Latest & greatest articles for asthma

The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on asthma or other clinical topics then use Trip today.

This page lists the very latest high quality evidence on asthma and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

What is Trip?

Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.

As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.

For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com

Top results for asthma

121. Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. (PubMed)

Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. 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.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. Secondary end points included the exacerbation rate and FEV1 in patients with a blood eosinophil count of 300 or more per cubic millimeter. Asthma control and dupilumab safety were also assessed.The annualized rate of severe asthma exacerbations

2018 NEJM

122. Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma. (PubMed)

Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma. Dupilumab is a fully human anti-interleukin-4 receptor α monoclonal antibody that blocks both interleukin-4 and interleukin-13 signaling. Its effectiveness in reducing oral glucocorticoid use in patients with severe asthma while maintaining asthma control is unknown.We randomly assigned 210 patients with oral glucocorticoid-treated asthma to receive add-on dupilumab (at a dose of 300 mg) or placebo every 2 weeks for 24 (...) with glucocorticoid-dependent severe asthma, dupilumab treatment reduced oral glucocorticoid use while decreasing the rate of severe exacerbations and increasing the FEV1. Transient eosinophilia was observed in approximately 1 in 7 dupilumab-treated patients. (Funded by Sanofi and Regeneron Pharmaceuticals; LIBERTY ASTHMA VENTURE ClinicalTrials.gov number, NCT02528214 .).

2018 NEJM

123. Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma. (PubMed)

Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma. 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.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 (...) in the budesonide-formoterol group, and 1282 in the budesonide maintenance group) were included in the full analysis and safety data sets. With respect to the mean percentage of weeks with well-controlled asthma per patient, budesonide-formoterol was superior to terbutaline (34.4% vs. 31.1% of weeks; odds ratio, 1.14; 95% confidence interval [CI], 1.00 to 1.30; P=0.046) but inferior to budesonide maintenance therapy (34.4% and 44.4%, respectively; odds ratio, 0.64; 95% CI, 0.57 to 0.73). The annual rate

2018 NEJM

124. As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. (PubMed)

As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. Patients with mild asthma often rely on inhaled short-acting β2-agonists for symptom relief and have poor adherence to maintenance therapy. Another approach might be for patients to receive a fast-acting reliever plus an inhaled glucocorticoid component on an as-needed basis to address symptoms and exacerbation risk.We conducted a 52-week, double-blind, multicenter trial involving patients 12 years of age or older who (...) had mild asthma and were eligible for treatment with regular inhaled glucocorticoids. Patients were randomly assigned to receive twice-daily placebo plus budesonide-formoterol (200 μg of budesonide and 6 μg of formoterol) used as needed or budesonide maintenance therapy with twice-daily budesonide (200 μg) plus terbutaline (0.5 mg) used as needed. The primary analysis compared budesonide-formoterol used as needed with budesonide maintenance therapy with regard to the annualized rate of severe

2018 NEJM

125. Effectiveness of indoor allergen reduction in asthma management: A systematic review

Effectiveness of indoor allergen reduction in asthma management: A systematic review This review will inform updated National Asthma Education and Prevention Program clinical practice guidelines.We sought to evaluate the effectiveness of allergen reduction interventions on asthma outcomes.We systematically searched the "gray literature" and 5 bibliographic databases. Eligible studies included systematic reviews, randomized controlled trials, and nonrandomized interventional studies. Risk (...) evaluated single-component interventions, and 30 studies assessed multicomponent interventions. Heterogeneity precluded meta-analysis. For most interventions and outcomes, the evidence base was inconclusive or showed no effect. No interventions were associated with improvement in validated asthma control measures or pulmonary physiology. Exacerbations were diminished in multicomponent studies that included HEPA vacuums or pest control (moderate strength of evidence [SOE] for both). Quality of life

2018 EvidenceUpdates

126. 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

2018 NIHR Dissemination Centre

127. Antibiotics are probably of no benefit for acute asthma attack

Antibiotics are probably of no benefit for acute asthma attack 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

2018 NIHR Dissemination Centre

128. 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

2018 NIHR Dissemination Centre

129. 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

2018 NIHR Dissemination Centre

130. 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

2018 NIHR Dissemination Centre

131. 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

2018 NIHR Dissemination Centre

132. 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

2018 NIHR Dissemination Centre

133. 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

2018 NIHR Dissemination Centre

134. A Randomized Trial of Itraconazole vs Prednisolone in Acute-Stage Allergic Bronchopulmonary Aspergillosis Complicating Asthma

A Randomized Trial of Itraconazole vs Prednisolone in Acute-Stage Allergic Bronchopulmonary Aspergillosis Complicating Asthma Whether itraconazole monotherapy is effective in the acute stage of allergic bronchopulmonary aspergillosis (ABPA) remains unknown. The goal of this study was to compare the efficacy and safety of itraconazole and prednisolone monotherapy in ABPA.Treatment-naive subjects with ABPA complicating asthma (January 2012 to December 2013) were randomized to receive either oral

2018 EvidenceUpdates

135. Association of Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists With Asthma Control in Patients With Uncontrolled, Persistent Asthma: A Systematic Review and Meta-analysis. (PubMed)

