Latest & greatest articles for asthma

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Top results for asthma

141. Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations. (PubMed)

Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations. Asthma exacerbations occur frequently despite the regular use of asthma-controller therapies, such as inhaled glucocorticoids. Clinicians commonly increase the doses of inhaled glucocorticoids at early signs of loss of asthma control. However, data on the safety and efficacy of this strategy in children are limited.We studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma and had had (...) at least one asthma exacerbation treated with systemic glucocorticoids in the previous year. Children were treated for 48 weeks with maintenance low-dose inhaled glucocorticoids (fluticasone propionate at a dose of 44 μg per inhalation, two inhalations twice daily) and were randomly assigned to either continue the same dose (low-dose group) or use a quintupled dose (high-dose group; fluticasone at a dose of 220 μg per inhalation, two inhalations twice daily) for 7 days at the early signs of loss

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2018 NEJM

142. Budesonide/formoterol maintenance and reliever therapy in adolescent patients with asthma

Budesonide/formoterol maintenance and reliever therapy in adolescent patients with asthma Asthma control is often suboptimal in adolescents, but few studies have evaluated asthma treatments in this population.This post hoc analysis assessed the efficacy and safety of budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (MART) for treatment of persistent asthma in adolescent (age 12-17 years) subgroups within six randomised, double-blind trials. The primary end-point was time (...) to first severe exacerbation. Secondary end-points included number of severe exacerbations, asthma-related symptoms, night-time awakenings, morning peak expiratory flow, forced expiratory volume in 1 s, as-needed medication use and five-item asthma control questionnaire scores.In adolescents (n=1847), BUD/FORM MART was similar to or more effective than comparators across each of the studies in reducing the risk of a first severe exacerbation (hazard ratios (HR) BUD/FORM MART versus comparators 0.15

2018 EvidenceUpdates

143. Pilot Clinical Trial of High-Flow Oxygen Therapy in Children with Asthma in the Emergency Service

Pilot Clinical Trial of High-Flow Oxygen Therapy in Children with Asthma in the Emergency Service To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED).This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients (...) hours of treatment in children with moderate-to-severe asthma exacerbation refractory to first-line treatment. Further studies are needed to demonstrate its overall efficacy in the management of asthma and respiratory failure in the ED.EudraCT: 2012-001771-36.Copyright © 2017 Elsevier Inc. All rights reserved.

2018 EvidenceUpdates

144. Effectiveness of Indoor Allergen Reduction in Management of Asthma

Effectiveness of Indoor Allergen Reduction in Management of Asthma Comparative Effectiveness Review Number 201 Effectiveness of Indoor Allergen Reduction in Management of Asthma e12 Comparative Effectiveness Review Number 201 Effectiveness of Indoor Allergen Reduction in Management of Asthma Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00005-I Prepared by: ECRI (...) Institute–Penn Medicine Evidence-based Practice Center Plymouth Meeting, PA Investigators: Brian F. Leas, M.S., M.A., and Kristen E. D’Anci, Ph.D.* Andrea J. Apter, M.D., M.Sc. Tyra Bryant-Stephens, M.D. Karen Schoelles, M.D., S.M. Craig A. Umscheid, M.D., M.S.C.E. *Mr. Leas and Dr. D’Anci contributed equally to this report. AHRQ Publication No. 18-EHC002-EF February 2018 ii Key Messages Purpose of Review To evaluate the effectiveness of indoor allergen reduction interventions on asthma outcomes. Key

2018 Effective Health Care Program (AHRQ)

145. Is There Really a Link between Asthma and Reflux?

Is There Really a Link between Asthma and Reflux? Is There Really a Link between Asthma and Reflux? – Clinical Correlations Search Is There Really a Link between Asthma and Reflux? February 27, 2018 7 min read By Scott Statman, MD Peer Reviewed There is little doubt that an association between asthma and gastroesophageal reflux disease (GERD) exists. However clinicians have debated the nature of this relationship for decades. Asthma and GERD are among the most common disorders encountered (...) by physicians, with 1 and 2 respectively. Studies have shown that up to 80% of 3 and that people with GERD are nearly1.2 times more . 4 This may in fact be an underestimate as , 5 while ambulatory esophageal pH monitoring can detect abnormal acid reflux . 6 There are multiple biologically plausible theories to explain the connection between GERD and its extra-esophageal manifestations such as asthma. 5 The controversy lies in an inability of research to date to demonstrate neither a causal relationship

