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achieving asthma control

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https://www.readbyqxmd.com/read/28725641/mechanisms-mediating-pediatric-severe-asthma-and-potential-novel-therapies
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28646883/ioeasma-an-integrated-clinical-and-educational-pathway-for-managing-asthma-in-children-and-adolescents
#5
Sebastiano Guarnaccia, Gaia Pecorelli, Marina Bianchi, Massimo Cartabia, Gianluigi Casadei, Ada Pluda, Cristina Quecchia, Valeria Gretter, Maurizio Bonati
BACKGROUND: Due to the lack of real life clinical and educational studies, "Io e l'Asma" Centre performed this implementation research (IR). Evaluate long-term effectiveness on bronchial asthma control of an integrated clinical and educational pathway for asthmatic children and adolescents. METHODS: An observational retrospective pre-post intervention IR study was conducted among 262 children with asthma, ages 6-15 yrs. The intervention protocol included three clinical visits 8 weeks apart; an educational course at visit 1, post intervention consisted in two follow-up visits 6 months apart...
June 24, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28609567/safety-tolerability-pharmacokinetics-and-pharmacodynamics-of-the-novel-crth2-antagonist-bi-1021958-at-single-oral-doses-in-healthy-men-and-multiple-oral-doses-in-men-and-women-with-well-controlled-asthma
#6
Andy Fowler, Rüdiger Koenen, James Hilbert, Jon Blatchford, Dominik Kappeler, Ewald Benediktus, Chester Wood, Abhya Gupta
BI 1021958, a novel antagonist of the chemoattractant-receptor-homologous molecule (CRTH2), targets airway inflammation in asthma by inhibiting prostaglandin binding to CRTH2 receptors. Two phase 1 studies assessed BI 1021958 safety/tolerability and pharmacokinetics (PK)/pharmacodynamics (PD) following single doses in healthy men and multiple doses in men/women with well-controlled asthma. Studies 1 had 2 parts: a placebo-controlled, fixed-sequence, single-blind, single-rising-dose part (n = 56) and a randomized, 2-way crossover, open-label, repeated-dose part studying the food effect on PK/PD (n = 12)...
June 13, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28594249/a-pilot-randomized-trial-of-school-based-administration-of-inhaled-corticosteroids-for-at-risk-children-with-asthma
#7
Cherise B Harrington, Eric Langhans, Deborah Q Shelef, Molly Savitz, Colleen Whitmore, Stephen J Teach
OBJECTIVE: To investigate whether high adherence to inhaled corticosteroids (ICS) among disadvantaged urban public school children on public insurance with persistent asthma is achievable by having school nurses administer morning doses on each day that school is in session. DESIGN/METHODS: This was a pilot prospective randomized clinical trial of home versus school nurse-administered ICS among children on Medicaid enrolled in grades K-8. The primary outcome was the proportion of expected morning doses of ICS given to the intervention group in school over the 60-day treatment period...
June 8, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28543086/allergen-immunotherapy-for-allergic-asthma-a-systematic-review-and-meta-analysis
#8
REVIEW
Sangeeta Dhami, Artemisia Kakourou, Felix Asamoah, Ioana Agache, Susanne Lau, Jutel Marek, Antonella Muraro, Graham Roberts, Cezmi A Akdis, Matteo Bonini, Ozlem Cavkaytar, Breda Flood, Pawel Gajdanowicz, Kenji Izuhara, Ömer Kalayci, Ralph Mosges, Oscar Palomares, Oliver Pfaar, Sylwia Smolinska, Milena Sokolowska, Miqdad Asaria, Gopal Netuveli, Hader Zaman, Ather Akhlaq, Aziz Sheikh
BACKGROUND: To inform the development of the European Academy of Allergy and Clinical Immunonology's (EAACI) Guidelines on Allergen Immunotherapy (AIT) for allergic asthma, we assessed the evidence on the effectiveness, cost-effectiveness and safety of AIT. METHODS: We performed a systematic review, which involved searching nine databases. Studies were screened against pre-defined eligibility criteria and critically appraised using established instruments. Data were synthesized using random-effects meta-analyses...