Association of Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists With Asthma Control in Patients With Uncontrolled, Persistent Asthma: A Systematic Review and Meta-analysis. Long-acting muscarinic antagonists (LAMAs) are a potential adjunct therapy to inhaled corticosteroids in the management of persistent asthma.To conduct a systematic review and meta-analysis of the effects associated with LAMA vs placebo or vs other controllers as an add-on therapy to inhaled corticosteroids (...) corticosteroids or triple therapy vs inhaled corticosteroids and LABA in patients with uncontrolled, persistent asthma reporting on an outcome of interest.Meta-analyses using a random-effects model was conducted to calculate risk ratios (RRs), risk differences (RDs), and mean differences (MDs) with corresponding 95% CIs. Citation screening, data abstraction, risk assessment, and strength-of-evidence grading were completed by 2 independent reviewers.Asthma exacerbations.Of 1326 records identified, 15

Full Text available with Trip Pro

2018 JAMA

136. Association of Inhaled Corticosteroids and Long-Acting β-Agonists as Controller and Quick Relief Therapy With Exacerbations and Symptom Control in Persistent Asthma: A Systematic Review and Meta-analysis. (PubMed)

Association of Inhaled Corticosteroids and Long-Acting β-Agonists as Controller and Quick Relief Therapy With Exacerbations and Symptom Control in Persistent Asthma: A Systematic Review and Meta-analysis. Combined use of inhaled corticosteroids and long-acting β-agonists (LABAs) as the controller and the quick relief therapy termed single maintenance and reliever therapy (SMART) is a potential therapeutic regimen for the management of persistent asthma.To conduct a systematic review and meta (...) -agonists as the relief therapy for patients aged 5 years or older with persistent asthma and reporting on an outcome of interest.Meta-analyses were conducted using a random-effects model to calculate risk ratios (RRs), risk differences (RDs), and mean differences with corresponding 95% CIs. Citation screening, data abstraction, risk assessment, and strength of evidence grading were completed by 2 independent reviewers.Asthma exacerbations.The analyses included 16 randomized clinical trials (N = 22 748

Full Text available with Trip Pro

2018 JAMA

137. Anti-inflammatory and endothelium protective effect of long-term pioglitazone intake in patients suffering from bronchial asthma concurrent with ischemic heart disease. (PubMed)

Anti-inflammatory and endothelium protective effect of long-term pioglitazone intake in patients suffering from bronchial asthma concurrent with ischemic heart disease. Treatment of co-morbidities, including bronchial asthma (BA) and coronary heart disease (CHD), is a relevant issue of modern therapy. The aim of the research is to study the impact of long-term intake of pioglitazone on the development of inflammation and ED in patients with BA concurrent with CHD.The clinical study involved 50 (...) people aged 40-75 who suffered from asthma concurrent with CHD. On the first day of the study, blood samples were collected and clinical examinations were performed, after which patients were randomized and divided into the control group who continued to receive only the standard therapy, and the study group, who received pioglitazone (Pioglar, Ranbaxy, India) 15 mg once a day along with comprehensive therapy. Re-examination was carried out in 6 months.It has been found that inclusion of pioglitazone

2018 Wiadomosci lekarskie (Warsaw, Poland : 1960)

138. Interventions for autumn exacerbations of asthma in children. (PubMed)

Interventions for autumn exacerbations of asthma in children. Asthma exacerbations in school-aged children peak in autumn, shortly after children return to school following the summer holiday. This might reflect a combination of risk factors, including poor treatment adherence, increased allergen and viral exposure, and altered immune tolerance. Since this peak is predictable, interventions targeting modifiable risk factors might reduce exacerbation-associated morbidity and strain upon health (...) resources. The peak occurs in September in the Northern Hemisphere and in February in the Southern Hemisphere.To assess the effects of pharmacotherapy and behavioural interventions enacted in anticipation of school return during autumn that are designed to reduce asthma exacerbations in children during this period.We searched the Cochrane Airways Group Trials Register, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform, reference lists of primary studies

Full Text available with Trip Pro

2018 Cochrane

139. An algorithmic approach for the treatment of severe uncontrolled asthma (PubMed)

An algorithmic approach for the treatment of severe uncontrolled asthma A small subgroup of patients with asthma suffers from severe disease that is either partially controlled or uncontrolled despite intensive, guideline-based treatment. These patients have significantly impaired quality of life and although they constitute <5% of all asthma patients, they are responsible for more than half of asthma-related healthcare costs. Here, we review a definition for severe asthma and present all (...) therapeutic options currently available for these severe asthma patients. Moreover, we suggest a specific algorithmic treatment approach for the management of severe, difficult-to-treat asthma based on specific phenotype characteristics and biomarkers. The diagnosis and management of severe asthma requires specialised experience, time and effort to comprehend the needs and expectations of each individual patient and incorporate those as well as his/her specific phenotype characteristics

Full Text available with Trip Pro

2018 ERJ open research

140. Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations. (PubMed)

Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations. Asthma exacerbations are frightening for patients and are occasionally fatal. We tested the concept that a plan for patients to manage their asthma (self-management plan), which included a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control started to deteriorate, would reduce the incidence of severe asthma exacerbations among adults and adolescents with asthma.We conducted a pragmatic, unblinded (...) , randomized trial involving adults and adolescents with asthma who were receiving inhaled glucocorticoids, with or without add-on therapy, and who had had at least one exacerbation in the previous 12 months. We compared a self-management plan that included an increase in the dose of inhaled glucocorticoids by a factor of 4 (quadrupling group) with the same plan without such an increase (non-quadrupling group), over a period of 12 months. The primary outcome was the time to a first severe asthma

Full Text available with Trip Pro

2018 NEJM