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Inhaled corticosteroids and asthma

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https://www.readbyqxmd.com/read/29339126/addressing-the-impact-and-unmet-needs-of-nonadherence-in-asthma-and-chronic-obstructive-pulmonary-disease-where-do-we-go-from-here
#1
Richard Dekhuijzen, Federico Lavorini, Omar S Usmani, Job F M van Boven
Nonadherence to treatment, and its associated health and economic burden, is particularly problematic in asthma and chronic obstructive pulmonary disease management because of heterogeneous patient populations and the need for an inhaled route of drug administration. Symptom variability, comorbidities, and device switching further add to suboptimal adherence rates. As opposed to controlled clinical trials, real-life studies show consistently low inhaler adherence in daily practice, yet exact adherence rates have long been affected by disagreement on standardized definitions...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29338973/asthma-copd-overlap-a-portuguese-survey
#2
E Padrão, D Araújo, A Todo Bom, C Robalo Cordeiro, J Correia de Sousa, J Cardoso, M Morais-Almeida, R Costa, F Pavão, R B Leite, A Marques
INTRODUCTION: The overlap between asthma and chronic obstructive pulmonary disease (COPD) (ACO) has been discussed for many years but clinical recommendations for this entity have been diverse. This study is intended to reach a consensus on diagnosis, treatment and patient orientation for ACO, within the Portuguese medical community. METHODS: This study was conducted by a multidisciplinary panel of experts from three distinct medical specialties (Pulmonology, Family Medicine and Immunoallergology)...
January 12, 2018: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29332144/long-acting-%C3%AE-2-agonists-in-asthma-enantioselective-safety-studies-are-needed
#3
Glenn A Jacobson, Sharanne Raidal, Morten Hostrup, Luigino Calzetta, Richard Wood-Baker, Mark O Farber, Clive P Page, E Haydn Walters
Long-acting β2-agonists (LABAs) such as formoterol and salmeterol are used for prolonged bronchodilatation in asthma, usually in combination with inhaled corticosteroids (ICSs). Unexplained paradoxical asthma exacerbations and deaths have been associated with LABAs, particularly when used without ICS. LABAs clearly demonstrate effective bronchodilatation and steroid-sparing activity, but long-term treatment can lead to tolerance of their bronchodilator effects. There are also concerns with regard to the effects of LABAs on bronchial hyperresponsiveness (BHR), where long-term use is associated with increased BHR and loss of bronchoprotection...
January 13, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29331617/asthma-predictive-index-in-relation-to-respiratory-mechanics-by-impulse-oscillometry-in-recurrent-wheezers
#4
T Arikoglu, S B Batmaz, D D Yildirim, Ö Tezol, G Bozlu, S Kuyucu
BACKGROUND: The identification of children who will have persistent asthma has become a focus of recent research. The aim of this study was to assess whether impulse oscillometry (IOS) has a diagnostic value to predict modified API (asthma predictive index) in pre-schoolers with recurrent wheezing. METHODS: Pre-school children aged 3-6 years with recurrent wheezing were enrolled. The study population was divided into two groups based on mAPI criteria. Lung function was assessed by IOS...
January 10, 2018: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29331313/predictors-of-exacerbation-risk-and-response-to-budesonide-in-patients-with-chronic-obstructive-pulmonary-disease-a-post-hoc-analysis-of-three-randomised-trials
#5
Mona Bafadhel, Stefan Peterson, Miguel A De Blas, Peter M Calverley, Stephen I Rennard, Kai Richter, Malin Fagerås
BACKGROUND: The peripheral blood eosinophil count might help identify those patients with chronic obstructive pulmonary disease (COPD) who will experience fewer exacerbations when taking inhaled corticosteroids (ICS). Previous post-hoc analyses have proposed eosinophil cutoffs that are both arbitrary and limited in evaluating complex interactions of treatment response. We modelled eosinophil count as a continuous variable to determine the characteristics that determine both exacerbation risk and clinical response to ICS in patients with COPD...
January 10, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29328030/modern-approaches-to-fractional-exhaled-nitric-oxide-as-a-useful-biomarker-for-allergic-asthma-phenotyping-and-management
#6
N Mgaloblishvili, M Gotua
Asthma is a pathologically heterogeneous disease, consisting of several phenotypes. Different types of airway inflammation are the cornerstone feature of this condition. Fraction of nitric oxide in exhaled air (FENO) has been proposed as a noninvasive, specific biomarker for eosinophilic airway inflammation and has been shown to be elevated in patients with allergic asthma phenotype. More recent studies indicate that FeNO identifies T-helper cell type 2 (Th2)-mediated airway inflammation with a high predictive value for identifying inhaled corticosteroid (ICS) responsive airway inflammation...
