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Inhaled corticosteroids and asthma

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https://www.readbyqxmd.com/read/28081237/co-occurrence-of-asthma-and-nephrolithiasis-in-children
#1
Ganesh K Kartha, Ina Li, Suzy Comhair, Serpil C Erzurum, Manoj Monga
It has been proposed that epithelial dysfunction and inflammation may predispose patients to kidney stone formation. Asthma is another chronic condition related to epithelial dysfunction and inflammation. We hypothesized that pediatric patients with asthma would have an increased prevalence of nephrolithiasis. Furthermore, we investigated if asthma patients with nephrolithiasis have clinical characteristics and urine profiles that point to mechanisms of stone formation. We evaluated 865 pediatric patients who had a diagnosis of nephrolithiasis...
2017: PloS One
https://www.readbyqxmd.com/read/28073701/effect-of-asthma-therapies-on-the-natural-course-of-asthma
#2
REVIEW
Elissa M Abrams, Stanley J Szefler, Allan B Becker
OBJECTIVE: To provide an evidence-based review on the role of pharmacologic (inhaled corticosteroids, leukotriene receptor antagonists, biologic therapies, aeroallergen immunotherapy) and nonpharmacologic therapies (environmental modifications, microbiome) in secondary and tertiary asthma prevention. DATA SOURCES: A PubMed search for English-language publications regarding asthma and secondary or tertiary prevention was performed. Some articles cited in selected studies were also considered for inclusion in this review...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28069248/race-is-associated-with-differences-in-airway-inflammation-in-patients-with-asthma
#3
Sharmilee M Nyenhuis, Jerry A Krishnan, Alalia Berry, William J Calhoun, Vernon M Chinchilli, Linda Engle, Nicole Grossman, Fernando Holguin, Elliot Israel, Rick A Kittles, Monica Kraft, Stephen C Lazarus, Erik B Lehman, David T Mauger, James N Moy, Stephen P Peters, Wanda Phipatanakul, Lewis J Smith, Kaharu Sumino, Stanley J Szefler, Michael E Wechsler, Sally Wenzel, Steven R White, Steven J Ackerman
BACKGROUND: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. OBJECTIVE: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS-, respectively). METHODS: We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute-sponsored Asthma Clinical Research Network and AsthmaNet...
December 31, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28069068/the-sygma-programme-of-phase-3-trials-to-evaluate-the-efficacy-and-safety-of-budesonide-formoterol-given-as-needed-in-mild-asthma-study-protocols-for-two-randomised-controlled-trials
#4
Paul M O'Byrne, J Mark FitzGerald, Nanshan Zhong, Eric Bateman, Peter J Barnes, Christina Keen, Gun Almqvist, Kristine Pemberton, Carin Jorup, Stefan Ivanov, Helen K Reddel
BACKGROUND: In many patients with mild asthma, the low frequency of symptoms and the episodic nature of exacerbations make adherence to regular maintenance treatment difficult. This often leads to over-reliance on short-acting β2-agonist (SABA) reliever medication and under-treatment of the underlying inflammation, with poor control of asthma symptoms and increased risk of exacerbations. The use of budesonide/formoterol 'as needed' in response to symptoms may represent an alternative treatment option for patients with mild asthma...
January 10, 2017: Trials
https://www.readbyqxmd.com/read/28065396/inhaled-corticosteroid-dose-response-in-asthma-should-we-measure-inflammation
#5
William J Anderson, Philip M Short, Sunny Jabbal, Brian J Lipworth
BACKGROUND: Inhaled corticosteroid (ICS) titration in asthma is primarily based on symptoms and pulmonary function. ICSs may not be increased on this basis despite residual airway inflammation. OBJECTIVE: To compare the dose-response relationships of ICSs on measures of pulmonary function, symptoms, and inflammation in patients with persistent asthma. METHODS: We performed a pooled post hoc analysis of 121 patients with mild to moderate asthma from 4 randomized clinical trials that incorporated an ICS dose ramp...