May 19, 2017: Allergy
https://www.readbyqxmd.com/read/28533690/accreditation-of-specialized-asthma-units-for-adults-in-spain-an-applicable-experience-for-the-management-of-difficult-to-control-asthma
#9
Carolina Cisneros, Rocío Magdalena Díaz-Campos, Núria Marina, Carlos Melero, Alicia Padilla, Silvia Pascual, Celia Pinedo, Andrea Trisán
This paper, developed by consensus of staff physicians of accredited asthma units for the management of severe asthma, presents information on the process and requirements for already-existing asthma units to achieve official accreditation by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Three levels of specialized asthma care have been established based on available resources, which include specialized units for highly complex asthma, specialized asthma units, and basic asthma units. Regardless of the level of accreditation obtained, the distinction of "excellence" could be granted when more requirements in the areas of provision of care, technical and human resources, training in asthma, and teaching and research activities were met at each level...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28503097/asthma-management-among-allergists-in-italy-results-from-a-survey
#10
M S Magnoni, M Caminati, G W Canonica, F Arpinelli, A Rizzi, G Senna
BACKGROUND: In Europe more than 50% of asthmatic treated patients have not well-controlled asthma. Asthma affects about 2.5 million of patients in Italy. AIMS AND OBJECTIVES: The present survey aims at investigating how Italian allergists approach asthmatic patients, in order to highlight pitfalls and unmet needs concerning real-life asthma management. METHODS: An anonymous 16 item web questionnaire was available (April-October 2015) to all allergists who visited the web site of SIAAIC (Società Italiana di Allergologia, Asma Immunologia Clinica)...
2017: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/28502418/a-multicenter-cross-sectional-observational-study-of-budesonide-formoterol-maintenance-and-reliever-therapy-in-real-world-settings
#11
Jiangtao Lin, Jing Li, Wencheng Yu, Yuejian Liu, Chuntao Liu, Ping Chen, Huijie He, Bei He, Shuang Liu, Xiangdong Zhou
BACKGROUND: To assess the level of asthma control achieved with budesonide/formoterol in Chinese patients with asthma, based on the Global Initiative for Asthma (GINA) definition and Asthma Control Test (ACT) score. METHODS: This multicenter, cross-sectional study (NCT01785901) evaluated asthma control levels in Chinese patients receiving physician-prescribed budesonide/formoterol treatment. Adults with a diagnosis of asthma ≥6 months and receiving budesonide/formoterol treatment ≥3 months before screening were consecutively enrolled...
June 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28499773/stability-of-asthma-symptom-control-in-a-longitudinal-study-of-mild-moderate-asthmatics
#12
Kate M Johnson, J Mark FitzGerald, Hamid Tavakoli, Wenjia Chen, Mohsen Sadatsafavi
BACKGROUND: Achieving and maintaining symptom control is a primary goal of asthma management. Although factors associated with the likelihood of achieving symptom control have been studied, there are unanswered questions on the stability of symptom control, that is, the tendency of individuals to remain at a given symptom control level over time. OBJECTIVE: The objective of this study was to evaluate the stability of symptom control using a longitudinal cohort of mild-moderate asthmatics...
May 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28478972/long-term-management-of-moderate-to-severe-atopic-dermatitis-with-dupilumab-and-concomitant-topical-corticosteroids-liberty-ad-chronos-a-1-year-randomised-double-blinded-placebo-controlled-phase-3-trial
#13
Andrew Blauvelt, Marjolein de Bruin-Weller, Melinda Gooderham, Jennifer C Cather, Jamie Weisman, David Pariser, Eric L Simpson, Kim A Papp, H Chih-Ho Hong, Diana Rubel, Peter Foley, Errol Prens, Christopher E M Griffiths, Takafumi Etoh, Pedro Herranz Pinto, Ramon M Pujol, Jacek C Szepietowski, Karel Ettler, Lajos Kemény, Xiaoping Zhu, Bolanle Akinlade, Thomas Hultsch, Vera Mastey, Abhijit Gadkari, Laurent Eckert, Nikhil Amin, Neil M H Graham, Gianluca Pirozzi, Neil Stahl, George D Yancopoulos, Brad Shumel
BACKGROUND: Dupilumab (an anti-interleukin-4-receptor-α monoclonal antibody) blocks signalling of interleukin 4 and interleukin 13, type 2/Th2 cytokines implicated in numerous allergic diseases ranging from asthma to atopic dermatitis. Previous 16-week monotherapy studies showed that dupilumab substantially improved signs and symptoms of moderate-to-severe atopic dermatitis with acceptable safety, validating the crucial role of interleukin 4 and interleukin 13 in atopic dermatitis pathogenesis...
June 10, 2017: Lancet
https://www.readbyqxmd.com/read/28472499/a-pharmacy-management-service-for-adults-with-asthma-a-cluster-randomised-controlled-trial
#14
Lai-Yan Wong, Siew-Siang Chua, Abdul-Rahman Husin, Hanisah Arshad
Background.: Although clinical guidelines are available for the management of asthma, this health condition is still poorly managed in many countries. Objectives.: To assess the effects of a Pharmacy Management Service (PharMS) on asthma control of adult patients. Methods.: This study comprised of a cluster randomised controlled trial (RCT) that was conducted from April 2014 to July 2015 at four government health clinics. The control participants received usual pharmacy service, while the intervention participants were recruited into the PharMS...