December 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29325854/considerations-in-the-diagnosis-of-oral-hairy-leukoplakia-an-institutional-experience
#7
Andres Flores-Hidalgo, Si On Lim, Alice E Curran, Ricardo J Padilla, Valerie Murrah
OBJECTIVE: We report here the 10-year experience with oral hairy leukoplakia (OHL) at the Division of Oral and Maxillofacial Pathology at the University of North Carolina at Chapel Hill, NC, USA. STUDY DESIGN: All the associated hematoxylin and eosin and Epstein-Barr virus encoding region in situ hybridization slides of OHL cases between January 1, 2008, and February 1, 2017, were retrieved and reviewed. Collected demographic characteristics, clinical presentation, medical and social histories were reviewed and reported...
November 15, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29325420/adolescent-and-caregivers-experiences-of-electronic-adherence-assessment-in-paediatric-problematic-severe-asthma
#8
Amy C Stewart, Kenneth N Gannon, Fran Beresford, Louise Fleming
This study explored the experiences of adolescents and their caregivers regarding adherence to inhaled corticosteroids which are assessed through an electronic monitoring device (EMD). These devices are increasingly being used for assessing medication adherence, yet there is little information about patient's experience of these tools. Semi-structured interviews were conducted with eight adolescents with severe asthma, aged 11-15 years, who were electronically monitored as part of their care, along with their caregivers...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29317923/identification-of-inhaler-technique-errors-with-a-routine-procedure-in-portuguese-community-pharmacy
#9
M Margarida Castel-Branco, Ana Fontes, Isabel V Figueiredo
Background: A correct selection of drugs prescribed, but also the choice of the appropriate inhaler device, is crucial for the control of respiratory diseases. Objective: To evaluate the inhaler technique and identify potential errors of patients when treated with inhalers by testing a routinary procedure to be implemented in any community pharmacy. Methods: Adults with asthma/COPD and under inhalation therapy were invited to demonstrate how they use their inhalers...
October 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/29316890/risk-factors-of-postoperative-pulmonary-complications-in-patients-with-asthma-and-copd
#10
Takanori Numata, Katsutoshi Nakayama, Satoko Fujii, Yoko Yumino, Nayuta Saito, Masahiro Yoshida, Yusuke Kurita, Kenji Kobayashi, Saburo Ito, Hirofumi Utsumi, Haruhiko Yanagisawa, Mitsuo Hashimoto, Hiroshi Wakui, Shunsuke Minagawa, Takeo Ishikawa, Hiromichi Hara, Jun Araya, Yumi Kaneko, Kazuyoshi Kuwano
BACKGROUND: Postoperative pulmonary complications (PPC) in patients with pulmonary diseases remain to be resolved clinical issue. However, most evidence regarding PPC has been established more than 10 years ago. Therefore, it is necessary to evaluate perioperative management using new inhalant drugs in patients with obstructive pulmonary diseases. METHODS: April 2014 through March 2015, 346 adult patients with pulmonary diseases (257 asthma, 89 chronic obstructive pulmonary disease (COPD)) underwent non-pulmonary surgery except cataract surgery in our university hospital...
January 9, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29301585/a-randomised-pragmatic-trial-of-corticosteroid-optimization-in-severe-asthma-using-a-composite-biomarker-algorithm-to-adjust-corticosteroid-dose-versus-standard-care-study-protocol-for-a-randomised-trial
#11
Catherine E Hanratty, John G Matthews, Joseph R Arron, David F Choy, Ian D Pavord, P Bradding, Christopher E Brightling, Rekha Chaudhuri, Douglas C Cowan, Ratko Djukanovic, Nicola Gallagher, Stephen J Fowler, Tim C Hardman, Tim Harrison, Cécile T Holweg, Peter H Howarth, James Lordan, Adel H Mansur, Andrew Menzies-Gow, Sofia Mosesova, Robert M Niven, Douglas S Robinson, Dominick E Shaw, Samantha Walker, Ashley Woodcock, Liam G Heaney
BACKGROUND: Patients with difficult-to-control asthma consume 50-60% of healthcare costs attributed to asthma and cost approximately five-times more than patients with mild stable disease. Recent evidence demonstrates that not all patients with asthma have a typical type 2 (T2)-driven eosinophilic inflammation. These asthmatics have been called 'T2-low asthma' and have a minimal response to corticosteroid therapy. Adjustment of corticosteroid treatment using sputum eosinophil counts from induced sputum has demonstrated reduced severe exacerbation rates and optimized corticosteroid dose...
