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Latest & greatest articles for asthma
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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
with intermittent treatment. 1,2 • Previous systematic review 3 (6 RCTs; 1211 children and adults) of intermittent versus daily ICS (excluded ICS/LABA combination trials) found: o No difference in risk of exacerbation. o Fewer asthma-controlled days with intermittent versus daily ICS. o For children: daily ICS resulted in ~0.5cm less growth (height) at ~1 year. 3 Context: • Up to 75% of asthmatics have mild asthma. 4 • Guidelines recommend daily ICS for mild persistent asthma, 5 but only ~50% adhere. 6 (...) Less puffing, more breathing? Intermittent inhaled steroids for asthma March 4, 2019 (en français) Less puffing, more breathing? Intermittent inhaled steroids for asthma Clinical Question: In patients with mild persistent asthma, is intermittent use of inhaled corticosteroids (ICS) as effective as daily use? Bottom Line: In patients with mild persistent asthma, intermittent use of ICS or ICS/LABA is similar to daily ICS in preventing exacerbations but is associated with ~5 fewer weeks per year
Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT Few trials have been conducted to address the psychological difficulties of parents in managing their child's asthma. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help parents to accept these psychological difficulties and improve their management of childhood asthma.In this randomized controlled trial, a 4-session, group-based ACT plus asthma education (ACT (...) group) was compared with an asthma education talk plus 3 telephone follow-ups (control group) to train parents of children diagnosed with asthma. The use of health care services due to asthma exacerbations in children and the psychological well-being of their parents were assessed before, immediately after, and at 6 months after the intervention.A total of 168 parents and their children aged 3 to 12 years with asthma were consecutively recruited in a public hospital in Hong Kong. When compared
The long-term effect of an exercise and diet intervention in asthma patients: aÂ 1-year follow-up on a randomised controlled trial. In the EFFORT (Effects of Exercise and Diet in Nonobese Asthma Patients - A Randomized Controlled Trial) study, maximum exercise capacity (V'O2max) increased significantly within a 2-month high-intensity spinning period. Furthermore, the study concluded that only the combined exercise and diet intervention improved asthma control, significantly. This study examined (...) whether original improvements in V'O2max and asthma control were present 1 year after intervention completion.In the original trial, 149 patients were randomised into four study groups. Participants were assessed with an incremental cycle ergometer test and the Asthma Control Questionnaire (ACQ). Of the 149 patients, 66 accepted the follow-up invitation. Participants were distributed in their original groups: exercise group (n=18), diet group (n=117), combined diet and exercise group (n=115
The Reliability of Adjusting Stepped Care Based on FeNO Monitoring for Patients with Chronic Persistent Asthma. To examine the feasibility of fractional exhaled nitrous oxide (FeNO) guided stepped care in patients with chronic persistent asthma.160 patients with asthma were enrolled and randomly divided into study and control groups, and were given standardized treatment according to GINA 2014. All patients were evaluated every 3 months and their medication was adjusted according to the results (...) of asthma.
The effectiveness of relaxation training in the quality of life and anxiety of patients with asthma. With a 5-10% global prevalence, asthma, as a chronic condition which can strongly affect the quality of life of patients and care givers, needs comprehensive approach, including medications and psychological techniques, to get the optimal control. This is why the current study aimed to assess the effectiveness of the Papworth method relaxation training among patients with asthma, considering (...) reduced anxiety and improved quality of life.Through a randomized controlled trial, 30 patients with asthma 20-45 years of age referring to a tertiary university hospital in Tehran enrolled two study groups, including disease cases and controls. The Papworth method of relaxation was used and was finally assessed for its effectiveness by two questionnaires, namely STAI for anxiety and SF-36 for the quality of life. Pre-test and post-test were done for both groups.The scores of the anxiety questionnaire
Tiotropium (Spiriva Respimat) - as add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma who experienced one or more severe asthma exacerbations in the preceding year Published 14 January 2019 www.scottishmedicines.org.uk Product update SMC2118 tiotropium 2.5 microgram solution for inhalation (Spiriva® Respimat®) Boehringer Ingelheim Limited 7 December 2018 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 tiotropium (Spiriva® Respimat®) is accepted for use within NHSScotland. Indication under review: as add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma who experienced one or more severe asthma exacerbations in the preceding year. Tiotropium has previously been accepted for use
Bronchial thermoplasty for severe asthma Bronchial thermoplasty for se Bronchial thermoplasty for sev vere asthma ere asthma Interventional procedures guidance Published: 19 December 2018 nice.org.uk/guidance/ipg635 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However (...) should be interpreted in a way that would be inconsistent with compliance with those duties. 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. This guidance replaces IPG419. 1 1 Recommendations Recommendations 1.1 Current evidence on the safety and efficacy of bronchial thermoplasty for severe asthma is adequate to support
