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asthma randomized controlled trial

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https://www.readbyqxmd.com/read/29892940/the-impact-of-modifiable-risk-factor-reduction-on-childhood-asthma-development
#1
REVIEW
Andrew Abreo, Tebeb Gebretsadik, Cosby A Stone, Tina V Hartert
Childhood asthma is responsible for significant morbidity and health care expenditures in the United States. The incidence of asthma is greatest in early childhood, and the prevalence is projected to continue rising in the absence of prevention and intervention measures. The prevention of asthma will likely require a multifaceted intervention strategy; however, few randomized controlled trials have assessed such approaches. The purpose of this review was to use previous meta-analyses to identify the most impactful risk factors for asthma development and evaluate the effect of risk factor reduction on future childhood asthma prevalence...
June 11, 2018: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/29870462/does-evidence-support-the-use-of-cat-allergen-immunotherapy
#2
Sangeeta Dhami, Arnav Agarwal
PURPOSE OF REVIEW: Cat allergy can manifest as allergic rhinitis, conjunctivitis and/or asthma. With widespread cat ownership and exposure, cat allergy has emerged as a major cause of morbidity. Cat allergen immunotherapy is a potential disease modifying treatment for patients with cat allergy. We examine evidence on the effectiveness, cost-effectiveness and safety of cat allergen immunotherapy and consider the clinical contexts in which it should be prescribed. RECENT FINDINGS: The European Association of Allergy and Clinical Immunology systematic reviews on allergic rhinitis and asthma along with the accompanying guidelines on allergic rhinitis were used as primary sources of evidence...
June 4, 2018: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29870146/predictors-of-repeated-acute-hospital-attendance-for-asthma-in-children-a-systematic-review-and-meta-analysis
#3
Cristina Ardura-Garcia, Marie Stolbrink, Seher Zaidi, Philip J Cooper, John D Blakey
BACKGROUND: Asthma attacks are common and have significant physical, psychological, and financial consequences. Improving the assessment of a child's risk of subsequent asthma attacks could support front-line clinicians' decisions on augmenting chronic treatment or specialist referral. We aimed to identify predictors for emergency department (ED) or hospital readmission for asthma from the published literature. METHODS: We searched MEDLINE, EMBASE, AMED, PsycINFO, and CINAHL with no language, location, or time restrictions...
June 5, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29865929/noninvasive-ventilation-and-respiratory-physical-therapy-reduce-exercise-induced-bronchospasm-and-pulmonary-inflammation-in-children-with-asthma-randomized-clinical-trial
#4
Maisi Muniz Cabral David, Evelim Leal de Freitas Dantas Gomes, Maryjose Carvalho Mello, Dirceu Costa
BACKGROUND: Asthma is characterized by hyperresponsiveness of the airways, and exercise-induced bronchospasm (EIB) is a symptom that limits a large proportion of asthmatic patients, especially children. Continuous positive airway pressure (CPAP) leads to a reduction in the reactivity of the airways. The aim of this study was to evaluate the effect of outpatient treatment with CPAP and bilevel pressure combined with respiratory physical therapy for children and adolescents with asthma following bronchial hyperresponsiveness caused by an exercise bronchoprovocation test...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29863899/risk-factors-for-asthma-exacerbation-and-treatment-failure-in-adults-and-adolescents-with-well-controlled-asthma-during-continuation-and-step-down-therapy
#5
Emily DiMango, Linda Rogers, Joan Reibman, Lynn B Gerald, Mark Brown, Elizabeth A Sugar, Robert Henderson, Janet T Holbrook
RATIONALE: Although national and international guidelines recommend reduction of asthma controller therapy or 'step-down" therapy in patients with well controlled asthma, it is expected that some individuals may experience worsening of asthma symptoms or asthma exacerbations during step-down. Characteristics associated with subsequent exacerbations during step-down therapy have not been well defined. The effect of environmental tobacco smoke (ETS) exposure on risk of treatment failure during asthma step down therapy has not been reported...