January 4, 2018: Trials
https://www.readbyqxmd.com/read/29288175/applicability-of-evidence-from-previous-systematic-reviews-on-immunotherapy-in-current-practice-of-childhood-asthma-treatment-a-grade-grading-of-recommendations-assessment-development-and-evaluation-systematic-review
#12
Erik-Jonas van de Griendt, Mariska K Tuut, Hans de Groot, Paul L P Brand
OBJECTIVE: Because most children with asthma now use inhaled corticosteroids (ICS), the added benefit of immunotherapy in asthmatic children needs to be examined. We re-assessed the effectiveness of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) in childhood asthma treatment focusing on studies with patient-relevant outcome measures and children using ICS. METHODS: We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to systematically search and appraise the evidence using predefined critical patient-relevant outcomes (asthma symptoms, asthma control and exacerbations)...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29285264/decreased-incidence-of-glaucoma-in-children-with-asthma-using-inhaled-corticosteroid-a-cohort-study
#13
Ling-Sai Chang, Hui-Ching Lee, Yuh-Chyn Tsai, Lien-Shi Shen, Ching-Ling Li, Shih-Feng Liu, Ho-Chang Kuo
Among the anti-inflammatory medications used for treating asthma, corticosteroids are the most effective. The effects of orally administered corticosteroids on intraocular pressure and lens opacity have been well defined, but the influence of inhaled corticosteroids (ICS) on children has yet to be clearly explained. Therefore, we used a nationwide cohort database to investigate glaucoma in childhood asthma patients using ICS. We analyzed a dataset of 1,000,000 randomly sampled individuals from Taiwan's 2000 National Health Insurance Research Database...
December 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/29279056/a-review-of-the-efficacy-and-safety-of-once-daily-tiotropium-respimat-2-5-micrograms-in-adults-and-adolescents-with-asthma
#14
Eli O Meltzer, William E Berger
BACKGROUND: Despite current guidelines, many patients with asthma remain symptomatic, particularly those intolerant of, unresponsive to, or uncontrolled by long-acting beta 2-agonists (LABAs). Tiotropium bromide, delivered through the Respimat soft-mist inhaler in 2 puffs of 1.25 micrograms each, is approved for the long-term, maintenance treatment of asthma in patients aged ≥6 years. OBJECTIVE: An overview of the use of once-daily tiotropium Respimat 2.5 micrograms in adults and adolescents with varying degrees of asthma severity...
January 6, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29278942/objective-confirmation-of-asthma-diagnosis-improves-medication-adherence
#15
V Backer, L Stensen, A Sverrild, E Wedge, C Porsbjerg
OBJECTIVE: The impact of diagnostic work-up in asthma management on medication redemption and probably also drug adherence is largely unknown, but we hypothesized that a confirmed diagnosis of asthma in a hospital-based out-patient clinic increases the willingness to subsequent medication redemption in a real life setting. METHODS: In a retrospective register-based study, 300 medical records of patients referred with possible asthma during one year were examined, of whom 171 had asthma (57%)...
December 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29273557/overweight-obesity-status-in-preschool-children-associates-with-worse-asthma-but-robust-improvement-on-inhaled-corticosteroids
#16
Jason E Lang, Anne M Fitzpatrick, David T Mauger, Theresa W Guilbert, Daniel J Jackson, Robert F Lemanske, Fernando D Martinez, Robert C Strunk, Robert S Zeiger, Wanda Phipatanakul, Leonard B Bacharier, Jacqueline A Pongracic, Fernando Holguin, Michael D Cabana, Ronina A Covar, Hengameh H Raissy, Monica Tang, Stanley J Szefler
BACKGROUND: Overweight/obesity (OW) is linked to worse asthma and poorer inhaled corticosteroid (ICS) response in older children and adults. OBJECTIVE: We sought to describe the relationships between OW and asthma severity and response to ICS in preschool children. METHODS: This post hoc study of 3 large multicenter trials involving 2- to 5-year-old children compared annualized asthma symptom days and exacerbations among normal weight (NW) (body mass index: 10th-84th percentiles) versus OW (body mass index: ≥85th percentile) participants...
