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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.
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Why and how to step down chronic asthma drugs. Asthma is a common chronic airways disease. The goal of asthma management is to control symptoms while minimizing the side effects of treatment. Following a period of stable asthma, clinicians should consider stepping down treatment. This approach is recommended by current guidelines. Step-down has been studied for several types of asthma drug regimens, and certain approaches may have lower risk than others. Systematic reviews of multiple trials (...) trials support an increased risk of asthma exacerbation for patients who completely stop taking inhaled corticosteroid or long acting bronchodilator. Strategies to implement step-down in practice include the use of risk prediction as well as tools to support shared decision making and communication about risk between clinicians and patients.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights
after rhinoviral infection exclusively in bronchial epithelial cells from asthmatics. In a translational mouse model of asthma exacerbation effects of caspase-1 on airway inflammation and Th2-upstream cytokines were explored. Caspase-1 deficient mice exhibited no alterations of general lung inflammatory parameters, but showed markedly reduced eosinophilia. Furthermore, the Th2-upstream cytokines IL-33, TSLP and IL-25 were reduced at exacerbation in mice lacking caspase-1. Rhinovirus infection (...) Caspase-1 deficiency reduces eosinophilia and interleukin-33 in an asthma exacerbation model Rhinovirus infections are common triggers of asthma exacerbations. Viruses can activate the inflammasome, resulting in processing and activation of caspase-1. This recruitment triggers production of interleukin (IL)-1β and IL-18, which have been implicated in asthma. Elucidating the involvement of the inflammasome and its compartments, such as caspase-1, in asthma exacerbations is warranted. Gene
Shared decision-making for people with asthma. Asthma is a chronic inflammatory disease that affects the airways and is common in both adults and children. It is characterised by symptoms including wheeze, shortness of breath, chest tightness, and cough. People with asthma may be helped to manage their condition through shared decision-making (SDM). SDM involves at least two participants (the medical practitioner and the patient) and mutual sharing of information, including the patient's values (...) and preferences, to build consensus about favoured treatment that culminates in an agreed action. Effective self-management is particularly important for people with asthma, and SDM may improve clinical outcomes and quality of life by educating patients and empowering them to be actively involved in their own health.To assess benefits and potential harms of shared decision-making for adults and children with asthma.We searched the Cochrane Airways Trials Register, which contains studies identified in several
Selective citation in the literature on swimming in chlorinated water and childhood asthma: a network analysis Knowledge development depends on an unbiased representation of the available evidence. Selective citation may distort this representation. Recently, some controversy emerged regarding the possible impact of swimming on childhood asthma, raising the question about the role of selective citation in this field. Our objective was to assess the occurrence and determinants of selective (...) (OR 4.1, CI 2.1-8.0). Further, there was some evidence for citation bias: articles that confirmed the relation between swimming and asthma were cited more often (OR 1.8, CI 1.1-2.9), but this finding was not robust.There is clear evidence of selective citation in this research field, but the evidence for citation bias is not very strong.
in differentiating between obstructed asthmatic breathing and normal function. T able 2 summarises the clinical evidence as well as its strengths and limitations. Overall assessment of the evidence The published evidence for Thora-3Di is based on small studies mostly published as abstracts. These are generally relevant to the NHS pathway but are descriptive, comparing a variety of respiratory parameters measured using Thora-3Di with conventional spirometry in healthy volunteers and patients with asthma, both (...) Thora-3Di for assessing asthma in children Thor Thora-3Di for assessing asthma in children a-3Di for assessing asthma in children Medtech innovation briefing Published: 2 October 2017 nice.org.uk/guidance/mib122 pathways Summary Summary The technology technology described in this briefing is Thora-3Di for assessing respiratory function in children with asthma. The inno innovativ vative aspects e aspects are that the measurements are taken non-invasively without the need for special breathing
Early Probiotic Supplementation for Eczema and Asthma Prevention: A Randomized Controlled Trial To determine if probiotic administration during the first 6 months of life decreases childhood asthma and eczema.We conducted a randomized, double-blind controlled trial of Lactobacillus rhamnosus GG (LGG) supplementation on the cumulative incidence of eczema (primary end point) and asthma and rhinitis (secondary end points) in high-risk infants. For the first 6 months of life, intervention infants (...) cumulative incidence of eczema was 30.9% (95% confidence interval [CI], 21.4%-40.4%) in the control arm and 28.7% (95% CI, 19.4%-38.0%) in the LGG arm, for a hazard ratio of 0.95 (95% CI, 0.59-1.53) (log-rank P = .83). At 5 years of age, the cumulative incidence of asthma was 17.4% (95% CI, 7.6%-27.1%) in the control arm and 9.7% (95% CI, 2.7%-16.6%) in the LGG arm, for a hazard ratio of 0.88 (95% CI, 0.41-1.87) (log-rank P = .25).For high-risk infants, early LGG supplementation for the first 6 months