June 4, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29862274/benralizumab-from-the-basic-mechanism-of-action-to-the-potential-use-in-the-biological-therapy-of-severe-eosinophilic-asthma
#6
REVIEW
Corrado Pelaia, Cecilia Calabrese, Alessandro Vatrella, Maria Teresa Busceti, Eugenio Garofalo, Nicola Lombardo, Rosa Terracciano, Girolamo Pelaia
Asthma is a very frequent chronic airway disease that includes many different clinical phenotypes and inflammatory patterns. In particular, eosinophilic bronchial inflammation is often associated with allergic as well as nonallergic asthma. The most important cytokine involved in the induction, maintenance, and amplification of airway eosinophilia in asthma is interleukin-5 (IL-5), released by both T helper 2 (Th2) lymphocytes and group 2 innate lymphoid cells (ILC2). Hence, IL-5 and its receptor are suitable targets for selective biologic drugs which can play a key role in add-on treatment of severe eosinophilic asthma refractory to corticosteroids...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29859017/intramuscular-versus-oral-corticosteroids-to-reduce-relapses-following-discharge-from-the-emergency-department-for-acute-asthma
#7
REVIEW
Scott W Kirkland, Elfriede Cross, Sandra Campbell, Cristina Villa-Roel, Brian H Rowe
BACKGROUND: Acute asthma is a common cause of presentations to acute care centres, such as the emergency department (ED), and while the majority of patients can be discharged, relapse requiring additional medical care is common. Systemic corticosteroids are a major part in the treatment of moderate to severe acute asthma; however, there is no clear evidence regarding the most effective route of administration for improving outcomes in patients discharged from acute care. OBJECTIVES: To examine the effectiveness and safety of a single dose of intramuscular (IM) corticosteroids provided prior to discharge compared to a short course of oral corticosteroids in the treatment of acute asthma patients discharged from an ED or equivalent acute care setting...
June 2, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29858000/efficacy-safety-and-dose-response-of-glycopyrronium-administered-by-metered-dose-inhaler-using-co-suspension-delivery-technology-in-subjects-with-intermittent-or-mild-to-moderate-persistent-asthma-a-randomized-controlled-trial
#8
Edward Kerwin, Andrew Wachtel, Lawrence Sher, Jack Nyberg, Patrick Darken, Shahid Siddiqui, Elizabeth A Duncan, Colin Reisner, Paul Dorinsky
OBJECTIVES: This randomized, double-blind, placebo-controlled, cross-over, Phase II dose-ranging study investigated the efficacy and safety of GP MDI (glycopyrronium administered by metered dose inhaler formulated using co-suspension delivery technology) compared with an open-label active comparator, salmeterol dry powder inhaler (SAL DPI), in subjects with intermittent or mild-to-moderate persistent asthma. METHODS: Subjects were randomized to receive five of seven treatments (GP MDI 28...
June 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29857783/efficacy-and-safety-of-fluticasone-propionate-formoterol-fumarate-in-pediatric-asthma-patients-a-randomized-controlled-trial
#9
Anna Płoszczuk, Miroslava Bosheva, Kay Spooner, Tammy McIver, Sanjeeva Dissanayake
BACKGROUND: The efficacy and safety of fluticasone propionate/formoterol fumarate pressurized metered-dose inhaler (pMDI) (fluticasone/formoterol; Flutiform® ; 100/10 µg b.i.d.) was compared with fluticasone propionate (Flixotide® Evohaler® pMDI; 100 µg b.i.d.) and fluticasone/salmeterol (Seretide® Evohaler® pMDI; 100/50 µg b.i.d.) in a pediatric asthma population (EudraCT number: 2010-024635-16). METHODS: A double-blind, double-dummy, parallel group, multicenter study...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29851914/intravenous-and-nebulized-magnesium-sulfate-for-treating-acute-asthma-in-children-a-systematic-review-and-meta-analysis
#10
Zhantao Su, Rui Li, Zhongtao Gai
OBJECTIVE: This study aimed to evaluate the efficacy of intravenous (IV) and nebulized magnesium sulfate in acute asthma in children. METHODS: The PubMed, Cochrane Library, and EMBASE databases were searched. Randomized controlled trials and quasi-randomized controlled trials of IV and nebulized magnesium sulfate in pediatric acute asthma were included. The outcomes subject to meta-analysis were pulmonary function, hospitalization, and further treatment. If statistical heterogeneity was significant, random-effects models were used for meta-analysis, otherwise, fixed-effects models were applied...
June 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29851030/individuals-with-filaggrin-related-eczema-and-asthma-have-increased-long-term-medication-and-hospital-admission-costs
#11
P Soares, K Fidler, J Felton, R Tavendale, A Hövels, S A Bremner, C N A Palmer, S Mukhopadhyay
BACKGROUND: Eczema and asthma are chronic diseases with onset usually before the age of 5 years. More than 50% of individuals with eczema will develop asthma and/or other allergic diseases. Several loss-of-function mutations in filaggrin (FLG) have been identified in patients with eczema. However, the association of FLG with healthcare use is unknown. OBJECTIVES: To determine whether FLG mutations are associated with increased prescribing for eczema and asthma and whether increased prescribing is associated with increased healthcare costs...