January 3, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28053970/leukotriene-b4-levels-in-sputum-from-asthma-patients
#6
Andrew Higham, Paul Cadden, Thomas Southworth, Matthew Rossall, Umme Kolsum, Simon Lea, Richard Knowles, Dave Singh
Poor asthma control is associated with increased airway neutrophils. Leukotriene B4 (LTB4) is a potent neutrophil chemoattractant. We examined the levels of LTB4 levels in the sputum of asthma patients and the relationship with disease severity. 47 asthma patients (categorised according to Global Initiative for Asthma treatment stage) and 12 healthy controls provided sputum samples that were processed first with PBS to obtain supernatants and secondly with dithiothreitol (DTT) to obtain supernatants. LTB4 levels were determined by ELISA...
October 2016: ERJ Open Research
https://www.readbyqxmd.com/read/28052803/childhood-obesity-in-pediatric-patients-with-difficult-to-control-asthma-in-a-tertiary-pediatric-subspecialty-clinic
#7
Yasmin Hamzavi Abedi, Amy M Perkins, Maripaz B Morales
BACKGROUND: Identifying clinical features associated with difficult-to-control asthma will help address overall control and more-effective asthma management. OBJECTIVE: To evaluate our clinical observation that the proportion of patients who are overweight or obese is significantly higher in patients with difficult-to-control asthma than in patients with well-controlled asthma. METHODS: This was a retrospective chart review of 400 patients, ages 5 to 18 years...
January 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28044257/targeted-therapy-for-severe-asthma-identifying-the-right-patients
#8
Kathy Low, Philip G Bardin
Asthma affects over 300 million people worldwide. Most asthmatics are well controlled with inhaled corticosteroids and long-acting beta-agonists; however, a proportion of patients are unresponsive and attain limited disease control. This group represents a considerable healthcare and financial burden, particularly patients who experience frequent exacerbations and require hospital admission. Development of new biological agents and disease biomarkers has provided novel avenues for treatment. These treatments have been highly successful, reducing exacerbations and yielding modest improvements in quality of life and lung function...
January 2, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/28042004/the-potential-role-of-allergen-immunotherapy-in-stepping-down-asthma-treatment
#9
Pascal Demoly, Melina Makatsori, Thomas B Casale, Moises A Calderon
For patients whose asthma is controlled and who have a low risk for future exacerbations, current guidelines recommend gradually stepping down pharmacotherapy to identify the lowest dose needed to maintain control. This review article will discuss the benefits and risks of step down in asthma management and the different strategies of achieving step down with particular focus on allergen immunotherapy (AIT). A literature search was conducted to identify studies that assessed the effect of AIT on asthma step down and evaluated this and asthma control as one of the outcomes...
December 29, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28039105/long-acting-%C3%AE-2-agonists-promote-glucocorticoid-mediated-repression-of-nf-%C3%AE%C2%BAb-by-enhancing-expression-of-the-feedback-regulator-tnfaip3
#10
Mohammed Omar Altonsy, Mahmoud M Mostafa, Anthony N Gerber, Robert Newton
Glucocorticoids, or corticosteroids, are effective treatments for many chronic inflammatory diseases and, in mild/moderate asthma, long-acting β2-adrenoceptor agonists (LABAs) enhance the efficacy of inhaled corticosteroids (ICSs) more than increasing the ICS dose. In human bronchial epithelial, BEAS-2B, cells, expression of TNFα-induced protein 3 (TNFAIP3), or A20, a dual-ubiquitin ligase that provides feedback inhibition of NF-κB, was induced by budesonide, an ICS, formoterol, a LABA, and was further enhanced by budesonide/formoterol combination...