A Roadmap for Optimizing Asthma Care Management via Computational Approaches Asthma affects 9% of Americans and incurs US $56 billion in cost, 439,000 hospitalizations, and 1.8 million emergency room visits annually. A small fraction of asthma patients with high vulnerabilities, severe disease, or great barriers to care consume most health care costs and resources. An effective approach is urgently needed to identify high-risk patients and intervene to improve outcomes and to reduce costs
Asthma-COPD overlap syndrome: pathogenesis, clinical features, and therapeutic targets. Asthma-COPD overlap syndrome (ACOS) or asthma-COPD overlap captures the subset of patients with airways disease who have features of both asthma and chronic obstructive pulmonary disease (COPD). Although definitions of ACOS vary, it is generally thought to encompass persistent airflow limitation in a patient older than 40 years of age with either a history of asthma or large bronchodilator reversibility (...) . ACOS affects about a quarter of patients with COPD and almost a third of patients who previously had asthma. Compared with their counterparts with asthma or COPD alone, patients with ACOS have significantly worse respiratory symptoms, poorer quality of life, and increased risk of exacerbations and hospital admissions. Whether this condition emerges after gradual shifts in airway remodelling and inflammation in a patient with COPD, as the result of noxious exposures in a patient with asthma, or even
Effectiveness of fluticasone furoate plus vilanterol on asthma control in clinical practice: an open-label, parallel group, randomised controlled trial. Evidence for management of asthma comes from closely monitored efficacy trials done in highly selected patient groups. There is a need for randomised trials that are closer to usual clinical practice.We did an open-label, randomised, controlled, two-arm effectiveness trial at 74 general practice clinics in Salford and South Manchester, UK (...) . Patients aged 18 years or older with a general practitioner's diagnosis of symptomatic asthma and on maintenance inhaler therapy were randomly assigned to initiate treatment with a once-daily inhaled combination of either 100 μg or 200 μg fluticasone furoate with 25 μg vilanterol or optimised usual care and followed up for 12 months. The primary endpoint was the percentage of patients who achieved an asthma control test (ACT) score of 20 or greater or an increase in ACT score from baseline of 3
2017LancetControlled trial quality: predicted high
Tezepelumab in Adults with Uncontrolled Asthma. In some patients with moderate-to-severe asthma, particularly those with noneosinophilic inflammation, the disease remains uncontrolled. This trial evaluated the efficacy and safety of tezepelumab (AMG 157/MEDI9929), a human monoclonal antibody specific for the epithelial-cell-derived cytokine thymic stromal lymphopoietin (TSLP), in patients whose asthma remained uncontrolled despite treatment with long-acting beta-agonists and medium-to-high (...) doses of inhaled glucocorticoids.In this phase 2, randomized, double-blind, placebo-controlled trial, we compared subcutaneous tezepelumab at three dose levels with placebo over a 52-week treatment period. The primary end point was the annualized rate of asthma exacerbations (events per patient-year) at week 52.The use of tezepelumab at a dose of 70 mg every 4 weeks (low dose; 145 patients), 210 mg every 4 weeks (medium dose; 145 patients), or 280 mg every 2 weeks (high dose; 146 patients) resulted
Rapid vs Maintenance Vitamin D Supplementation in Deficient Children With Asthma to Prevent Exacerbations Whether vitamin D reduces clinically important exacerbations of childhood asthma remains uncertain. We compared rapid to maintenance vitamin D repletion analyzed by baseline vitamin D level.Children presenting to the ED with moderate-to-severe asthma exacerbations and vitamin D levels ≤ 25 ng/mL underwent masked randomization, and then open dosing to either IM+oral (the latter daily (...) ) therapy or daily oral-only therapy, and were followed for 12 months. The primary outcome was patient-initiated unplanned visits for asthma exacerbations, examined two ways: cumulative proportions with an exacerbation, and average exacerbation frequency. As this was a nutrient study, we analyzed treatment groups by quartile of baseline vitamin D level, collecting repeat levels and clinical observations at 3, 6, 9, and 12 months after enrollment.One hundred and sixteen patients in the IM+oral cohort vs
of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Reslizumab (Asthma): addendum zum auftrag A17-02; auftrag A17-22. [Reslizumab (asthma) - addendum to Commission A17-02] Cologne: Institut fuer Qualitaet und Wirtschaftlichkeit im Gesundheitswesen (IQWiG). IQWiG-Berichte 516. 2017 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Anti-Asthmatic Agents; Antibodies, Monoclonal, Humanized; Asthma; Humans (...) [Reslizumab (asthma) - addendum to Commission A17-02] Reslizumab (Asthma): addendum zum auftrag A17-02; auftrag A17-22 [Reslizumab (asthma) - addendum to Commission A17-02] Reslizumab (Asthma): addendum zum auftrag A17-02; auftrag A17-22 [Reslizumab (asthma) - addendum to Commission A17-02] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality
Acarizax - house dust mite allergic rhinitis and allergic asthma Acarizax® × Insert searchphrase to search the website Insert searchphrase to search the website > > > Acarizax® Conclusion It is IRF's overall assessment that Acarizax may be considered a relevant add-on therapy in house dust mite allergic rhinitis and allergic asthma in adults when symptomatic treatment is not adequate. Immunotherapy is a long-term treatment form, requiring high patient motivation, and after treatment
