Latest & greatest articles for asthma

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Top results for asthma

21. Mepolizumab (Nucala) - severe refractory eosinophilic asthma in adolescents and children aged 6 years and older

Mepolizumab (Nucala) - severe refractory eosinophilic asthma in adolescents and children aged 6 years and older Final Appraisal Recommendation Advice No: 0619 – April 2019 Mepolizumab (Nucala ® ) 100 mg powder for solution for injection Limited submission by GlaxoSmithKline UK Additional note(s): • Please refer to the Summary of Product Characteristics for the full licensed indication. In reaching the above recommendation AWMSG has taken account of the appraisal documentation prepared (...) ) is recommended as an option for restricted use within NHS Wales. Mepolizumab (Nucala ® ) is licensed as an add-on treatment for severe refractory eosinophilic asthma in adolescents and children aged 6 years and older. Mepolizumab (Nucala ® ) is restricted for use in a subpopulation of the licensed indication in line with the National Institute of Health and Care Excellence recommendation for the restricted use of mepolizumab for treating severe refractory eosinophilic asthma in adults (TA431). Mepolizumab

2019 All Wales Medicines Strategy Group

22. Mepolizumab (Nucala) - as an add-on treatment for severe refractory eosinophilic asthma in adolescents and children aged 6 years and older

Mepolizumab (Nucala) - as an add-on treatment for severe refractory eosinophilic asthma in adolescents and children aged 6 years and older Published 08 April 2019 1 Product update SMC2139 mepolizumab 100mg powder for solution for injection (Nucala®) GlaxoSmithKline UK Limited 8 March 2019 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice (...) is summarised as follows: ADVICE: following an abbreviated submission mepolizumab (Nucala®) is accepted for restricted use within NHSScotland. Indication under review: as an add-on treatment for severe refractory eosinophilic asthma in adolescents and children aged 6 years and older. SMC restriction: patients who have eosinophils of at least 150 cells per microlitre (0.15 x 10 9 /L) at initiation of treatment and have had at least four asthma exacerbations in the preceding year or are receiving maintenance

2019 Scottish Medicines Consortium

23. Benralizumab (asthma) - Benefit assessment according to §35a Social Code Book V

Benralizumab (asthma) - Benefit assessment according to §35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Benralizumab (Asthma) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 9 May 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. IQWiG Reports – Commission No. A18-11 Benralizumab (asthma) – Benefit (...) assessment according to §35a Social Code Book V 1 Extract of dossier assessment A18-11 Version1.0 Benralizumab (asthma) 9 May 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Benralizumab (asthma) – Benefit assessment according to §35a Social Code Book V Commissioning agency: Federal Joint Committee Commission awarded on: 15 February 2018 Internal Commission No.: A18-11 Address of publisher

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

24. Benralizumab (asthma) - Addendum to Commission A18-11

Benralizumab (asthma) - Addendum to Commission A18-11 1 Translation of addendum A18-42 Benralizumab (Asthma) – Addendum zum Auftrag A18-11 (Version 1.0; Status: 13 July 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. Addendum 13 July 2018 1.0 Commission: A18-42 Version: Status: IQWiG Reports – Commission No. A18-42 Benralizumab (asthma) – Addendum (...) to Commission A18-11 1 Addendum A18-42 Version 1.0 Benralizumab – Addendum to Commission A18-11 13 July 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Benralizumab (asthma) – Addendum to Commission A18-11 Commissioning agency: Federal Joint Committee Commission awarded on: 26 June 2018 Internal Commission No.: A18-42 Address of publisher: Institut für Qualität und Wirtschaftlichkeit im

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

25. Sublingual allergen immunotherapy with a liquid birch pollen product in patients with seasonal allergic rhinoconjunctivitis with or without asthma

Sublingual allergen immunotherapy with a liquid birch pollen product in patients with seasonal allergic rhinoconjunctivitis with or without asthma Sublingual allergen immunotherapy (SLIT) has been demonstrated to be both clinically efficacious and safe. However, in line with the current regulatory guidance from the European Medicines Agency, allergen immunotherapy (AIT) products must demonstrate their efficacy and safety in pivotal phase III trials for registration.We sought to investigate (...) the efficacy and safety of sublingual high-dose liquid birch pollen extract (40,000 allergy units native [AUN]/mL) in adults with birch pollen allergy.A randomized, double-blind, placebo-controlled, parallel-group multicenter trial was conducted in 406 adult patients with moderate-to-severe birch pollen-induced allergic rhinoconjunctivitis with or without mild-to-moderate controlled asthma. Treatment was started 3 to 6 months before the birch pollen season and continued during the season in 40 clinical