2018 Clinical Correlations

146. Effect of the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) Program on Asthma Morbidity: A Randomized Clinical Trial

Effect of the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) Program on Asthma Morbidity: A Randomized Clinical Trial Poor adherence to recommended preventive asthma medications is common, leading to preventable morbidity. We developed the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program to build on school-based supervised therapy programs by incorporating telemedicine at school to overcome barriers to preventive asthma care.To evaluate the effect of the SB (...) -TEAM program on asthma morbidity among urban children with persistent asthma.In this randomized clinical trial, children with persistent asthma aged 3 to 10 years in the Rochester City School District in Rochester, New York, were stratified by preventive medication use at baseline and randomly assigned to the SB-TEAM program or enhanced usual care for 1 school year. Participants were enrolled at the beginning of the school year (2012-2016), and outcomes were assessed through the end of the school

2018 EvidenceUpdates

147. Randomized Trial of Dexamethasone Versus Prednisone for Children with Acute Asthma Exacerbations

Randomized Trial of Dexamethasone Versus Prednisone for Children with Acute Asthma Exacerbations To determine whether 2 doses of dexamethasone is as effective as 5 days of prednisolone/prednisone therapy in improving symptoms and quality of life of children with asthma exacerbations admitted to the emergency department (ED).We conducted a randomized, noninferiority trial including patients aged 1-14 years who presented to the ED with acute asthma to compare the efficacy of 2 doses (...) of dexamethasone (0.6 mg/kg/dose, experimental treatment) vs a 5-day course of prednisolone/prednisone (1.5 mg/kg/d, followed by 1 mg/kg/d on days 2-5, conventional treatment). Two follow-up telephone interviews were completed at 7 and 15 days. The primary outcome measures were the percentage of patients with asthma symptoms and quality of life at day 7. Secondary outcomes were unscheduled returns, admissions, adherence, and vomiting.During the study period, 710 children who met the inclusion criteria were

2018 EvidenceUpdates

148. The effect of self-care education on the quality of life in children with allergic asthma. (PubMed)

The effect of self-care education on the quality of life in children with allergic asthma. Asthma is a condition where the airways become tiny and swollen producing extra mucus. This can cause breathing difficulty and wheezing, coughing, and shortness of breath. Self-care education affects the quality of life of children. This study examined the effect of self-care education on quality of life for children between 8 and 11 years with allergic asthma. This study was a randomized controlled trial (...) . Study sample included 70 children between 8 and 11 years with asthma allergy referred to Children's Hospital Clinic of Khorramabad, Lorestan Province in 2015; they were selected by possible non-consecutive sampling method. Children were divided by random sampling of blocks, and classified into two groups of 35 patients each in the experimental and control groups. Both groups were matched for age and sex of children's and parents' educational level and initial quality of life scores were analyzed

2018 Comprehensive child and adolescent nursing

149. Prospective Open-Label Study of 48-Week Subcutaneous Administration of Mepolizumab in Japanese Patients with Severe Eosinophilic Asthma. (PubMed)

Prospective Open-Label Study of 48-Week Subcutaneous Administration of Mepolizumab in Japanese Patients with Severe Eosinophilic Asthma. The long-term efficacy and safety of mepolizumab in patients with severe eosinophilic asthma has been evaluated in large-scale double-blind placebo-controlled trials. However, a prospective open-label trial of long-term subcutaneous administration of mepolizumab has not been performed in Japanese patients with severe eosinophilic asthma.This study (...) was a prospective, 48-week, open-label trial in 32 Japanese patients with severe eosinophilic asthma who received subcutaneous mepolizumab 100 mg every 4 weeks. Nine patients required oral corticosteroids daily despite receiving high-dose inhaled corticosteroids. Six patients had aspirin-exacerbated respiratory disease.All patients took mepolizumab throughout the study period. No patients experienced adverse events during the treatment. None of the patients experienced asthma exacerbations during the trial

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2018 Journal of investigational allergology & clinical immunology

150. The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management

The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management Comparative Effectiveness Review Number 197 The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management Evidence Summary Objectives and Rationale for the Review This report summarizes a systematic review on “The Clinical Utility of Fractional Exhaled Nitric Oxide in Asthma Management”. This was one of the 6 high priority topics within asthma identified by an NHLBI Advisory Council Asthma (...) Expert Working group. 1 Background The diagnosis of asthma is a clinical diagnosis and is challenging without a criterion standard test. Fractional exhaled nitric oxide (FeNO) testing has been suggested as a diagnostic test for asthma. It has also been studied as a tool that aids in selecting asthma treatments, predicting response to therapy (e.g., inhaled corticosteroids) and for monitoring the response to therapy. In young children with recurrent wheezing, FeNO may predict the ones who are likely

