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Asthma trials

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https://www.readbyqxmd.com/read/29049049/treatable-traits-of-chronic-airways-disease
#1
James Fingleton, Jo Hardy, Richard Beasley
PURPOSE OF REVIEW: To describe the rationale on which the treatable traits approach to the management of airways disease is based and the issues that need to be considered for its implementation in clinical practice. RECENT FINDINGS: In clinical practice, treatable traits can be classified according to both endotypes and phenotypes, broadly grouped within pulmonary, extrapulmonary, environmental and behavioural factors. Specific investigations and treatments are undertaken for each of the traits rather than a 'one size fits all' stepwise approach to pharmacological treatment which currently represents the core of asthma and chronic obstructive pulmonary disease (COPD) guidelines...
October 18, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29042832/evaluation-of-the-efficacy-of-a-onetime-injectable-dexamethasone-administered-orally-in-the-pediatric-emergency-department-for-asthma-exacerbation
#2
Ashley McCallister, Tsz-Yin So, Josh Stewart
OBJECTIVE: This study assessed the efficacy of injectable dexamethasone administered orally in pediatric patients who presented to the emergency department with asthma exacerbation. METHODS: This was a retrospective study of patients 0 to 18 years of age who presented to and who were directly discharged from the emergency department at Moses H. Cone Memorial Hospital between September 1, 2012, and September 30, 2015, for the diagnosis of asthma or asthma exacerbation...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29038166/why-and-how-to-step-down-chronic-asthma-drugs
#3
REVIEW
Michael R Gionfriddo, John B Hagan, Matthew A Rank
Asthma is a common chronic airways disease. The goal of asthma management is to control symptoms while minimizing the side effects of treatment. Following a period of stable asthma, clinicians should consider stepping down treatment. This approach is recommended by current guidelines. Step-down has been studied for several types of asthma drug regimens, and certain approaches may have lower risk than others. Systematic reviews of multiple trials support the following specific step-down approaches: optimizing inhaled corticosteroid dosing when stepping down oral corticosteroid, reducing inhaled corticosteroid from a higher dose, lowering inhaled corticosteroid-long acting bronchodilator (ICS-LABA) dose while adding ICS-LABA on-demand, adding leukotriene receptor antagonist (LTRA) while lowering inhaled corticosteroid dose, and using allergen immunotherapy when reducing inhaled corticosteroid from a higher dose...
October 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29038045/effects-of-procalcitonin-guided-treatment-on-antibiotic-use-and-need-for-mechanical-ventilation-in-patients-with-acute-asthma-exacerbation-meta-analysis-of-randomized-controlled-trials
#4
Wanis H Ibrahim, Kamran Mushtaq, Tasleem Raza, Anand Kartha, Ahmed O Saleh, Rayaz A Malik
OBJECTIVE: The primary outcome was to determine whether serum procalcitonin-guided antibiotic therapy can reduce antibiotic exposure in patients with an acute exacerbation of asthma presenting to the primary care facility, emergency department or during hospital admission. The secondary outcome was the need for mechanical ventilation. METHODS: In this meta-analysis, we performed extensive literature search for randomized controlled clinical trials (published in English) that compared serum procalcitonin-guided antibiotic therapy versus antibiotic use according to physician's discretion for adult participants with mild, moderate or severe acute asthma exacerbations...
October 13, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29036020/novel-methods-for-device-and-adherence-monitoring-in-asthma
#5
Matteo Bonini, Omar S Usmani
PURPOSE OF REVIEW: The article aims to provide an updated and evidence-based review of the innovative electronic health interventions to monitor and improve inhaler technique and adherence to recommended therapy in asthma. RECENT FINDINGS: Out of the 290 articles identified by the search strategy, 23 manuscripts fulfilled the review inclusion criteria. Included studies mainly addressed m-health, electronic reminders, telemedicine, and inhaler tracker interventions...