May 3, 2017: Family Practice
https://www.readbyqxmd.com/read/28454528/asthma-control-using-fluticasone-propionate-salmeterol-in-asian-and-non-asian-populations-a-post-hoc-analysis-of-the-goal-study
#15
Jean Bousquet, Neil Barnes, Michael Gibbs, Nadeem Gul, Susan A Tomkins, Xin Zhou, Young-Joo Cho, Hae-Sim Park, William Busse, Nanshan Zhong
BACKGROUND: To analyse the efficacy of fluticasone propionate (FP) alone and combined with salmeterol (SAL) in achieving guideline-defined asthma control in Asian patients. METHODS: A post hoc analysis of the GOAL study in which patients were stratified by prior-medication use into inhaled corticosteroid (ICS)-naïve (Stratum [S] 1), low-dose ICS (S2), and medium-dose ICS (S3), and randomised to receive FP/SAL or FP. Doses were stepped-up every 12 weeks until Totally Controlled asthma or maximum dose was reached (PhI) and then maintained until study end (PhII)...
April 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28453378/effectiveness-of-written-action-plans-for-acute-asthma-a-systematic-review
#16
Cristina Villa-Roel, Britt Voaklander, Maria B Ospina, Taylor Nikel, Sandra Campbell, Brian H Rowe
OBJECTIVE: Self-management is an essential part of achieving asthma control and improving long-term outcomes. While guidelines recommend the provision of written asthma action plans (AAPs), few patients presenting to emergency departments (ED) have one. This systematic review examined if individualized written AAPs reduce relapses in adults following an ED visit for acute asthma. DATA SOURCES: Comprehensive searches of seven electronic databases and grey literature were conducted...
April 28, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28448379/effect-of-an-outpatient-pulmonary-rehabilitation-program-on-exercise-tolerance-and-asthma-control-in-obese-asthma-patients
#17
Yasemin Türk, Astrid van Huisstede, Frits M E Franssen, Pieter S Hiemstra, Arjan Rudolphus, Cristian Taube, Gert-Jan Braunstahl
PURPOSE: To compare the effects of an outpatient pulmonary rehabilitation (PR) program on exercise tolerance and asthma control in obese and nonobese patients with asthma. METHODS: Nonobese (body mass index [BMI] <30 kg/m) and obese (BMI ≥ 30 kg/m) patients with asthma who participated in a local multidisciplinary 12-week PR program were analyzed retrospectively. Effects of PR were assessed by changes in 6-minute walking distance (6MWD) and Asthma Control Questionnaire (ACQ)...
May 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28439076/practice-makes-perfect-self-reported-adherence-a-positive-marker-of-inhaler-technique-maintenance
#18
Elizabeth Azzi, Pamela Srour, Carol Armour, Cynthia Rand, Sinthia Bosnic-Anticevich
Poor inhaler technique and non-adherence to treatment are major problems in the management of asthma. Patients can be taught how to achieve good inhaler technique, however maintenance remains problematic, with 50% of patients unable to demonstrate correct technique. The aim of this study was to determine the clinical, patient-related and/or device-related factors that predict inhaler technique maintenance. Data from a quality-controlled longitudinal community care dataset was utilized. 238 patients using preventer medications where included...
April 24, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28427550/home-made-spacer-as-an-auxiliary-device-in-administration-of-beclomethasone-via-pressurized-metered-dose-inhaler-for-asthma-control-a-randomized-controlled-pragmatic-trial
#19
Deborah Schor, José Ângelo Rizzo, Decio Medeiros, Ana Carolina Dela Bianca, Almerinda Rego Silva, Carlos Nunes, Mário Morais-Almeida, Emanuel Sarinho
BACKGROUND: Holding chambers or spacers can enhance the efficacy of pressurized metered dose inhalers (pMDI) in delivering inhaled medications, as they reduce the need for hand-breath coordination and improve lower airways deposition. Nevertheless, their cost can be high for patients in low-income countries. OBJECTIVE: To compare asthma control achieved with beclomethasone-dipropionate administered through a hydrofluoroalkane-driven pMDI (BDp-pMDI) coupled to a home-made spacer (HmS) or to a valved commercial spacer (VCS) as auxiliary devices...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28427296/predictors-of-response-to-therapy-with-omalizumab-in-patients-with-severe-allergic-asthma-a-real-life-study
#20
Maria Kallieri, Andriana I Papaioannou, Evgenia Papathanasiou, Polyxeni Ntontsi, Spyridon Papiris, Stelios Loukides
OBJECTIVES: Omalizumab is a recombinant humanized IgG1 monoclonal anti-IgE antibody, used for the treatment of severe refractory allergic asthma. However, not all patients with IgE levels within the limits of administration, respond to treatment. The aim of the present study, was to determine clinical and inflammatory characteristics that could predict response to omalizumab. METHODS: We studied retrospectively patients treated with omalizumab as per GINA guidelines in one asthma tertiary referral center...
April 28, 2017: Postgraduate Medicine
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