Stratification of eosinophilic asthma patients treated with reslizumab and GINA Step 4 or 5 therapy Reslizumab, an anti-interleukin-5 monoclonal antibody, significantly reduces exacerbation frequency and improves lung function, asthma control and quality of life in adults with severe eosinophilic asthma, as demonstrated in Phase III studies. This secondary analysis assessed reslizumab's efficacy in patients receiving baseline treatment per Global Initiative for Asthma (GINA) Step 4 and Step 5 (...) guidelines. Pooled data from duplicate, Phase III, reslizumab versus placebo studies in patients with severe eosinophilic asthma (blood eosinophils ≥400 cells·µL-1) were stratified by baseline therapy. Efficacy assessments were exacerbation rates and changes from baseline forced expiratory volume in 1 s (FEV1) and patient-reported outcomes. Of 953 patients, 69% (n=657) and 11% (n=106) were receiving Step 4 and Step 5 therapy, respectively. Compared with placebo, reslizumab reduced exacerbation rates
Trends in international asthma mortality: analysis of data from the WHO Mortality Database from 46 countries (1993-2012). International time trends in asthma mortality have been strongly affected by changes in management and in particular drug treatments. However, little is known about how asthma mortality has changed over the past decade. In this study, we assessed these international trends.We collated age-standardised country-specific asthma mortality rates in the 5-34 year age group from (...) the online WHO Mortality Database for 46 countries. To be included in the analysis, we specified that a country must have 10 years of complete data in the WHO Mortality Database between 1993 and 2012. In the absence of consistent and accurate asthma prevalence and prescribing data, we chose to use a locally weighted scatter plot smoother (LOESS) curve, weighted by the individual country population in the 5-34-year age group to show the global trends in asthma mortality rates with time.Of the 46 countries
Preventing Severe Asthma Exacerbations in Children. A Randomized Trial of Mite-Impermeable Bedcovers Allergen exposure in sensitized individuals with asthma interacts with viruses to increase the risk of asthma exacerbation.To evaluate the use of house dust mite-impermeable bedding and its impact on severe asthma exacerbations in children.We randomized mite-sensitized children with asthma (ages 3-17 yr) after an emergency hospital attendance with an asthma exacerbation to receive mite (...) -impermeable (active group) or control (placebo group) bed encasings.Over a 12-month intervention period, the occurrence of severe asthma exacerbations was investigated. Of 434 children with asthma who consented, 286 (mean age, 7.7 yr; male sex, 65.8%) were mite sensitized, and 284 were randomized (146 to the active group and 138 to the placebo group). At 12 months, significantly fewer children in the active group than in the placebo group had attended the hospital with an exacerbation (36 [29.3%] of 123
Omega-3 fatty acids during pregnancy and asthma prevention. Are we talking here about more than just a suspect involved? Ácidos grasos omega-3 durante el embarazo y prevención del asma, ¿algo más que un presunto implicado? - Evidencias en pediatría Buscando, por favor espere. Mostrar menú Gestión de biblioteca Aún no ha añadido ningún artículo a su biblioteca. | Buscar Toma de decisiones clínicas basadas en pruebas científicas Toma de decisiones clínicas basadas en pruebas científicas Mostrar (...) embarazo para realizar el ensayo clínico. Los hijos de estas mujeres forman parte de la cohorte de Copenhagen Prospective Studies on Asthma in Chilhood 2010 (COPSAC2010). Las mujeres rellenaron un cuestionario de frecuencias de consumo de alimentos y se midieron sus niveles de ácido eicosapentaenoico (EPA) y docosahexaenoico (DHA) antes de la aleatorización y una semana después del parto. Tras el parto, la cohorte se formó con 695 niños, de los que el 95,5% completaron el periodo de tres años de
Reslizumab (severe eosinophilic asthma) ? Benefit assessment according to § 35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Reslizumab (Asthma) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 11 April 2017). 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. A17-02 Reslizumab (...) (asthma) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A17-02 Version 1.0 Reslizumab (asthma) 11 April 2017 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Reslizumab (asthma) – Benefit assessment according to §35a Social Code Book V Commissioning agency: Federal Joint Committee Commission awarded on: 16 January 2017 Internal Commission No.: A17-02
a provisional diagnosis of COPD is first made on presentation to the ED, but more commonly these patients have already been diagnosed with chronic bronchitis or emphysema through pulmonary function testing. Most patients will have visited the ED before. The initial management of these patients is similar to the management of patients with asthma, but these patients are more likely to require antibiotic treatment for an acute exacerbation. 1 In both these patients and asthmatics, the clinician must (...) . On the other hand, intubation is delayed as long as possible for asthmatic patients. 3 Aspiration in children or the elderly or those with developmental delay: Inhalation of a foreign body, secretions, or a mucous plug is of particular concern in children, the elderly, and patients with cognitive deficits or developmental delay. The wheeze of aspiration can often by differentiated from asthmatic wheeze by its nature; the wheeze of asthma is bilateral and usually end-expiratory, whereas foreign body wheeze