life-threatening condition. Diagnosis of EM is a challenge and requires an extensive workup, including endomyocardial biopsy. Treatment options are limited because EM is rare and there is a lack of randomised controlled trials...
May 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28514601/mepolizumab-or-placebo-for-eosinophilic-granulomatosis-with-polyangiitis
#10
RANDOMIZED CONTROLLED TRIAL
Michael E Wechsler, Praveen Akuthota, David Jayne, Paneez Khoury, Amy Klion, Carol A Langford, Peter A Merkel, Frank Moosig, Ulrich Specks, Maria C Cid, Raashid Luqmani, Judith Brown, Stephen Mallett, Richard Philipson, Steve W Yancey, Jonathan Steinfeld, Peter F Weller, Gerald J Gleich
BACKGROUND: Eosinophilic granulomatosis with polyangiitis is an eosinophilic vasculitis. Mepolizumab, an anti-interleukin-5 monoclonal antibody, reduces blood eosinophil counts and may have value in the treatment of eosinophilic granulomatosis with polyangiitis. METHODS: In this multicenter, double-blind, parallel-group, phase 3 trial, we randomly assigned participants with relapsing or refractory eosinophilic granulomatosis with polyangiitis who had received treatment for at least 4 weeks and were taking a stable prednisolone or prednisone dose to receive 300 mg of mepolizumab or placebo, administered subcutaneously every 4 weeks, plus standard care, for 52 weeks...
May 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28501884/the-effect-of-systemic-treatments-on-periostin-expression-reflects-their-interference-with-the-eosinophilic-inflammation-in-chronic-rhinosinusitis-with-nasal-polyps
#11
E De Schryver, L Derycke, L Calus, G Holtappels, P W Hellings, T Van Zele, C Bachert, P Gevaert
BACKGROUND: Periostin is a recently discovered biomarker for eosinophilic inflammation. Chronic rhinosinusitis with nasal polyps is a T-helper 2-skewed chronic inflammatory airway disease. Medical treatments aim to relieve symptoms and maintain clinical control by interfering with the inflammatory cascade. The effect on nasal and serum periostin levels is however yet unknown. We aimed to evaluate the effect of omalizumab, mepolizumab, methylprednisolone and doxycycline on nasal and systemic periostin expression...
June 1, 2017: Rhinology
https://www.readbyqxmd.com/read/28459601/omalizumab-versus-mepolizumab-as-add-on-therapy-in-asthma-patients-not-well-controlled-on-at-least-an-inhaled-corticosteroid-a-network-meta-analysis
#12
Zahi Nachef, Amita Krishnan, Terry Mashtare, Tingting Zhuang, M Jeffery Mador
OBJECTIVE: The purpose of this study is to examine the comparative efficacy of Omalizumab (OMA) and Mepolizumab (Mepo) in the treatment of severe asthma by performing a network meta-analysis. METHOD: Data Sources: A systematic review of the literature was performed through four databases from their inception to February 2016. STUDY SELECTIONS: Randomized control trials and cohort studies were considered if they addressed the individual efficacy of OMA and Mepo in the treatment of asthma that was not well controlled on inhaled corticosteroids (ICSs) with or without other agents...
May 1, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28406319/benralizumab-as-a-potential-treatment-of-asthma
#13
Sabina Antonela Antoniu
Current anti-inflammatory asthma therapies including inhaled corticosteroids and leukotriene modifiers, are not always able to appropriately control the disease and other approaches are needed. These therapies specific target IgE (omalizumab) or IL-5 (mepolizumab). However, there is research underway investigating interleukin-based monoclonal antibodies such as benralizumab, an anti-IL-5R monoclonal antibody which is currently in phase III clinical development. Areas covered: This review summarizes the existing preclinical and clinical data of benralizumab...
