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https://www.readbyqxmd.com/read/28933002/mepolizumab-for-treating-severe-eosinophilic-asthma-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#1
REVIEW
Iñigo Bermejo, Matt Stevenson, Katy Cooper, Sue Harnan, Jean Hamilton, Mark Clowes, Christopher Carroll, Tim Harrison, Shironjit Saha
As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the company (GlaxoSmithKline) that manufactures mepolizumab (Nucala(®)) to submit evidence on the clinical and cost effectiveness of mepolizumab for the treatment of severe eosinophilic asthma. The School of Health and Related Research Technology Appraisal Group (ScHARR-TAG) at the University of Sheffield was commissioned to act as the independent evidence review group (ERG). The ERG produced a review of the evidence for the clinical and cost effectiveness of mepolizumab as add-on to standard of care (SoC) compared with SoC and omalizumab, based upon the company's submission to NICE...
September 20, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28903951/managing-problematic-severe-asthma-beyond-the-guidelines
#2
REVIEW
Katharine C Pike, Mark L Levy, John Moreiras, Louise Fleming
This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management...
September 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28903864/effectiveness-of-fluticasone-furoate-plus-vilanterol-on-asthma-control-in-clinical-practice-an-open-label-parallel-group-randomised-controlled-trial
#3
Ashley Woodcock, Jørgen Vestbo, Nawar Diar Bakerly, John New, J Martin Gibson, Sheila McCorkindale, Rupert Jones, Susan Collier, James Lay-Flurrie, Lucy Frith, Loretta Jacques, Joanne L Fletcher, Catherine Harvey, Henrik Svedsater, David Leather
BACKGROUND: Evidence for management of asthma comes from closely monitored efficacy trials done in highly selected patient groups. There is a need for randomised trials that are closer to usual clinical practice. METHODS: We did an open-label, randomised, controlled, two-arm effectiveness trial at 74 general practice clinics in Salford and South Manchester, UK. Patients aged 18 years or older with a general practitioner's diagnosis of symptomatic asthma and on maintenance inhaler therapy were randomly assigned to initiate treatment with a once-daily inhaled combination of either 100 μg or 200 μg fluticasone furoate with 25 μg vilanterol or optimised usual care and followed up for 12 months...
September 8, 2017: Lancet
https://www.readbyqxmd.com/read/28888614/curricular-intervention-increases-adolescents-knowledge-about-asthma-a-randomized-trial
#4
Ana Carla C Coelho, Carolina de Souza-Machado, Thiara S de Oliveira, Tássia Natalie N Dos Santos, Álvaro A Cruz, Adelmir Souza-Machado
OBJECTIVES: To evaluate the impact of a curricular intervention concerning the knowledge about asthma among adolescents from a public school. METHODS: This was a randomized, controlled trial study on a curricular intervention in asthma, carried out with asthmatic and non-asthmatic adolescents. The study participants were divided into a curricular intervention group for asthma (IG), and a control group with traditional curriculum (CG). Topics related to asthma were included in the curriculum, such as the disease concept, triggering factors, treatment, symptoms, action plan, and beliefs in popular myths about the disease...