December 29, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28031210/randomised-feasibility-study-of-a-novel-experience-based-internet-intervention-to-support-self-management-in-chronic-asthma
#11
Nikki Newhouse, Angela Martin, Sena Jawad, Ly-Mee Yu, Mina Davoudianfar, Louise Locock, Sue Ziebland, John Powell
OBJECTIVE: To determine the feasibility of a randomised controlled trial (RCT) assessing the effects of an experience-based website as a resource for the self-management of chronic asthma. DESIGN AND SETTING: Feasibility, single-blind RCT in 2 regions of England. Randomisation used computer-generated random number sequence in a 1:1 ratio, after baseline data collection, to website access for 2 weeks. PARTICIPANTS: Adults (age ≥18 years), with clinically diagnosed asthma as coded in their primary care electronic record, prescribed inhaled corticosteroids for at least 3 months in the previous year, were recruited from 9 general practices...
December 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/28012663/knemometry-is-more-sensitive-to-systemic-effects-of-inhaled-corticosteroids-in-children-with-asthma-than-24-hour-urine-cortisol-excretion
#12
Bo Chawes, Erik Nilsson, Sarah Nørgaard, Anna Dossing, Li Mortensen, Hans Bisgaard
BACKGROUND: Pharmacodynamic assessment of the systemic effect of inhaled corticosteroids (ICSs) is often done by measuring 24-hour urine free cortisol (UFC) excretion. Knemometry assessing short-term lower-leg growth rate (LLGR) is a more rarely used alternative. OBJECTIVE: The primary aim of this study was to compare the sensitivity of LLGR and 24-hour UFC excretion for evaluating systemic exposure to ICSs in prepubertal children with asthma. The secondary aim was to evaluate factors influencing the precision of LLGR calculated by the traditional 1 leg nonparametric method versus a new 2 leg parametric method...
December 15, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28008228/spotlight-on-fluticasone-furoate-vilanterol-trifenatate-for-the-once-daily-treatment-of-asthma-design-development-and-place-in-therapy
#13
REVIEW
Timothy E Albertson, Samuel W Bullick, Michael Schivo, Mark E Sutter
The use of inhaled corticosteroids (ICSs) plays a key role in the treatment of asthmatic patients, and international guidelines have designated ICSs as an early maintenance therapy in controlling asthma symptoms. When asthmatic patients remain symptomatic on ICSs, one common option is to add a long-acting beta2 agonist (LABA) to the maintenance treatment. Fixed combination inhalers that contain both an ICS and a LABA have been popular for both chronic obstructive pulmonary disease (COPD) and asthma. Historically, these inhalers have been dosed twice daily...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28000298/the-feasibility-of-using-multiple-databases-to-study-rare-outcomes-the-potential-effect-of-long-acting-beta-agonists-with-inhaled-corticosteroid-therapy-on-asthma-mortality
#14
Catherine B Johannes, Lisa J McQuay, Kirk D Midkiff, Brian Calingaert, Elizabeth B Andrews, Patricia Tennis, Jeffrey S Brown, Carlos A Camargo, Rachael L DiSantostefano, Kenneth J Rothman, Til Stürmer, Stephan Lanes, Kourtney J Davis
PURPOSE: Long-acting beta agonists (LABAs) when used without concomitant inhaled corticosteroids (ICS) increase the risk of asthma-related deaths, but the effect on asthma-related death of LABA used in combination with ICS therapy is unknown. To address this question, we explored the feasibility of conducting an observational study using multiple US health care data sources. METHODS: Retrospective cohort study to evaluate the likelihood of getting an upper 95% confidence limit ≤1...