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2019 EvidenceUpdates

26. Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma

Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma Long-term oral corticosteroid (OCS) use in patients with severe asthma is associated with significant adverse effects.This 40-week, randomised, double-blind trial evaluated the OCS-sparing potential of tralokinumab in patients with severe, uncontrolled asthma requiring maintenance OCS treatment plus inhaled corticosteroids/long-acting β2-agonists. Overall, 140 patients were randomised to tralokinumab 300 mg (...) or placebo (n=70 in each group) administered subcutaneously every 2 weeks. The primary end-point was percentage change from baseline in average OCS dose at week 40, while maintaining asthma control. Secondary end-points included proportion of patients with a prescribed maintenance OCS dose of ≤5 mg, those with a ≥50% reduction in prescribed maintenance OCS dose and asthma exacerbation rate. Safety was also assessed.At week 40, the percentage reduction from baseline in the final daily average OCS dose

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2019 EvidenceUpdates

27. Effectiveness of school-based self-management interventions for asthma among children and adolescents: findings from a Cochrane systematic review and meta-analysis

Effectiveness of school-based self-management interventions for asthma among children and adolescents: findings from a Cochrane systematic review and meta-analysis The evidence that teaching self-management techniques to children and young people with asthma in schools is effective has not, to date, been the subject of systematic review.We conducted a systematic review of intervention studies. Studies were eligible if they employed a randomised parallel-group design and were published (...) in English from 1995 onwards. Participants included children with asthma aged 5-18 years who participated within their own school environment. Searches were conducted on the Cochrane Airways Group Specialised Register. Quantitative data were combined using random-effects meta-analyses.Thirty-three outcome evaluation studies were included. School-based interventions were effective in reducing the frequency of emergency department visits (OR 0.70, 95% CI 0.53 to 0.92; studies=13), and moderately effective

2019 EvidenceUpdates

28. Benralizumab for treating severe eosinophilic asthma

Benralizumab for treating severe eosinophilic asthma Benr Benralizumab for treating se alizumab for treating sev vere ere eosinophilic asthma eosinophilic asthma T echnology appraisal guidance Published: 6 March 2019 www.nice.org.uk/guidance/ta565 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights). Last updated September 2019Y Y our responsibility our responsibility The recommendations in this guidance represent (...) inequalities. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Benralizumab for treating severe eosinophilic asthma (TA565) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Last updated September 2019 Page 2 of 23Contents Contents 1 Recommendations 4 2

2019 National Institute for Health and Clinical Excellence - Technology Appraisals

29. Breathing exercises improve asthma and can be learned by DVD

Breathing exercises improve asthma and can be learned by DVD Breathing exercises improve asthma and can be learned by DVD Discover Portal Discover Portal Breathing exercises improve asthma and can be learned by DVD Published on 7 November 2017 doi: Breathing exercises taught by a physiotherapist in person or on DVD both improved the quality of life of adults with poorly controlled asthma to a small but similar extent. The DVD was the cheapest option, and it could lead to inexpensive internet (...) delivery in the future. This NIHR-funded trial recruited 655 UK adults with poorly controlled asthma. It showed about 63% of those receiving the breathing exercises had clinically important improvements in their asthma-related quality of life over a year, compared to 56% who improved receiving usual care. Exercises did not improve formally measured lung function, suggesting the underlying biology of the asthma was unchanged. The findings imply that breathing exercise programmes – currently recommended

2019 NIHR Dissemination Centre

30. Asthma self-management programmes can reduce unscheduled care

Asthma self-management programmes can reduce unscheduled care Asthma self-management programmes can reduce unscheduled care Discover Portal Discover Portal Asthma self-management programmes can reduce unscheduled care Published on 20 June 2017 doi: People with asthma who receive supported self-management are less likely to attend A&E or be admitted to hospital. The interventions are unlikely to increase overall costs for healthcare services. Those who self-manage are also likely to have more (...) controlled asthma and a better quality of life. This extensive overview of systematic reviews included evidence from 270 randomised controlled trials exploring the effects of asthma self-management on healthcare utilisation and costs. Self-management programmes were slightly more expensive, but this cost was likely to be offset by reducing unplanned medical visits and improving patient quality of life. Trials covered different self-care education programmes delivered in a range of contexts. However

