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Step-Up Therapy in Black Children and Adults with Poorly Controlled Asthma. Morbidity from asthma is disproportionately higher among black patients than among white patients, and black patients constitute the minority of participants in trials informing treatment. Data indicate that patients with inadequately controlled asthma benefit more from addition of a long-acting beta-agonist (LABA) than from increased glucocorticoids; however, these data may not be informative for treatment in black (...) patients.We conducted two prospective, randomized, double-blind trials: one involving children and the other involving adolescents and adults. In both trials, the patients had at least one grandparent who identified as black and had asthma that was inadequately controlled with low-dose inhaled glucocorticoids. We compared combinations of therapy, which included the addition of a LABA (salmeterol) to an inhaled glucocorticoid (fluticasone propionate), a step-up to double to quintuple the dose
Inhaled steroids with and without regular formoterol for asthma: serious adverse events. Epidemiological evidence has suggested a link between beta2-agonists and increases in asthma mortality. There has been much debate about whether regular (daily) long-acting beta2-agonists (LABA) are safe when used in combination with inhaled corticosteroids (ICS). This updated Cochrane Review includes results from two large trials that recruited 23,422 adolescents and adults mandated by the US Food and Drug (...) Administration (FDA).To assess the risk of mortality and non-fatal serious adverse events (SAEs) in trials that randomly assign participants with chronic asthma to regular formoterol and inhaled corticosteroids versus the same dose of inhaled corticosteroid alone.We identified randomised trials using the Cochrane Airways Group Specialised Register of trials. We checked websites of clinical trial registers for unpublished trial data as well as FDA submissions in relation to formoterol. The date of the most
Budesonide-formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild to moderate asthma (PRACTICAL): a 52-week, open-label, multicentre, superiority, randomised controlled trial. In adults with mild asthma, a combination of an inhaled corticosteroid with a fast-onset long-acting β-agonist (LABA) used as reliever monotherapy reduces severe exacerbations compared with short-acting β-agonist (SABA) reliever therapy. We investigated the efficacy (...) of combination budesonide-formoterol reliever therapy compared with maintenance budesonide plus as-needed terbutaline.We did a 52-week, open-label, parallel-group, multicentre, superiority, randomised controlled trial at 15 primary care or hospital-based clinical trials units and primary care practices in New Zealand. Participants were adults aged 18-75 years with a self-reported doctor's diagnosis of asthma who were using SABA for symptom relief with or without maintenance low to moderate doses of inhaled
2019LancetControlled trial quality: predicted high
myAsthma for the management of asthma in adults and adolescents myAsthma app - Health Technology Wales > myAsthma app myAsthma app Topic Status Complete myAsthma for the management of asthma in adults and adolescents. Summary Health Technology Wales researchers searched for evidence on the effectiveness of myAsthma as a self-management tool for people with asthma. HTW’s Assessment Group concluded not to progress this topic further, because there is very limited evidence on the use
British guideline on the management of asthma SIGN158 British guideline on the management of asthma A national clinical guideline First published 2003 Revised edition published July 2019Key to evidence statements and recommendations Levels of evidence 1 ++ High-quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 – Meta-analyses, systematic reviews, or RCTs with a high risk (...) (www.sign.ac.uk/sign-50). More information on accreditation can be viewed at www.evidence.nhs.ukBritish guideline on the management of asthma A national clinical guideline First published 2003 Revised edition published July 2019 Scottish Intercollegiate Guidelines Network British Thoracic Society 978-1-909103-70-2 First published 2003 Revised edition published July 2019 Scottish Intercollegiate Guidelines Network Gyle Square, 1 South Gyle Crescent Edinburgh EH12 9EB www.sign.ac.uk British Thoracic Society 17