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 the age at first severe respiratory syncytial virus (RSV) disease and subsequent asthma.Incidence rates and rate ratios of the first asthma-associated hospitalization after 2 years of age in children hospitalized for RSV disease at <3 months, 3 to <6 months, 6 to <12 months, and 12-24 months of age were (...) calculated.The incidence of asthma-associated hospitalization per 1000 child-years among children hospitalized for RSV disease at <3 months of age was 0.5 (95% confidence interval [CI], .2-.7); at 3 to <6 months of age, 0.9 (95% CI,.5-1.3); at 6 to <12 months of age, 2.0 (95% CI, 1.4-2.7); and at 12-24 months of age, 1.7 (95% CI, 1.0-2.5). The rate ratio of hospitalization for asthma was 2-7-fold greater among children hospitalized for RSV disease at ages ≥6 months than that among those hospitalized for RSV
Randomized Clinical Trial Comparing Breath-Enhanced to Conventional Nebulizers in the Treatment of Children with Acute Asthma To compare the efficacy of a breath-enhanced and a conventional jet nebulizer in the treatment of children with moderate to severe acute asthma.We enrolled subjects between 6 and 18 years of age presenting to the emergency department (ED) with acute asthma and an initial forced expiratory volume in 1 second (FEV1) <70% of predicted. We excluded patients with chronic (...) disease, who required immediate resuscitation, or failed spirometry. Subjects were randomized to breath-enhanced or conventional jet delivery of a 5-mg albuterol treatment. Our primary outcome was change in FEV1, and secondary outcomes included change in clinical asthma scores, ED length of stay, disposition, and side effects. Student t test and multivariable linear regression were used to evaluate the primary outcome.In total, 497 patients were assessed for eligibility with 118 enrolled and 107
Dupilumab (asthma) - Benefit assessment according to §35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Dupilumab (Asthma) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 28 November 2019). 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. 19-74 Dupilumab (asthma) – Benefit (...) assessment according to §35a Social Code Book V 1 Extract of dossier assessment A19-74 Version 1.0 Dupilumab (asthma) 28 November 2019 Institute for Quality and Efficiency in Health Care (IQWiG) - 1 - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Dupilumab (asthma) – Benefit assessment according to §35a Social Code Book V Commissioning agency: Federal Joint Committee Commission awarded on: 29 August 2019 Internal Commission No.: A19-74 Address of publisher
Mepolizumab (asthma) - Benefit assessment according to §35a Social Code Book V Extract 1 Translation of the executive summary of the dossier assessment Mepolizumab (Asthma bei Jugendlichen und Kindern ab 6 Jahren) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 20 December 2018). Please note: This document was translated by an external translator and 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. A18-58 Mepolizumab (asthma in adolescents and children aged 6 years and older) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A18-58 Version 1.0 Mepolizumab (asthma in adolescents and children aged 6 years and older) 20 December 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Mepolizumab (asthma
treatment we present studies showing a dose-response relationship in asthmatic patients treated with OCS and then consider by organ systems the undesired effects demonstrated in clinical and epidemiological studies in patients with OCS-dependent asthma. It was found that the risk of developing various OCS-related complications, including infections, diabetes and osteoporosis as well as psychiatric disorders, was higher for patients with long-term exposure to OCS compared with control groups. In addition (...) Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature This review provides an overview of the role of long-term treatment of severe asthma with oral corticosteroids (OCS) and its associated side-effects in adults. It is based on a systematic literature search conducted in MEDLINE, Embase and the Cochrane Library to identify relevant studies. After a short overview of severe asthma and its
that the lack of evidence available for other treatment options meant it was unfeasible to make a robust comparison with tiotropium of the clinical and cost-effectiveness of the other treatment options. ? Welsh clinical experts contacted by the All Wales Therapeutics and Toxicology Centre (AWTTC) commented that there are very limited effective treatment options at the later stages of asthma treatment, and that tiotropium is currently used as a treatment option for asthmatics at the add-on therapy stage (...) Tiotropium (Spiriva Respimat) add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma Tiotropium (Spiriva ® Respimat ® ). Reference number 1882. Page 1 of 3 AWMSG Secretariat Assessment Report – Limited submission Tiotropium (Spiriva ® Respimat ® ) 2.5 microgram, inhalation solution Company: Boehringer Ingelheim Ltd Licensed indication under consideration: add-on maintenance bronchodilator treatment in patients aged 6 years to < 18 years with severe
Limited clinical value of exhaled volatile organic compound measurements in childhood asthma Exhaled volatile organic compound measurements do not aid the clinician diagnosing asthma in children http://ow.ly/Z2d930lpZ60.