October 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29036019/targeting-the-interleukin-4-and-interleukin-13-pathways-in-severe-asthma-current-knowledge-and-future-needs
#6
Amit D Parulekar, Christina C Kao, Zuzana Diamant, Nicola A Hanania
PURPOSE OF REVIEW: Severe asthma is a heterogeneous disease that can be classified into phenotypes and endotypes based upon clinical or biological characteristics. Interleukin (IL)-4 and IL-13 play a key role in type 2 (T2) asthma. This article reviews the signaling pathway of IL-4 and IL-13 and highlights its targeted therapy in severe asthma. RECENT FINDINGS: Several clinical trials of biologics targeting the IL-4/IL-13 pathway have recently been completed. In patients with severe, uncontrolled asthma, targeting IL-13 alone with biologics including lebrikizumab and tralokinumab has not shown consistent reduction in asthma exacerbations...
October 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29036017/patient-reported-outcomes-in-asthma-clinical-trials
#7
Fulvio Braido, Ilaria Baiardini, Giorgio W Canonica
PURPOSE OF REVIEW: The review provides an overview of the results of asthma clinical trials published in peer review journals in the last 18 months that evaluated patient-reported outcomes (PROs). RECENT FINDINGS: In the last 10 years, health care moved toward a patient-centered approach, which includes patients' perspectives reflecting the impact of a disease and its treatment. SUMMARY: Surprisingly, among the almost 300 clinical trials published in the last one and a half year, PRO evaluation was performed in only 20 studies, and none of them held in a real-life setting...
October 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29035619/personalized-medicine-with-biologics-for-severe-type-2-asthma-current-status-and-future-prospects
#8
Marie Godar, Christophe Blanchetot, Hans de Haard, Bart N Lambrecht, Guy Brusselle
Asthma affects more than 300 million people worldwide and poses a large socioeconomic burden, particularly in the 5% to 10% of severe asthmatics. So far, each entry of new biologics in clinical trials has led to high expectations for treating all severe asthma forms, but the outcome has only been successful if the biologic, as add-on treatment, targeted specific patient subgroups. Indeed, we now realize that asthma is a heterogeneous disease with multiple phenotypes, based on distinct pathophysiological mechanisms, called endotypes...
October 16, 2017: MAbs
https://www.readbyqxmd.com/read/29035013/prebiotics-for-the-prevention-of-allergies-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Carlos Cuello-Garcia, Alessandro Fiocchi, Ruby Pawankar, Juan José Yepes-Nuñez, Gian Paolo Morgano, Yuan Zhang, Arnav Agarwal, Shreyas Gandhi, Luigi Terracciano, Holger J Schünemann, Jan L Brozek
BACKGROUND: Prevalence of allergic diseases in infants is approximately 10% reaching 20 to 30% in those with an allergic first-degree relative. Prebiotics are selectively fermented food ingredients that allow specific changes in composition/activity of the gastrointestinal microflora. They modulate immune responses and their supplementation has been proposed as an intervention to prevent allergies. OBJECTIVE: To assess in pregnant women, breastfeeding mothers, and infants (populations) the effect of supplementing prebiotics (intervention) versus no prebiotics (comparison) on the development of allergic diseases and to inform the World Allergy Organization guidelines...