2018 Effective Health Care Program (AHRQ)

151. Association Between Inhaled Corticosteroid Use and Bone Fracture in Children With Asthma

Association Between Inhaled Corticosteroid Use and Bone Fracture in Children With Asthma Daily use of inhaled corticosteroids is a widely recommended treatment for mild persistent asthma in children. There is concern that, similar to systemic corticosteroids, inhaled corticosteroids may have adverse effects on bone health.To determine whether there is an increased risk of bone fracture associated with inhaled corticosteroid use in children with asthma.In this population-based nested case (...) -control study, we used health administrative databases to identify a cohort of children aged 2 to 18 years with a physician diagnosis of asthma between April 1, 2003, and March 31, 2014, who were eligible for public drug coverage through the Ontario Drug Benefit Program (Ontario, Canada). We matched cases of first fracture after asthma diagnosis to fracture-free controls (ratio of 1 to 4) based on date of birth (within 1 year), sex, and age at asthma diagnosis (within 2 years). We used a 1-year

2018 EvidenceUpdates

152. Omalizumab (Xolair) PBS listed for use in children with asthma

Omalizumab (Xolair) PBS listed for use in children with asthma Omalizumab (Xolair) PBS listed for use in children with asthma - NPS MedicineWise Log In Menu Featured topics Professional development Publications An independent peer-reviewed journal providing critical commentary on drugs and therapeutics. Timely, independent, evidence-based information on new drugs and medical tests, and changes to the PBS and MBS. Featured topics Talk to a professional Information for consumers on prescription (...) and consumers. Featured resources 4 February 2019 4 February 2019 18 October 2018 Featured topic 20 years of helping Australians make better decisions about medicines, medical tests and other health technologies Partner with us Latest projects Search Search Search Search POPULAR Log in Log in All fields are required Email address* Password* Log in Breadcrumb And Text Resize Omalizumab (Xolair) PBS listed for use in children with asthma Omalizumab (Xolair) PBS listed for use in children with asthma 3 min

2018 National Prescribing Service Limited (Australia)

153. Benralizumab (Fasenra) - For add-on maintenance treatment of patients with severe asthma aged 12 years and older, and with an eosinophilic phenotype

Benralizumab (Fasenra) - For add-on maintenance treatment of patients with severe asthma aged 12 years and older, and with an eosinophilic phenotype Fasenra (benralizumab) 30 mg/mL Injection U.S. Department of Health and Human Services Search FDA Submit search Fasenra (benralizumab) 30 mg/mL Injection Fasenra Company: AstraZeneca Pharmaceuticals LP Application No.: 761070 Approval Date: 11/14/2017 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634

2018 FDA - Drug Approval Package

154. Effect of an Intervention to Promote Breastfeeding on Asthma, Lung Function, and Atopic Eczema at Age 16 Years: Follow-up of the PROBIT Randomized Trial

Effect of an Intervention to Promote Breastfeeding on Asthma, Lung Function, and Atopic Eczema at Age 16 Years: Follow-up of the PROBIT Randomized Trial Atopic diseases, including asthma and atopic eczema, are the most common chronic conditions of childhood.To investigate whether an intervention to promote prolonged and exclusive breastfeeding protects against asthma, atopic eczema, and low lung function in adolescence.Follow-up of the Promotion of Breastfeeding Intervention Trial (PROBIT (...) outcomes; secondary outcomes were self-reported asthma diagnosis ever, and wheezing and flexural eczema symptoms in the previous year.A total of 13 557 (79.5%) participants were followed up from September 15, 2012 to July 15, 2015. The intervention (7064 [79.7%]) and control (6493 [79.4%]) groups were similar at follow-up (3590 [50.8%] and 3391 [52.2%] male; mean [SD] age, 16.2 [0.6] and 16.1 [0.5] years, respectively). In the intervention group, 0.3% (21 of 7064) had flexural eczema on skin