September 6, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28860739/the-comparative-effectiveness-of-initiating-fluticasone-salmeterol-combination-therapy-via-pmdi-versus-dpi-in-reducing-exacerbations-and-treatment-escalation-in-copd-a-uk-database-study
#5
Rupert Jones, Jessica Martin, Vicky Thomas, Derek Skinner, Jonathan Marshall, Martina Stagno d'Alcontres, David Price
Chronic obstructive pulmonary disease (COPD), a complex progressive disease, is currently the third leading cause of death worldwide. One recommended treatment option is fixed-dose combination therapy of an inhaled corticosteroid (ICS)/long-acting β-agonist. Clinical trials suggest pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) show similar efficacy and safety profiles in COPD. Real-world observational studies have shown that combination therapy has significantly greater odds of achieving asthma control when delivered via pMDIs...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28831387/tissue-remodeling-in-chronic-eosinophilic-esophageal-inflammation-parallels-in-asthma-and-therapeutic-perspectives
#6
REVIEW
Quan M Nhu, Seema S Aceves
Chronic eosinophilic inflammation is associated with tissue remodeling and fibrosis in a number of chronic T-helper 2 (Th2)-mediated diseases including eosinophilic esophagitis (EoE) and asthma. Chronic inflammation results in dysregulated tissue healing, leading to fibrosis and end organ dysfunction, manifesting clinically as irreversible airway obstruction in asthma and as esophageal rigidity, strictures, narrowing, dysmotility, dysphagia, and food impactions in EoE. Current therapies for EoE and asthma center on reducing inflammation-driven tissue remodeling and fibrosis with corticosteroids, coupled with symptomatic control and allergen avoidance...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28811222/antitussive-antispasmodic-bronchodilating-and-cardiac-inotropic-effects-of-the-essential-oil-from-blepharocalyx-salicifolius-leaves
#7
Jehison Jiménez Hernández, María Inés Ragone, Patricia Bonazzola, Arnaldo L Bandoni, Alicia E Consolini
ETHNOPHARMACOLOGY RELEVANCE: Blepharocalyx salicifolius (Kunth) O. Berg (Myrtaceae) is a tree native to Argentina and Uruguay that grows and is cultivated along the riverside of the Rio de la Plata. The leaves of this plant species, locally known as "anacahuita" are used in South America to prepare infusions for the empiric treatment of cough and bronchospasm, as well as diarrhoea and other intestinal disorders. Although previous phytochemical studies have been performed with the essential oil extracted from Blepharocalyx salicifolius, pharmacological evidence supporting its traditional use is still lacking...
August 12, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28801654/perceptions-of-asthma-control-in-the-united-kingdom-a-cross-sectional-study-comparing-patient-and-healthcare-professionals-perceptions-of-asthma-control-with-validated-act-scores
#8
Andrew Menzies-Gow, Gavin Chiu
Perceptions of asthma control often vary between patients and physicians. This cross-sectional survey provided UK-specific data on actual and perceived asthma control in patients (18-75 years) attending routine asthma reviews in primary, secondary and tertiary settings. Differences between healthcare professionals' (HCP) and patients' perceptions of asthma control were evaluated via an online questionnaire and compared to a control-the validated asthma control test (ACT)-which patients completed. Treated patients (at least a short acting ß-agonist) with a documented diagnosis of asthma were enroled and consented within a month of their last appointment...
August 11, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28800273/assessing-the-impact-of-a-remote-digital-coaching-engagement-program-on-patient-reported-outcomes-in-asthma
#9
Mazi Rasulnia, Billy Stephen Burton, Robert P Ginter, Tracy Y Wang, Roy Alton Pleasants, Cynthia L Green, Njira Lugogo
BACKGROUND: Low adherence and poor outcomes provide opportunity for digital coaching to engage patients with uncontrolled asthma in their care to improve outcomes. OBJECTIVES: To examine the impact of a remote digital coaching program on asthma control and patient experience. METHODS: We recruited 51 adults with uncontrolled asthma, denoted by albuterol use of > 2 times per week and/or exacerbations requiring corticosteroids, and applied a 12-week patient-centered remote digital coaching program using a combination of educational pamphlets, symptom trackers, best peak flow establishment, physical activity, and dietary counseling, as well as coaches who implemented emotional enforcement  to motivate disease self-management through telephone, text, and email...
August 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28797611/video-instruction-is-more-effective-than-written-instruction-in-improving-inhaler-technique
#10
Romil F Shah, Rakesh M Gupta
INTRODUCTION: Many patients with asthma use inhalers incorrectly. Better inhaler technique is associated with better asthma control. We tested the effectiveness of a computer-based video training solution versus traditional written instructions, both which may be used in a resource-limited setting, for teaching inhaler technique. We hypothesized that computer based training will provide a higher quality of instruction which will improve technique more effectively than written training...