October 16, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29034234/interleukin-13-in-asthma-and-other-eosinophilic-disorders
#10
Emma Doran, Fang Cai, Cécile T J Holweg, Kit Wong, Jochen Brumm, Joseph R Arron
Asthma is characterized by episodic, reversible airflow obstruction associated with variable levels of inflammation. Over the past several decades, there has been an increasing appreciation that the clinical presentation of asthma comprises a diverse set of underlying pathologies. Rather than being viewed as a single disease entity, asthma is now thought of as a clinical syndrome with the involvement of multiple pathological mechanisms. While it is appreciated that eosinophilia is present in only a subset of patients, it remains a key feature of asthma and other eosinophilic disorders such as atopic dermatitis, eosinophilic esophagitis, and chronic rhinosinusitis with nasal polyps...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29033625/the-salford-lung-study-a-pioneering-comparative-effectiveness-approach-to-copd-and-asthma-in-clinical-trials
#11
REVIEW
Timothy E Albertson, Susan Murin, Mark E Sutter, James A Chenoweth
The Salford Lung Study (SLS) of patients with asthma and chronic obstructive pulmonary disease (COPD) is a practical, community-based, randomized, open-label pragmatic study on the efficacy and safety of the once-daily dry powder inhaler that combines the inhaled corticosteroid fluticasone furoate (FF) with the long-acting beta2 agonist vilanterol (VI). The asthma component of the SLS is not yet reported but the COPD component, done over a 12-month period, found a statistically significant 8.4% reduction in COPD exacerbations when compared to usual care...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29032888/calcium-channel-blockers-for-lung-function-improvement-in-asthma-a-systematic-review-and-meta-analysis
#12
Kam Yu Chiu, Jian Guo Li, Ying Lin
BACKGROUND: For decades, calcium channel blockers (CCBs) have been believed to play a role in asthma treatment. However, the clinical efficacy of CCBs for lung function improvement in patients with asthma has not been qualitatively evaluated. OBJECTIVE: To assess the effect of CCBs vs placebo on lung function test results in adults with asthma. METHODS: Various databases were systematically searched to identify all randomized clinical trials with adults with asthma...
October 9, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29027824/a-computable-phenotype-for-asthma-case-identification-in-adult-and-pediatric-patients-external-validation-in-the-chicago-area-patient-outcomes-research-network-capricorn
#13
Majid Afshar, Valerie G Press, Rachel G Robison, Abel N Kho, Sindhura Bandi, Ashvini Biswas, Pedro C Avila, Harsha Vardhan Madan Kumar, Byung Yu, Edward T Naureckas, Sharmilee M Nyenhuis, Christopher D Codispoti
OBJECTIVE: Comprehensive, rapid, and accurate identification of patients with asthma for clinical care and engagement in research efforts is needed. The original development and validation of a computable phenotype for asthma case identification occurred at a single institution in Chicago and demonstrated excellent test characteristics. However, its application in a diverse payer mix, across different health systems and multiple electronic health record vendors, and in both children and adults was not examined...
October 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29023938/a-pharmacist-led-program-to-evaluate-and-reduce-polypharmacy-and-potentially-inappropriate-prescribing-in-older-hiv-positive-patients
#14
I R McNicholl, M Gandhi, C Bradley Hare, M Greene, E Pierluissi
OBJECTIVE: The goal of this pharmacist-led study was to utilize 2 validated instruments, Beers and Screening Tool of Older Persons' Potentially inappropriate Prescriptions (STOPP), to assess potentially inappropriate prescribing (PIP) in older patients infected with the human immunodeficiency virus (HIV) and evaluate pharmacist interventions. DESIGN: Prospective, randomized, interventional trial. SETTING: Large urban clinic providing interdisciplinary primary and HIV care for approximately 2700 HIV-positive, publically insured patients...
October 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28992739/pharmacogenetic-and-pharmacogenomic-considerations-of-asthma-treatment
#15
Maria Gabriella Matera, Barbara Rinaldi, Luigino Calzetta, Mario Cazzola
Pharmacogenetic and pharmacogenomic approaches are already utilized in some areas, such as oncology and cardiovascular disease, for selecting appropriate patients and/or establishing treatment and dosing guidelines. This is not true in asthma although many patients have different responses to drug treatment due to genetic factors. Areas covered: Several genetic factors that affect the pharmacotherapeutic responses to asthma medications, such as β2-AR agonists, corticosteroids, and leukotriene modifiers and could contribute to significant between-person variability in response are described...