December 8, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29259760/lung-function-in-severe-pediatric-asthma-a-longitudinal-study-in-children-and-adolescents-in-brazil
#17
Mônica Versiani Nunes Pinheiro de Queiroz, Cristina Gonçalves Alvim, Álvaro A Cruz, Laura Maria de Lima Belizário Facury Lasmar
Background: In severe asthma, high doses of inhaled corticosteroids (ICS) are used in order to achieve clinical and functional control. This study aimed to evaluate lung function in outpatients (children and adolescents) with severe asthma in Brazil, all of whom were treated with high doses of ICS. We evaluated all spirometry tests together and by ICS dose: 800 and > 800 µg/day. Methods: This was a 3-year longitudinal study in which we analyzed 384 spirometry tests in 65 severe asthma patients (6-18 years of age), divided into two groups by the dose of ICS (budesonide or equivalent): 800 and > 800 µg/day...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29251255/effects-of-genetic-factors-to-inhaled-corticosteroid-response-in-children-with-asthma-a-literature-review
#18
Huong Duong-Thi-Ly, Ha Nguyen-Thi-Thu, Long Nguyen-Hoang, Hanh Nguyen-Thi-Bich, Timothy J Craig, Sy Duong-Quy
Numerous studies have examined the association between pharmacogenetic effects and the response to inhaled corticosteroids (ICS) in patients with asthma. In fact, several single nucleotide polymorphisms of a number of candidate genes have been identified that might influence the clinical response to ICS in children with asthma. Their direct or indirect effects depend on their role in the inflammatory process in asthma or the anti-inflammatory action of corticosteroids, respectively. Among the genes identified, variants in T-box 21 ( TBX21) and Fc fragment of IgE receptor II ( FCER2) contribute indirectly to the variability in the response to ICS by altering the inflammatory mechanisms in asthma, while other genes such as corticotropin releasing hormone receptor 1 ( CRHR1), nuclear receptor subfamily 3 group C member 1 ( NR3C1), stress induced phosphoprotein 1 ( STIP1), dual specificity phosphatase 1 (DUSP1), glucocorticoid induced 1 (GLCCI1), histone deacetylase 1 (HDAC), ORMDL sphingolipid biosynthesis regulator 3 (ORMDL3), and vascular endothelial growth factors (VEGF) directly affect this variability through the anti-inflammatory mechanisms of ICS...
December 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29247424/method-development-for-clinical-comprehensive-evaluation-of-pediatric-drugs-based-on-multi-criteria-decision-analysis-application-to-inhaled-corticosteroids-for-children-with-asthma
#19
Yuncui Yu, Lulu Jia, Yao Meng, Lihua Hu, Yiwei Liu, Xiaolu Nie, Meng Zhang, Xuan Zhang, Sheng Han, Xiaoxia Peng, Xiaoling Wang
BACKGROUND: Establishing a comprehensive clinical evaluation system is critical in enacting national drug policy and promoting rational drug use. In China, the 'Clinical Comprehensive Evaluation System for Pediatric Drugs' (CCES-P) project, which aims to compare drugs based on clinical efficacy and cost effectiveness to help decision makers, was recently proposed; therefore, a systematic and objective method is required to guide the process. METHODS: An evidence-based multi-criteria decision analysis model that involved an analytic hierarchy process (AHP) was developed, consisting of nine steps: (1) select the drugs to be reviewed; (2) establish the evaluation criterion system; (3) determine the criterion weight based on the AHP; (4) construct the evidence body for each drug under evaluation; (5) select comparative measures and calculate the original utility score; (6) place a common utility scale and calculate the standardized utility score; (7) calculate the comprehensive utility score; (8) rank the drugs; and (9) perform a sensitivity analysis...
December 15, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29245242/different-evolution-in-the-treatment-of-a-severe-persistent-asthma-in-2-twins-case-report-and-review-of-the-literature
#20
Ileana Ioniuc, Ingrith Miron, Ancuta Ignat, Vasile Valeriu Lupu, Cristina Gavrilovici, Magdalena Starcea, Elena Cristina Mitrofan, Alina Murgu
RATIONALE: Asthma is a multifactorial disease with complex genetic inheritance. In children under the age of 5 years, the diagnosis of asthma is a challenge. PATIENT CONCERN: We present the case of twin sisters under the same treatment for persistent asthma, but with different evolution over the time. DIAGNOSES: One of the sister is diagnosed with severe persistent bronchial asthma associated with bronchiectasis and dyslipidemia and the other one only with mild persistent asthma...
December 2017: Medicine (Baltimore)
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