2019 NIHR Dissemination Centre

31. Vitamin D supplements can reduce risk of asthma attacks

Vitamin D supplements can reduce risk of asthma attacks Vitamin D supplements can reduce risk of asthma attacks Discover Portal Discover Portal Vitamin D supplements can reduce risk of asthma attacks Published on 6 December 2016 doi: People with mild to moderate asthma experience fewer severe asthma attacks if they take vitamin D supplements. This review found that the average number of asthma attacks was equivalent to about one every four years in those taking vitamin D, compared to nearly one (...) every two years in those taking a placebo. Half as many people attended hospital for asthma treatment each year when taking vitamin D (3%) compared with those not taking vitamin D (6%). These reductions were clinically and statistically significant. There are a few unknowns still. It’s not clear if these results apply to everyone or just those with low levels of vitamin D. Also, these results apply to adults with mild to moderate asthma when taken alongside their usual asthma medication. The effects

2019 NIHR Dissemination Centre

32. Study shows no benefit of an antibiotic for acute asthma

Study shows no benefit of an antibiotic for acute asthma Study shows no benefit of an antibiotic for acute asthma Discover Portal Discover Portal Study shows no benefit of an antibiotic for acute asthma Published on 21 December 2016 doi: The antibiotic azithromycin did not reduce symptoms or change other outcomes in adults seeking emergency care for an acute asthma attack. However people not already taking antibiotics were hard to find and the trial failed to enrol enough people to answer (...) the research question. In this UK-based trial, people with asthma who received azithromycin on top of standard treatment with corticosteroids had no better symptoms ten days later than people who received corticosteroids alone. Almost half of almost 4,600 potential participants had already been given antibiotics. This study shows that many people are being prescribed antibiotics to treat an asthma attack despite British guidance stating that antibiotics should not be routinely used. This raises questions

2019 NIHR Dissemination Centre

33. The nitric oxide breath test offers little benefit when monitoring asthma

The nitric oxide breath test offers little benefit when monitoring asthma The nitric oxide breath test offers little benefit when monitoring asthma Discover Portal Discover Portal The nitric oxide breath test offers little benefit when monitoring asthma Published on 10 January 2017 doi: Using exhaled nitric oxide levels to guide the dose of asthma medication at regular clinic visits may reduce flare-ups but does not improve overall symptoms or quality of life. In this review hospitalisations (...) and the total inhaled steroid doses were unaffected by the intervention. Measuring the amount of fractional exhaled nitric oxide (FeNO) in the breath of people with asthma detects lung inflammation. If inflammation increases, this may indicate that a flare-up is likely and preventative action can be taken. The aim is to ensure medication corresponds to symptom severity, the ideal being the minimum dose needed to control symptoms. The usual monitoring strategy consists of subjective (such as self-reporting

2019 NIHR Dissemination Centre

34. GP letter to improve medication adherence did not reduce unplanned care for children with asthma

GP letter to improve medication adherence did not reduce unplanned care for children with asthma GP letter to improve medication adherence did not reduce unplanned care for children with asthma Discover Portal Discover Portal GP letter to improve medication adherence did not reduce unplanned care for children with asthma Published on 14 March 2017 doi: A one-off GP letter reminding parents of children with asthma to use their medications over the August summer holiday did not prevent (...) a characteristic annual peak in unplanned care on returning to school in September, but did lead to more prescriptions. Unplanned care represents visits to the GP or accident and emergency that is not part of the child’s asthma care plan. They do not include scheduled medical review or visits for repeat prescriptions. The letter prompted about a third more parents to collect inhaler prescriptions in August than parents receiving no letter. But this failed to reduce the high proportion of children receiving

2019 NIHR Dissemination Centre

35. Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children

Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Discover Portal Discover Portal Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Published on 22 November 2016 doi: Regular daily steroid inhalers reduce the number of severe asthma exacerbations requiring soluble tablets or injections in wheezing preschool children by about a third. Intermittent (...) high-dose steroid inhalers, given only when symptoms of a cold begin, were also effective for children with occasional asthma or wheezing triggered by a virus. This strategy may reduce the overall dose of steroids given to these children, though adverse effects may still occur. Wheezing is initially treated with a β2 agonist inhaler which opens up the airways. UK guidelines recommend adding in a daily low-dose steroid inhaler if symptoms are persistent, which is in keeping with the findings