October 10, 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28986245/applying-interactive-mobile-health-to-asthma-care-in-teens-aim2act-development-and-design-of-a-randomized-controlled-trial
#16
David A Fedele, Andrew McConville, J Graham Thomas, Elizabeth L McQuaid, David M Janicke, Elise M Turner, Jon Moon, Mutasim Abu-Hasan
Early adolescents have difficulties performing asthma self-management behaviors, placing them at-risk for poor asthma control and reduced quality of life. This paper describes the development and plans for testing an interactive mobile health (mHealth) tool for early adolescents, ages 12-15years, and their caregivers to help improve asthma management. Applying Interactive Mobile health to Asthma Care in Teens (AIM2ACT) is informed by the Pediatric Self-management model, which posits that helpful caregiver support is facilitated by elucidating disease management behaviors and allocating treatment responsibility in the family system, and subsequently engaging in collaborative caregiver-adolescent asthma management...
October 3, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28986128/vitamin-d-supplementation-to-prevent-asthma-exacerbations-a-systematic-review-and-meta-analysis-of-individual-participant-data
#17
David A Jolliffe, Lauren Greenberg, Richard L Hooper, Christopher J Griffiths, Carlos A Camargo, Conor P Kerley, Megan E Jensen, David Mauger, Iwona Stelmach, Mitsuyoshi Urashima, Adrian R Martineau
BACKGROUND: A previous aggregate data meta-analysis of randomised controlled trials showed that vitamin D supplementation reduces the rate of asthma exacerbations requiring treatment with systemic corticosteroids. Whether this effect is restricted to patients with low baseline vitamin D status is unknown. METHODS: For this systematic review and one-step and two-step meta-analysis of individual participant data, we searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for double-blind, placebo-controlled, randomised controlled trials of vitamin D3 or vitamin D2 supplementation in people with asthma that reported incidence of asthma exacerbation, published between database inception and Oct 26, 2016...
October 3, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28983485/anti-ige-treatment-for-disorders-other-than-asthma
#18
REVIEW
Jeffrey Stokes
Immunoglobulin E (IgE) plays a key role in the pathogenesis of many allergic diseases. Thus, IgE-mediated immunologic pathways are an attractive target for intervention in allergic diseases. Omalizumab is a recombinant humanized monoclonal antibody that binds IgE and has been used treat allergic asthma for over a decade. Currently, omalizumab is approved for the treatment of both allergic asthma and chronic spontaneous urticaria. Since IgE plays a critical role in other allergic diseases, anti-IgE therapy has been evaluated in other allergic diseases in small clinical trials and case reports...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28983084/patients-experiences-of-breathing-retraining-for-asthma-a-qualitative-process-analysis-of-participants-in-the-intervention-arms-of-the-breathe-trial
#19
Emily Arden-Close, Lucy Yardley, Sarah Kirby, Mike Thomas, Anne Bruton
Poor symptom control and impaired quality of life are common in adults with asthma, and breathing retraining exercises may be an effective method of self-management. This study aimed to explore the experiences of participants in the intervention arms of the BREATHE trial, which investigated the effectiveness of breathing retraining as a mode of asthma management. Sixteen people with asthma (11 women, 8 per group) who had taken part in the intervention arms of the BREATHE trial (breathing retraining delivered by digital versatile disc (DVD) or face-to-face sessions with a respiratory physiotherapist) took part in semi-structured telephone interviews about their experiences...
October 5, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28982775/a-virtual-asthma-clinic-for-children-fewer-routine-outpatient-visits-same-asthma-control
#20
Lara S van den Wijngaart, Jolt Roukema, Annemie L M Boehmer, Marianne L Brouwer, Cindy A C Hugen, Laetitia E M Niers, Arwen J Sprij, Eleonora R V M Rikkers-Mutsaerts, Bart L Rottier, A Rogier T Donders, Chris M Verhaak, Mariëlle W Pijnenburg, Peter J F M Merkus
eHealth is an appealing medium to improve healthcare and its value (in addition to standard care) has been assessed in previous studies. We aimed to assess whether an eHealth intervention could improve asthma control while reducing 50% of routine outpatient visits.In a multicentre, randomised controlled trial with a 16-month follow-up, asthmatic children (6-16 years) treated in eight Dutch hospitals were randomised to usual care (4-monthly outpatient visits) and online care using a virtual asthma clinic (VAC) (8-monthly outpatient visits with monthly web-based monitoring)...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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