August 7, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28794645/asthma-referrals-a-key-component-of-asthma-management-that-needs-to-be-addressed
#11
REVIEW
David Price, Leif Bjermer, David A Bergin, Rafael Martinez
Heterogeneity of asthma and difficulty in achieving optimal control are the major challenges in the management of asthma. To help attain the best possible clinical outcomes in patients with asthma, several guidelines provide recommendations for patients who will require a referral to a specialist. Such referrals can help in clearing the uncertainty from the initial diagnosis, provide tailored treatment options to patients with persistent symptoms and offer the patients access to health care providers with expertise in the management of the asthma; thus, specialist referrals have a substantial impact on disease prognosis and the patient's health status...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28783413/fluticasone-furoate-vilanterol-once-daily-improves-night-time-awakenings-in-asthma-patients-with-night-symptoms-post-hoc-analyses-of-three-randomized-controlled-trials
#12
Edward Kerwin, Neil Barnes, Michael Gibbs, David Leather, Richard Forth, Loretta Jacques, Louisa J Yates
Symptoms, including night-time awakenings, affect the quality of life of people with asthma. Fluticasone furoate/vilanterol (FF/VI) reduces exacerbations, improves lung function, and rescue-free and symptom-free 24-hour periods in patients with asthma. These post-hoc analyses compared daytime and night-time symptoms in patients with asthma who received FF/VI, versus FF, fluticasone propionate (FP) or placebo. Daytime and night-time symptoms were collected via electronic daily diary cards in three Phase III randomized studies of once-daily FF/VI in patients with uncontrolled asthma on inhaled corticosteroids (ICS) ±long-acting beta2-agonists (LABA) (n = 609/1039/586)...
August 7, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28764257/a-randomized-comparison-between-video-demonstration-and-verbal-instruction-in-improving-rota-haler-technique-in-children-with-persistent-asthma-a-pilot-study
#13
Archana Arumugom, Venkatesh Chandrasekaran
INTRODUCTION: Inhalation therapy is the cornerstone in management of asthma. Failure to use the device properly is one of the factors incriminated in poor control of asthma. AIM: To compare the technique of rota haler use in children with persistent asthma immediately after receiving either verbal instruction or a video based demonstration and again at one month following intervention. MATERIALS AND METHODS: A total of 28 children, older than six years attending the childhood asthma clinic of our hospital, who were prescribed rota halers for the first time and who were technique naïve were enrolled into the study, after obtaining informed consent from the parents after meeting inclusion and exclusion criteria...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28762366/prevalence-and-factors-associated-with-exercise-induced-bronchospasm-among-rural-school-children-in-ilesa-nigeria
#14
Bankole Peter Kuti, Demilade Kehinde Kuti, Kehinde Oluyori Omole, Lasisi Oluwafemi Mohammed, Busayo Gideon Ologun, Bolanle Idowu Oso
BACKGROUND: Exercise-induced bronchospasm (EIB) assessed using changes in peak expiratory flow rates (PEFRs) to free range exercise is a relatively cheap way of screening for asthma in resource-poor centres where children with asthma are often undiagnosed and poorly managed. This study sets out to determine the prevalence and factors associated with EIB among rural schoolchildren in Ilesa, Nigeria. SUBJECTS AND METHODS: Children aged 8-16 years from two middle schools in rural Ilesa were selected by multistage sampling...
April 2017: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28753498/the-impact-of-epilepsy-on-academic-achievement-in-children-with-normal-intelligence-and-without-major-comorbidities-a-systematic-review
#15
REVIEW
S W Wo, L C Ong, W Y Low, P S M Lai
PURPOSE: To systematically examine published literature which assessed the prevalence of academic difficulties in children with epilepsy (CWE) of normal intelligence, and its associating factors. METHODS: A search was conducted on five databases for articles published in English from 1980 till March 2015. Included were studies who recruited children (aged 5-18 years), with a diagnosis or newly/recurrent epilepsy, an intelligent quotient (IQ) of ≥70 or attending regular school, with or without a control group, which measured academic achievement using a standardised objective measure, and published in English...