Asthma severity and fertility outcome in women with polycystic ovary syndrome: a registry-based study Recent research suggests that women with polycystic ovary syndrome (PCOS) have a higher risk of asthma. However, the severity of asthma, use of antiasthma medication and effect on fertility have yet to be investigated. In a case-control cross-sectional registry study using the Danish National Patient Register and other Danish registries, asthma prevalence, asthma severity, antiasthma medication (...) use and fertility outcome were investigated among two groups of women with PCOS (n=1358 and n=17 123) and a healthy control group (n=5340). Both asthma prevalence (OR 1.45, 95% CI 1.24-1.70) and mean daily inhaled corticosteroid dose were higher among women with PCOS compared with healthy controls, whereas asthma severity was the same in women with and without PCOS. Women with PCOS and asthma had more in vitro fertilisation treatments than women in the control group with asthma, but the numbers
Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents : media-1vid110.1542/5804911922001PEDS-VA_2017-3737Video Abstract BACKGROUND: African American adolescents appear to be the most at risk for asthma morbidity and mortality even compared with other minority groups, yet there are few successful interventions for this population that are used to target poorly controlled asthma.African American adolescents (age 12-16 years) with moderate-to-severe (...) persistent asthma and ≥1 inpatient hospitalization or ≥2 emergency department visits in 12 months were randomly assigned to Multisystemic Therapy-Health Care or an attention control group (N = 167). Multisystemic Therapy-Health Care is a 6-month home- and community-based treatment that has been shown to improve illness management and health outcomes in high-risk adolescents by addressing the unique barriers for each individual family with cognitive behavioral interventions. The attention control
Does early onset asthma increase childhood obesity risk? A pooled analysis of 16 European cohorts The parallel epidemics of childhood asthma and obesity over the past few decades have spurred research into obesity as a risk factor for asthma. However, little is known regarding the role of asthma in obesity incidence. We examined whether early-onset asthma and related phenotypes are associated with the risk of developing obesity in childhood.This study includes 21 130 children born from 1990 (...) to 2008 in Denmark, France, Germany, Greece, Italy, The Netherlands, Spain, Sweden and the UK. We followed non-obese children at 3-4 years of age for incident obesity up to 8 years of age. Physician-diagnosed asthma, wheezing and allergic rhinitis were assessed up to 3-4 years of age.Children with physician-diagnosed asthma had a higher risk for incident obesity than those without asthma (adjusted hazard ratio (aHR) 1.66, 95% CI 1.18-2.33). Children with active asthma (wheeze in the last 12 months
). 80 asthmatic patients were included in a double-blinded, parallel, randomised controlled trial with follow-up visits after 8, 24 and 36 weeks. Treatment was tailored using either a FeNO or Asthma Control Questionnaire (ACQ) based algorithm. Inclusion criteria were asthma symptoms and a provocative dose causing a 15% fall in forced expiratory volume in 1 s <635 mg mannitol. At each visit AHR, FeNO, ACQ and blood tests were performed. No differences between the two groups were found at inclusion (...) FeNO-based asthma management results in faster improvement of airway hyperresponsiveness Asthma is characterised by inflammation and respiratory symptoms. Current asthma treatment is based on severity of asthma symptoms only. Exhaled nitric oxide fraction (FeNO) is not recommended by the Global Initiative for Asthma guidelines. The aim was to compare the usefulness of a FeNO guided versus symptom-based treatment in achieving improved asthma control assessed by airway hyperresponsiveness (AHR