One or Two Dose Steroid Regimens for Adult Asthma Exacerbation One of Two Dose Steroid Regimens for Adult Asthma Exacerbation | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search Vignette It’s a cold, blustery winter day in the local community emergency department where you’ve been moonlighting. You’ve seen half a dozen patients with Flu (...) A and just as many viral upper respiratory infections in the three hours you’ve been on shift. Your next patients is Mr. Z, a thirty-year-old with a history of asthma, who presents with a runny nose, nonproductive cough, and increased wheezing over the last 2 days. He has had some mild relief with his home albuterol MDI and is on no other meds. On exam, he has diffuse expiratory wheezes with an oxygen saturation of 97% on room air. He is no distress, is speaking in full sentences, and has an otherwise
Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Asthma is a common chronic airway disease worldwide. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of asthma. We therefore aimed to estimate the national prevalence of asthma in a representative sample of the Chinese population.A representative sample of 57 779 adults aged 20 years or older was recruited (...) . Asthma was determined on the basis of a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. All participants were assessed with a standard asthma questionnaire and were classed as having or not having airflow limitation through pulmonary function tests before and after the use of a bronchodilator (400 μg of salbutamol). Risk factors for asthma were examined by multivariable-adjusted analyses done in all participants for whom data on the variables
Fluticasone/formoterol (Flutiform) - the regular treatment of asthma in children aged 5 to 12 years 1 Published 10 June 2019 1 Product update SMC2178 fluticasone propionate/formoterol fumarate metered dose inhaler 50 microgram/5 microgram (flutiform®) Napp Pharmaceuticals Ltd 10 May 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 fluticasone propionate/formoterol fumarate (flutiform®) is accepted for use within NHSScotland. Indication under review: the regular treatment of asthma in children aged 5 to 12 years where the use of a combination product (an inhaled corticosteroid and a long-acting ß 2 agonist) is appropriate: • For patients not adequately controlled with inhaled corticosteroids and 'as required' inhaled short-acting ß 2 agonist. Or • For patients
Benralizumab (Fasenra) - treatment in adult patients with severe eosinophilic asthma 1 Published 10 June 2019 1 SMC2155 benralizumab 30mg solution for injection in pre filled syringe (Fasenra®) AstraZeneca UK Limited 10 May 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 a full submission (...) benralizumab (Fasenra ® ) is accepted for restricted use within NHSScotland. Indication under review: As an add-on maintenance treatment in adult patients with severe eosinophilic asthma inadequately controlled despite high-dose inhaled corticosteroids plus long-acting ß-agonists. SMC restriction: patients with blood eosinophils =150 cells/microlitre, and either =4 prior asthma exacerbations needing systemic corticosteroids in the previous 12 months or treatment with continuous oral corticosteroids over
Mometasone or Tiotropium in Mild Asthma with a Low Sputum Eosinophil Level. In many patients with mild, persistent asthma, the percentage of eosinophils in sputum is less than 2% (low eosinophil level). The appropriate treatment for these patients is unknown.In this 42-week, double-blind, crossover trial, we assigned 295 patients who were at least 12 years of age and who had mild, persistent asthma to receive mometasone (an inhaled glucocorticoid), tiotropium (a long-acting muscarinic (...) antagonist), or placebo. The patients were categorized according to the sputum eosinophil level (<2% or ≥2%). The primary outcome was the response to mometasone as compared with placebo and to tiotropium as compared with placebo among patients with a low sputum eosinophil level who had a prespecified differential response to one of the trial agents. The response was determined according to a hierarchical composite outcome that incorporated treatment failure, asthma control days, and the forced expiratory
Controlled Trial of Budesonide-Formoterol as Needed for Mild Asthma. In double-blind, placebo-controlled trials, budesonide-formoterol used on an as-needed basis resulted in a lower risk of severe exacerbation of asthma than as-needed use of a short-acting β2-agonist (SABA); the risk was similar to that of budesonide maintenance therapy plus as-needed SABA. The availability of data from clinical trials designed to better reflect clinical practice would be beneficial.We conducted a 52-week (...) , randomized, open-label, parallel-group, controlled trial involving adults with mild asthma. Patients were randomly assigned to one of three treatment groups: albuterol (100 μg, two inhalations from a pressurized metered-dose inhaler as needed for asthma symptoms) (albuterol group); budesonide (200 μg, one inhalation through a Turbuhaler twice daily) plus as-needed albuterol (budesonide maintenance group); or budesonide-formoterol (200 μg of budesonide and 6 μg of formoterol, one inhalation through