May 31, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29804794/clinical-and-immunological-profile-of-children-aged-5-9-years-with-persistent-egg-allergy-before-oral-immunotherapy-with-egg-a-multicenter-randomized-controlled-trial-of-the-spanish-society-of-pediatric-allergy-asthma-and-clinical-immunology-seicap
#12
L Echeverria, M F Martin-Muñoz, C Martorell, M T Belver, E Alonso Lebrero, L Zapatero, V Fuentes, M Piqué, A Plaza, C Muñoz, A Martorell, C Blasco, B Villa, C Gómez, S Nevot, J M García, R Madero
BACKGROUND: In children with egg protein allergy (EA), the probability of overcoming the allergy decreases with age, and the possibility of suffering severe adverse reactions as a consequence of dietetic transgressions results in worsened quality of life. One treatment option in such cases is oral immunotherapy (OIT) with foods. METHODS: We present a cohort of children with EA scheduled for OIT with pasteurized raw egg white, describing their clinical and allergic characteristics before the start of OIT...
May 24, 2018: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29793857/effect-of-tralokinumab-an-interleukin-13-neutralising-monoclonal-antibody-on-eosinophilic-airway-inflammation-in-uncontrolled-moderate-to-severe-asthma-mesos-a-multicentre-double-blind-randomised-placebo-controlled-phase-2-trial
#13
Richard J Russell, Latifa Chachi, J Mark FitzGerald, Vibeke Backer, Ronald Olivenstein, Ingrid L Titlestad, Charlotte Suppli Ulrik, Timothy Harrison, Dave Singh, Rekha Chaudhuri, Brian Leaker, Lorcan McGarvey, Salman Siddiqui, Millie Wang, Martin Braddock, Lars H Nordenmark, David Cohen, Himanshu Parikh, Gene Colice, Christopher E Brightling
BACKGROUND: The role of interleukin 13 in airway inflammation and remodelling in asthma is unclear. Tralokinumab is a human monoclonal antibody that neutralises interleukin 13. We aimed to evaluate whether tralokinumab would have an effect on airway eosinophilic infiltration, blood and sputum eosinophil concentrations, eosinophil activation, and airway remodelling. METHODS: We did a multicentre, double-blind, randomised, placebo-controlled phase 2 trial at 15 centres across the UK, Denmark, and Canada...
May 18, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29792288/tralokinumab-for-severe-uncontrolled-asthma-stratos-1-and-stratos-2-two-randomised-double-blind-placebo-controlled-phase-3-clinical-trials
#14
Reynold A Panettieri, Ulf Sjöbring, AnnaMaria Péterffy, Peter Wessman, Karin Bowen, Edward Piper, Gene Colice, Christopher E Brightling
BACKGROUND: Tralokinumab is an anti-interleukin-13 human monoclonal antibody developed for the treatment of severe, uncontrolled asthma. These clinical trials aimed to assess the efficacy and safety of tralokinumab in this population. METHODS: STRATOS 1 and STRATOS 2 were randomised, double-blind, parallel-group, placebo-controlled, phase 3 clinical trials that enrolled participants aged 12-75 years with severe asthma that was inadequately controlled despite use of inhaled corticosteroids (≥500 μg per day fluticasone or equivalent) and a long-acting β2 agonist (but not oral corticosteroids)...
May 18, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29785255/feasibility-of-high-intensity-training-in-asthma
#15
L L Toennesen, E D Soerensen, M Hostrup, C Porsbjerg, J Bangsbo, V Backer
Background: High-intensity interval training is an effective and popular training regime but its feasibility in untrained adults with asthma is insufficiently described. Objective: The randomized controlled trial 'EFFORT Asthma' explored the effects of behavioural interventions including high-intensity interval training on clinical outcomes in nonobese sedentary adults with asthma. In this article we present a sub analysis of data aiming to evaluate if patients' pre-intervention levels of asthma control, FEV1, airway inflammation and airway hyperresponsiveness (AHR) predicted their training response to the high-intensity interval training program, measured as increase in maximal oxygen consumption (VO2 max)...
2018: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29785146/provider-use-of-a-participatory-decision-making-style-with-youth-and-caregivers-and-satisfaction-with-pediatric-asthma-visits
#16
Betsy Sleath, Delesha M Carpenter, Imelda Coyne, Scott A Davis, Claire Hayes Watson, Ceila E Loughlin, Nacire Garcia, Daniel S Reuland, Gail E Tudor
Background: We conducted a randomized controlled trial to test the effectiveness of an asthma question prompt list with video intervention to engage the youth during clinic visits. We examined whether the intervention was associated with 1) providers including youth and caregiver inputs more into asthma treatment regimens, 2) youth and caregivers rating providers as using more of a participatory decision-making style, and 3) youth and caregivers being more satisfied with visits. Methods: English- or Spanish-speaking youth aged 11-17 years with persistent asthma and their caregivers were recruited from four pediatric clinics and randomized to the intervention or usual care groups...