December 21, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27998692/squill-oxymel-a-traditional-formulation-from-drimia-maritima-l-stearn-as-an-add-on-treatment-in-patients-with-moderate-to-severe-persistent-asthma-a-pilot-triple-blind-randomized-clinical-trial
#15
Fatemeh Nejatbakhsh, Hossein Karegar-Borzi, Gholamreza Amin, Alireza Eslaminejad, Mostafa Hosseini, Mahbubeh Bozorgi, Mehrnaz Asadi Gharabaghi
ETHNOPHARMACOLOGICAL RELEVANCE: In Traditional Iranian Medicine (TIM), Squill (Drimia maritima (L.) Stearn) Oxymel was utilized in the treatment of asthma. Squill has been reported to exert anti-inflammatory, anti-oxidant, anti-cholinergic, and mucus secretion modulating effects. OBJECTIVE: This study aimed to make a preliminary evaluation of the efficacy and safety of an add-on Squill Oxymel treatment in patients with moderate to severe persistent asthma. METHODS: In a 6-week, triple-blind, randomized, placebo-controlled trial, 60 patients with stable moderate to severe persistent asthma were randomly allocated to receive either 10ml syrup of Squill Oxymel, simple oxymel, or a placebo 2 times a day, as an add-on to their routine treatment (inhaled corticosteroids and β2 agonists)...
January 20, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27983888/eosinophilic-and-neutrophilic-airway-inflammation-in-the-phenotyping-of-mild-to-moderate-asthma-and-chronic-obstructive-pulmonary-disease
#16
Katarzyna Górska, Magdalena Paplińska-Goryca, Patrycja Nejman-Gryz, Krzysztof Goryca, Rafał Krenke
Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases with different inflammatory phenotypes. Various inflammatory mediators play a role in these diseases. The aim of this study was to analyze the neutrophilic and eosinophilic airway and systemic inflammation as the phenotypic characterization of patients with asthma and COPD. Twenty-four patients with asthma and 33 patients with COPD were enrolled in the study. All the patients were in mild-to-moderate stage of disease, and none of them were treated with inhaled corticosteroids...
December 16, 2016: COPD
https://www.readbyqxmd.com/read/27979022/association-of-severity-of-chronic-rhinosinusitis-with-degree-of-comorbid-asthma-control
#17
Katie M Phillips, Lloyd P Hoehle, David S Caradonna, Stacey T Gray, Ahmad R Sedaghat
BACKGROUND: Comorbid chronic rhinosinusitis (CRS) is associated with worse asthma control. However, no study has investigated whether CRS severity affects the degree of asthma control. OBJECTIVE: To determine the effect size of an association between CRS severity and asthma control. METHODS: A pilot study with a prospective cross-sectional design. Adult patients with CRS and asthma were recruited. CRS severity was measured using the 22-item Sinonasal Outcomes Test (SNOT-22), and asthma control was measured using the Asthma Control Test (ACT)...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27979018/patient-adherence-and-effective-communication
#18
Don A Bukstein
BACKGROUND: Poor adherence to inhaled corticosteroid medication is a critical problem for asthma because it contributes to morbidity and mortality through poor asthma control, frequent asthma exacerbations, acute care visits, and oral corticosteroid use. OBJECTIVE: To discuss evidence-based, time-efficient strategies that can be adopted by most practitioners to try to increase patient adherence. METHODS: Asthma management guidelines and other key publications are used to enhance discussion...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27979017/inhalation-devices-delivery-systems-and-patient-technique
#19
Harold S Nelson
BACKGROUND: In real-life clinical settings, physicians often consider the properties of various inhaled corticosteroids (ICSs), but typically little consideration is given to the properties of different inhalers and formulations. OBJECTIVE: To discuss the effects of inhalation devices and user technique on efficacy, safety, and adherence with the aim of improving asthma management. METHODS: Relevant publications were selected to augment discussion...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27979016/safety-of-intranasal-corticosteroids
#20
Greg W Bensch
BACKGROUND: Concurrent use of intranasal corticosteroids (INCSs) and inhaled corticosteroids (ICSs) is indicated for patients who are comorbid for asthma and allergic rhinitis. Clinicians need to know the data regarding INCS safety for their patients with asthma. OBJECTIVE: To discuss INCS safety data for the use of INCSs in patients with asthma and allergic rhinitis. METHODS: INCS safety studies were selected for their relevance to the discussion...
December 2016: Annals of Allergy, Asthma & Immunology
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