2019 NIHR Dissemination Centre

36. Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks

Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks Discover Portal Discover Portal Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks Published on 30 May 2017 doi: Using a combination of two inhaled drugs to open the airways may modestly reduce the need to admit an adult with asthma attack to hospital, though (...) the underlying evidence is weak. The first-line treatment for an asthma attack is an inhaled β2 agonist, like salbutamol. This Cochrane review compared emergency department treatment with this drug alone, or combined with an inhaled short-acting anticholinergic, like ipratropium bromide. Pooled results from 16 trials included found that combination therapy would mean about 65 fewer patients per 1000 are admitted to hospital. As most underlying trials were conducted outside the NHS, the admission rates

2019 NIHR Dissemination Centre

37. Increasing inhaled steroids for short periods reduces asthma exacerbations

Increasing inhaled steroids for short periods reduces asthma exacerbations Asthma exacerbations can be reduced by increasing inhaled steroids for short periods Discover Portal Discover Portal Increasing inhaled steroids for short periods reduces asthma exacerbations Published on 17 July 2018 doi: Taking four times the usual dose of inhaled corticosteroids for up to two weeks can modestly reduce the chance of asthma worsening. This NIHR-funded trial assessed increasing the inhaled corticosteroid (...) dose compared with staying on the usual dose, as part of a self-management plan. Participants were adults and adolescents with uncontrolled asthma and had at least one exacerbation needing additional medical attention in the year before the trial. Quadrupling the inhaled corticosteroid dose when asthma worsens is already recommended by NICE guidance, but previously there was little research evidence to support the clinical practice. What there was, suggested that doubling the dose of inhaled

2019 NIHR Dissemination Centre

38. School-based self-management interventions for asthma in children and adolescents: a mixed methods systematic review. (PubMed)

School-based self-management interventions for asthma in children and adolescents: a mixed methods systematic review. Asthma is a common respiratory condition in children that is characterised by symptoms including wheeze, shortness of breath, chest tightness, and cough. Children with asthma may be able to manage their condition more effectively by improving inhaler technique, and by recognising and responding to symptoms. Schools offer a potentially supportive environment for delivering (...) interventions aimed at improving self-management skills among children. The educational ethos aligns with skill and knowledge acquisition and makes it easier to reach children with asthma who do not regularly engage with primary care. Given the multi-faceted nature of self-management interventions, there is a need to understand the combination of intervention features that are associated with successful delivery of asthma self-management programmes.This review has two primary objectives.• To identify

2019 Cochrane

39. Association of age at first severe RSV disease with subsequent risk of severe asthma: a population-based cohort study

Association of age at first severe RSV disease with subsequent risk of severe asthma: a population-based cohort study In a population-based cohort study we determined the association between age at first severe respiratory syncytial viral (RSV) disease and subsequent asthma.Incidence rates and rate ratios of first asthma hospitalisation beyond 2 years of age in children with RSV hospitalisation at <3 months, 3 - <6 months, 6 - <12 months, and 12 - 24 months were calculated.The incidence/1000 (...) child - years (95% CI) of asthma hospitalisation in children who had RSV hospitalisation at <3 months was 0.5 (0.2 - 0.7), 3 - <6 months was 0.9 (0.5 - 1.3), 6 - <12 months was 2.0 (1.4 - 2.7) and 12 - 24 months was 1.7 (1.0 - 2.5). The rate ratio of asthma hospitalisation was 2 - 7 fold greater in children who had RSV hospitalisation at ages ≥6 months compared to those who had RSV at ages 0-<6 months.Although burden of RSV is highest in children aged <6 months, the burden of subsequent asthma

2019 EvidenceUpdates

40. Matching-adjusted indirect comparison of benralizumab versus interleukin-5 inhibitors for the treatment of severe asthma: a systematic review

Matching-adjusted indirect comparison of benralizumab versus interleukin-5 inhibitors for the treatment of severe asthma: a systematic review Benralizumab is an interleukin-5 receptor α-directed cytolytic monoclonal antibody that directly depletes eosinophils. Its relative efficacy versus other IL-5-targeted treatments for patients with severe, uncontrolled asthma is not yet fully characterised.We performed a matching-adjusted indirect comparison (MAIC) of benralizumab versus mepolizumab (...) populations. When baseline patient characteristics were matched across asthma trials, benralizumab and mepolizumab yielded similar efficacy.Copyright ©ERS 2018.

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2019 EvidenceUpdates