2018 EvidenceUpdates

155. Acute asthma exacerbation in adults

Acute asthma exacerbation in adults Acute asthma exacerbation in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acute asthma exacerbation in adults Last reviewed: February 2019 Last updated: June 2018 Summary Presents as an acute or subacute episode of progressive worsening of symptoms, such as shortness of breath, wheezing, cough, and chest tightness. Pulse rate, respiratory rate, subjective assessment (...) , mechanical ventilation. Pneumonia, pneumothorax, pneumomediastinum, and respiratory failure are complications. Definition An asthma exacerbation is an acute or subacute episode of progressive worsening of symptoms of asthma, including shortness of breath, wheezing, cough, and chest tightness. Exacerbations are marked by decreases from baseline in objective measures of pulmonary function, such as peak expiratory flow rate and FEV1. History and exam presence of risk factors cough wheezing shortness

2018 BMJ Best Practice

156. Asthma in adults

Asthma in adults Asthma in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Asthma in adults Last reviewed: February 2019 Last updated: June 2018 Summary Patients present with recurrent episodes of shortness of breath, chest tightness, wheezing, or coughing. Examination typically demonstrates an expiratory wheeze; however, in severe asthma there is poor air entry and the chest is silent. Treatment is step-wise (...) , based on symptoms. Patients may need to monitor their peak expiratory flow daily and should be aware of the warning signs of a severe attack. Some patients may develop progressive, irreversible obstructive lung disease. Definition Asthma is a chronic inflammatory airway disease characterised by intermittent airway obstruction and hyper-reactivity. Many cellular components are involved in the asthmatic pathway, including mast cells, eosinophils, T lymphocytes, macrophages, neutrophils, and epithelial

2018 BMJ Best Practice

157. Occupational asthma

Occupational asthma Occupational asthma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Occupational asthma Last reviewed: February 2019 Last updated: September 2018 Summary Should be suspected in all adult patients with asthma. An occupational history should be taken to identify work-related causes. Details of work exposures should be obtained from material safety data sheets and other material available (...) to the patient from their workplace. Objective evidence of asthma should be obtained from spirometry, a bronchodilator response, and/or a methacholine challenge. Tests should be performed when the patient is symptomatic and/or within days of having exposure to a suspected aetiological agent. If sensitiser-induced occupational asthma is suspected, additional testing of asthma should be done, preferably while the patient is still working. Whenever possible an immunological response to a suspected work

2018 BMJ Best Practice

158. Acute asthma exacerbation in children

Acute asthma exacerbation in children Acute asthma exacerbation in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acute asthma exacerbation in children Last reviewed: February 2019 Last updated: July 2018 Summary Asthma exacerbations present with acute or sub-acute onset of wheeze and respiratory distress, the symptoms and signs of which vary depending on the developmental and maturational age of the child (...) , intravenous bronchodilators, and intramuscular adrenaline (if anaphylaxis is present). Severe and life-threatening cases may require non-invasive ventilation or intubation, and the intensive care team should be involved as early as possible. In children not responding to standard asthmatic treatment, other differential diagnoses should be considered. On discharge from hospital, a clear asthma management plan and asthma education is essential to optimise asthma control and prevent future exacerbations

2018 BMJ Best Practice

159. Asthma in children

Asthma in children Asthma in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Asthma in children Last reviewed: February 2019 Last updated: July 2018 Summary As paediatric asthma differs from adult asthma, child-specific asthma guidelines should be used and adult and adolescent guidelines should not be extrapolated to younger age groups. The prevalence of childhood asthma appears to have plateaued in many (...) affluent countries. However, asthma remains a significant cause of childhood morbidity and mortality, and is still a common problem managed in ambulatory and emergency care settings. Most children with asthma have mild intermittent asthma and do not require daily therapy. Minimum doses and medications for maximal control should be used in those who require preventative therapies. Therapy should be individualised. A number of important differential diagnoses, adherence and environmental issues should

2018 BMJ Best Practice

160. Chronic Asthma

Chronic Asthma CHRONIC ASTHMA Clinical Practice Guideline | April 2018 These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making. OBJECTIVE Alberta clinicians will adopt a comprehensive patient-centred interdisciplinary team approach to asthma management including diagnosis, assessing control, treating (...) and preventing exacerbation and ongoing follow-up. TARGET POPULATION Adults and children >6 years old, with important considerations for preschool aged children. EXCLUSIONS Asthma in acute care settings; asthma-COPD overlap; detailed management for preschool ages. RECOMMENDATIONS HISTORY AND EXAM ? Patients with asthma present with a range of clinical findings, arising from a shared core of intermittent inflammation and bronchoconstriction (Table 1). ? It is important to determine the appropriate diagnosis

2018 Toward Optimized Practice