2018: Patient related Outcome Measures
https://www.readbyqxmd.com/read/29782217/dupilumab-efficacy-and-safety-in-moderate-to-severe-uncontrolled-asthma
#17
Mario Castro, Jonathan Corren, Ian D Pavord, Jorge Maspero, Sally Wenzel, Klaus F Rabe, William W Busse, Linda Ford, Lawrence Sher, J Mark FitzGerald, Constance Katelaris, Yuji Tohda, Bingzhi Zhang, Heribert Staudinger, Gianluca Pirozzi, Nikhil Amin, Marcella Ruddy, Bolanle Akinlade, Asif Khan, Jingdong Chao, Renata Martincova, Neil M H Graham, Jennifer D Hamilton, Brian N Swanson, Neil Stahl, George D Yancopoulos, Ariel Teper
Background Dupilumab is a fully human anti-interleukin-4 receptor α monoclonal antibody that blocks both interleukin-4 and interleukin-13 signaling. We assessed its efficacy and safety in patients with uncontrolled asthma. Methods We randomly assigned 1902 patients 12 years of age or older with uncontrolled asthma in a 2:2:1:1 ratio to receive add-on subcutaneous dupilumab at a dose of 200 or 300 mg every 2 weeks or matched-volume placebos for 52 weeks. The primary end points were the annualized rate of severe asthma exacerbations and the absolute change from baseline to week 12 in the forced expiratory volume in 1 second (FEV1 ) before bronchodilator use in the overall trial population...
May 21, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29778650/obesity-surgery-makes-patients-healthier-and-more-functional-real-world-results-from-the-united-kingdom-national-bariatric-surgery-registry
#18
Alexander Dimitri Miras, Kamocka Anna, Patel Darshan, Dexter Simon, Finlay Ian, Hopkins C James, Khan Omar, Reddy Marcus, Sedman Peter, Small Peter, Somers Shaw, Suzie Cro, Walton Peter, le Roux Carel W, Welbourn Richard
BACKGROUND: The National Bariatric Surgery Registry (NBSR) is the largest bespoke database in the field in the United Kingdom. OBJECTIVES: Our aim was to analyze the NBSR to determine whether the effects of obesity surgery on associated co-morbidities observed in small, randomized controlled clinical trials could be replicated in a "real life" setting within U.K. healthcare. SETTING: United Kingdom. METHODS: All NBSR entries for operations between 2000 and 2015 with associated demographic and co-morbidity data were analyzed retrospectively...
February 15, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29777633/hypertrophic-effect-of-inhaled-beta-2-agonist-with-and-without-concurrent-exercise-training-a-randomized-controlled-trial
#19
Søren Jessen, Johan Onslev, Anders Lemminger, Vibeke Backer, Jens Bangsbo, Morten Hostrup
INTRODUCTION: Due to a high prevalence of asthma and exercise-induced bronchoconstriction in elite athletes, there is a high use of beta2 -adrenoceptor agonists (beta2 -agonists) in the athletic population. While anabolic in rodents, no study has been able to detect hypertrophy in humans after chronic beta2 -agonist inhalation. METHODS: We investigated if inhaled beta2 -agonist, terbutaline, alters body composition and metabolic rate with and without concurrent exercise training in healthy young men...
May 19, 2018: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29768149/inhaled-combined-budesonide-formoterol-as-needed-in-mild-asthma
#20
RANDOMIZED CONTROLLED TRIAL
Paul M O'Byrne, J Mark FitzGerald, Eric D Bateman, Peter J Barnes, Nanshan Zhong, Christina Keen, Carin Jorup, Rosa Lamarca, Stefan Ivanov, Helen K Reddel
BACKGROUND: In patients with mild asthma, as-needed use of an inhaled glucocorticoid plus a fast-acting β2 -agonist may be an alternative to conventional treatment strategies. METHODS: We conducted a 52-week, double-blind trial involving patients 12 years of age or older with mild asthma. Patients were randomly assigned to one of three regimens: twice-daily placebo plus terbutaline (0.5 mg) used as needed (terbutaline group), twice-daily placebo plus budesonide-formoterol (200 μg of budesonide and 6 μg of formoterol) used as needed (budesonide-formoterol group), or twice-daily budesonide (200 μg) plus terbutaline used as needed (budesonide maintenance group)...
May 17, 2018: New England Journal of Medicine
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