July 20, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28749014/use-of-the-control-of-allergic-rhinitis-and-asthma-test-and-pulmonary-function-tests-to-assess-asthma-control-in-pregnancy
#16
Luís Amaral, Carla Martins, Alice Coimbra
INTRODUCTION: Asthma is one of the most prevalent chronic medical conditions to complicate pregnancy. Similarly, active management strategies that prioritise asthma control in this vulnerable population can have a far-reaching impact. AIM: To describe lung function parameters and results of the Control of Allergic Rhinitis and Asthma Test (CARAT) questionnaire in pregnant asthmatics and to analyse correlations between lung function tests and CARAT results. METHODS: All pregnant asthmatics who performed spirometry and CARAT between September 2014 and August 2015 were included...
July 27, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28725641/mechanisms-mediating-pediatric-severe-asthma-and-potential-novel-therapies
#17
REVIEW
Aldara Martin Alonso, Sejal Saglani
Although a rare disease, severe therapy-resistant asthma in children is a cause of significant morbidity and results in utilization of approximately 50% of health-care resources for asthma. Improving control for children with severe asthma is, therefore, an urgent unmet clinical need. As a group, children with severe asthma have severe and multiple allergies, steroid resistant airway eosinophilia, and significant structural changes of the airway wall (airway remodeling). Omalizumab is currently the only add-on therapy that is licensed for use in children with severe asthma...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28704107/asthma-medication-use-among-adults-with-current-asthma-by-work-related-asthma-status-asthma-call-back-survey-29-states-2012-2013
#18
Katelynn E Dodd, Jacek M Mazurek
OBJECTIVE: Asthma severity is defined as the intensity of treatment required to achieve good control of asthma symptoms. Studies have shown that work-related asthma (WRA) can be associated with poorer asthma control and more severe symptoms than non-WRA. Associations between asthma medications and WRA status were assessed using data from the 2012-2013 Asthma Call-back Survey among ever-employed adults (≥18 years) with current asthma from 29 states. METHODS: Persons with WRA had been told by a physician that their asthma was work-related...
July 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28678392/adding-azathioprine-to-remission-induction-glucocorticoids-for-eosinophilic-granulomatosis-with-polyangiitis-microscopic-polyangiitis-or-polyarteritis-nodosa-without-poor-prognosis-factors-a-randomized-controlled-trial
#19
Xavier Puéchal, Christian Pagnoux, Gabriel Baron, Thomas Quémeneur, Antoine Néel, Christian Agard, François Lifermann, Eric Liozon, Marc Ruivard, Pascal Godmer, Nicolas Limal, Arsène Mékinian, Thomas Papo, Anne-Marie Ruppert, Anne Bourgarit, Boris Bienvenu, Loïck Geffray, Jean-Luc Saraux, Elisabeth Diot, Bruno Crestani, Xavier Delbrel, Laurent Sailler, Pascal Cohen, Véronique Le Guern, Benjamin Terrier, Matthieu Groh, Claire Le Jeunne, Luc Mouthon, Philippe Ravaud, Loïc Guillevin
OBJECTIVE: Most patients with nonsevere systemic necrotizing vasculitides (SNVs) achieve remission with glucocorticoids alone but one-third relapse within 2 years. This study aimed to determine whether azathioprine adjunction to glucocorticoids could achieve a higher sustained remission rate of newly diagnosed nonsevere eosinophilic granulomatosis with polyangiitis (EGPA), microscopic polyangiitis (MPA) or polyarteritis nodosa (PAN). METHODS: All patients included in this double-blind trial received glucocorticoids, gradually tapered over 12 months, and were randomized to receive azathioprine or placebo for 12 months, with stratification according to SNV (EGPA or MPA/PAN)...
July 5, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28670249/the-effect-of-the-training-program-on-the-quality-of-life-in-patients-with-asthma-based-on-the-precede-model-in-ahvaz-iran
#20
Mina Motaghi Nejad, Ghodratollah Shakeri Nejad, Heshmatollah Tavakol, Maria Cheraghi
AIM: The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. MATERIAL AND METHODS: It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires...
June 2017: Postȩpy Dermatologii i Alergologii
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