July 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28395936/efficacy-of-mepolizumab-add-on-therapy-on-health-related-quality-of-life-and-markers-of-asthma-control-in-severe-eosinophilic-asthma-musca-a-randomised-double-blind-placebo-controlled-parallel-group-multicentre-phase-3b-trial
#14
Geoffrey L Chupp, Eric S Bradford, Frank C Albers, Daniel J Bratton, Jie Wang-Jairaj, Linda M Nelsen, Jennifer L Trevor, Antoine Magnan, Anneke Ten Brinke
BACKGROUND: Mepolizumab, an anti-interleukin-5 monoclonal antibody approved as add-on therapy to standard of care for patients with severe eosinophilic asthma, has been shown in previous studies to reduce exacerbations and dependency on oral corticosteroids compared with placebo. We aimed to further assess mepolizumab in patients with severe eosinophilic asthma by examining its effect on health-related quality of life (HRQOL). METHODS: We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial (MUSCA) in 146 hospitals or research centres in 19 countries worldwide...
May 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28395935/mepolizumab-quality-of-life-and-severe-eosinophilic-asthma
#15
Ian D Pavord
No abstract text is available yet for this article.
April 5, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28379047/benralizumab-for-the-treatment-of-asthma
#16
Tara Vinyette Saco, Amber N Pepper, Richard F Lockey
The classification of asthma into phenotypes and endotoypes allows for the use of targeted therapies, including three biologics which target interleukin 5 (IL-5) signaling in eosinophilic asthma. Areas covered: As of December 2016, two monoclonal antibodies, mepolizumab and reslizumab, are approved by U.S. Food and Drug Administration and one, benralizumab, is in clinical development. Two phase 3 trials for benralizumab, SIROCCO and CALIMA, were published in September 2016. Although there are no direct comparisons among these three anti-IL-5 therapies, the goal of this review is to summarize the current data and discuss their potential similarities and differences, with a focus on benralizumab...
April 19, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28375933/use-of-biologics-in-severe-food-allergies
#17
Alessandro Fiocchi, Valentina Pecora, Rocco L Valluzzi, Vincenzo Fierro, Maurizio Mennini
PURPOSE OF REVIEW: Severe cases of food allergy account for the majority of the burden in terms of risks, quality of life, and resource expenditure. The traditional approach to these forms has been strict avoidance. More recently, Oral ImmunoTherapy (OIT) has gained a role in their management. However, in severe food allergies OIT is often infeasible. RECENT FINDINGS: Case reports, observational, and prospective studies have recently proposed different approaches to severe food allergy...
June 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28319473/precision-medicine-in-asthma-the-role-of-bronchial-thermoplasty
#18
Amber J Oberle, Praveen Mathur
PURPOSE OF REVIEW: The inflammatory makeup of severe asthma is heterogeneous. Identification of the predominant cellular endotype via biomarkers can aid in the selection of more advanced therapies. This review is clinically focused on how to use these biomarkers to help select between biologic agents and/or bronchial thermoplasty. RECENT FINDINGS: Several Th2 biomarkers exist for the detection of eosinophilic disease; however, the best biomarker for clinical practice is debatable depending upon local resources...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28281440/monoclonal-antibody-therapy-in-sinonasal-disease
#19
Sergio E Chiarella, Hendrik Sy, Anju T Peters
Chronic rhinosinusitis (CRS) affects 12.5% of the U.S. POPULATION: CRS can be divided into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps. Some individuals with CRSwNP do not respond to standard-of-care medical and surgical management. For these individuals, targeted biologic agents are emerging as an important therapeutic alternative. In this review, we described the most-relevant studies that addressed the use of anti-immunoglobulin E (omalizumab), anti-interleukin 5 (mepolizumab and reslizumab), and anti-interleukin 4/interleukin 13 (dupilumab) monoclonal antibodies for the treatment of CRSwNP...
March 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28279664/combination-omalizumab-and-mepolizumab-therapy-for-refractory-allergic-bronchopulmonary-aspergillosis
#20
Matthew C Altman, Jake Lenington, Steve Bronson, Andrew G Ayars
No abstract text is available yet for this article.
March 6, 2017: Journal of Allergy and Clinical Immunology in Practice
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