Association of Changes in Air Quality With Incident Asthma in Children in California, 1993-2014. Exposure to air pollutants is a well-established cause of asthma exacerbation in children; whether air pollutants play a role in the development of childhood asthma, however, remains uncertain.To examine whether decreasing regional air pollutants were associated with reduced incidence of childhood asthma.A multilevel longitudinal cohort drawn from 3 waves of the Southern California Children's Health (...) Study over a period of air pollution decline. Each cohort was followed up from 4th to 12th grade (8 years): 1993-2001, 1996-2004, and 2006-2014. Final follow-up for these data was June 2014. Population-based recruitment was from public elementary schools. A total of 4140 children with no history of asthma and residing in 1 of 9 Children's Health Study communities at baseline were included.Annual mean community-level ozone, nitrogen dioxide, and particulate matter less than 10 μm (PM10) and less than
Standardized Library of Asthma Outcome Measures Research White Paper Standardized Library of Asthma Outcome MeasuresResearch White Paper Standardized Library of Asthma Outcome Measures Prepared for: Agency for Healthcare Research and Quality Center for Outcomes and Evidence 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2014-00004-C Prepared by: L&M Policy Research, LLC Washington, DC 20009 With partners: OM1, AcademyHealth Investigators: Richard E. Gliklich, MD 1 Michelle (...) . For assistance contact firstname.lastname@example.org. Suggested citation: Gliklich RE, Leavy MB, Li F. Standardized Library of Asthma Outcome Measures. Research White Paper. (Prepared by L&M Policy Research, LLC under Contract No. 290-2014-00004-C.) AHRQ Publication No. 19-EHC004-EF. Rockville, MD: Agency for Healthcare Research and Quality; April 2019. Posted final reports are located on the Effective Health Care Program search page. DOI: https://doi.org/10.23970/AHRQEPCLIBRARYASTHMA. iii Preface The Agency
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
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
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
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
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
High-Dose Vitamin D Supplementation During Pregnancy and Asthma in Offspring at the Age of 6 Years. 30860552 2019 03 25 2019 09 12 1538-3598 321 10 2019 03 12 JAMA JAMA High-Dose Vitamin D Supplementation During Pregnancy and Asthma in Offspring at the Age of 6 Years. 1003-1005 10.1001/jama.2019.0052 Brustad Nicklas N Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte University Hospital, Copenhagen, Denmark. Eliasen Anders U AU Copenhagen Prospective Studies on Asthma (...) in Childhood, Herlev and Gentofte University Hospital, Copenhagen, Denmark. Stokholm Jakob J Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte University Hospital, Copenhagen, Denmark. Bønnelykke Klaus K Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte University Hospital, Copenhagen, Denmark. Bisgaard Hans H Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte University Hospital, Copenhagen, Denmark. Chawes Bo L BL Copenhagen
Serious asthma events with mometasone furoate plus formoterol compared with mometasone furoate The safety of long-acting β-agonists added to inhaled corticosteroids for the treatment of persistent asthma has been controversial.We sought to determine whether administering formoterol in combination with mometasone furoate increases the risk of serious asthma outcomes (SAOs) compared with mometasone furoate alone. This clinical trial is registered as NCT01471340.We conducted a 26-week, randomized (...) , double-blind trial in adolescent and adult patients (≥12 years) with persistent asthma in 35 countries with the primary objective of evaluating whether mometasone furoate-formoterol increases the risk of SAOs (adjudicated hospitalization, intubation, or death) compared with mometasone furoate alone. The key efficacy end point was asthma exacerbation (composite of hospitalization of ≥24 hours, emergency department visits of <24 hours requiring systemic corticosteroids, or use of systemic