Latest & greatest articles for asthma

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Top results for asthma

201. Benefit of hospital pharmacy intervention on the current status of dry powder inhaler technique in patients with asthma and COPD: a study from the Central Development Region, Nepal Full Text available with Trip Pro

Benefit of hospital pharmacy intervention on the current status of dry powder inhaler technique in patients with asthma and COPD: a study from the Central Development Region, Nepal The majority of patients with asthma and chronic obstructive pulmonary disease (COPD) have been known to perform inhaler technique inadequately. We aimed to evaluate the benefit of hospital pharmacy intervention on the current status of dry powder inhaler (Rotahaler®) technique in such patients and the factors (...) associated with the correct use.A pre-post interventional study was conducted at the outpatient pharmacy in a teaching hospital of the Central Development Region, Nepal, in patients with asthma and COPD currently using a Rotahaler device. Patients' demographics and Rotahaler technique were assessed before intervention. Those who failed to demonstrate the correct technique were educated and trained by the pharmacist, and their technique was reassessed after 2 weeks of intervention. Descriptive statistics

2016 Integrated pharmacy research & practice

202. Patient- and parent-initiated oral steroids for asthma exacerbations. Full Text available with Trip Pro

Patient- and parent-initiated oral steroids for asthma exacerbations. Asthma is a chronic inflammatory disease of the airways affecting an estimated 334 million people worldwide. During severe exacerbations, patients may need to attend a medical centre or hospital emergency department for treatment with systemic corticosteroids, which can be administered intravenously or orally. Some people with asthma are prescribed oral corticosteroids (OCS) for self-administration (i.e. patient-initiated (...) ) or to administer to their child with asthma (i.e. parent-initiated), in the event of an exacerbation. This approach to treatment is becoming increasingly common.To evaluate the effectiveness and safety of patient- or parent-initiated oral steroids for adults and children with asthma exacerbations.We identified trials from Cochrane Airways' Specialised Register (CASR) and also conducted a search of the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (www.clinicaltrials.gov

2016 Cochrane

203. Fractional exhaled nitric oxygen in asthma patients

Fractional exhaled nitric oxygen in asthma patients Fractional exhaled nitric oxygen in asthma patients Fractional exhaled nitric oxygen in asthma patients Mengarelli C, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A, López A, Rey-Ares L Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Mengarelli C (...) , Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A, López A, Rey-Ares L. Fractional exhaled nitric oxygen in asthma patients. Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Informe de Respuesta Rapida No. 494. 2016 Authors' conclusions Evidence of low methodological quality suggests that fractional exhaled nitric oxide to monitor glucocorticoid therapy in adult asthma patients might reduce the number of exacerbations, while the evidence

2016 Health Technology Assessment (HTA) Database.

204. Should recommendations about starting inhaled corticosteroid treatment for mild asthma be based on symptom frequency: a post-hoc efficacy analysis of the START study. (Abstract)

Should recommendations about starting inhaled corticosteroid treatment for mild asthma be based on symptom frequency: a post-hoc efficacy analysis of the START study. Low-dose inhaled corticosteroids (ICS) are highly effective for reducing asthma exacerbations and mortality. Conventionally, ICS treatment is recommended for patients with symptoms on more than 2 days per week, but this criterion has scant evidence. We aimed to assess the validity of the previous symptom-based cutoff for starting (...) ICS by establishing whether there was a differential response to budesonide versus placebo for severe asthma exacerbations, lung function, and asthma symptom control across subgroups identified by baseline asthma symptom frequency.We did a post-hoc analysis of the 3 year inhaled Steroid Treatment As Regular Therapy (START) study, done in 32 countries, with clinic visits every 3 months. Patients (aged 4-66 years) with mild asthma diagnosed within the previous 2 years and no previous regular

2016 Lancet Controlled trial quality: predicted high

205. Breathe Easy at Home: A Qualitative Evaluation of a Pediatric Asthma Intervention Full Text available with Trip Pro

Breathe Easy at Home: A Qualitative Evaluation of a Pediatric Asthma Intervention The Breathe Easy at Home Program enables clinicians to refer asthmatic patients to Boston Inspectional Services Department (ISD) if they suspect housing conditions trigger symptoms. The authors conducted one-on-one interviews with clinicians (n = 10) who referred patients, and focus groups with inspectors from the ISD (n = 9) and a variety of stakeholders (n = 13), to gain insight into program function (...) families required additional support throughout the process. Despite recommendations for improvement in program implementation, clinicians, inspectors, and stakeholders felt that the program overall improved both the home environment and asthma outcomes.

2016 Global qualitative nursing research

206. Reslizumab for Inadequately Controlled Asthma With Elevated Blood Eosinophil Levels: A Randomized Phase 3 Study Full Text available with Trip Pro

Reslizumab for Inadequately Controlled Asthma With Elevated Blood Eosinophil Levels: A Randomized Phase 3 Study This phase 3 study further characterizes the efficacy and safety of reslizumab (a humanized anti-IL-5 monoclonal antibody) in patients aged 12 to 75 years with asthma inadequately controlled by at least a medium-dose inhaled corticosteroid and with a blood eosinophil count ≥ 400 cells/μL.Patients were randomized to receive reslizumab 0.3 or 3.0 mg/kg or placebo administered once every (...) 4 weeks for 16 weeks (total four doses). The primary end point was change from baseline in pre-bronchodilator FEV1 over 16 weeks. Secondary end points included FVC, forced expiratory flow at 25% to 75% of FVC (FEF25%-75%), patient-reported control of asthma symptoms, short-acting β-agonist (SABA) use, blood eosinophil levels, and safety.Reslizumab significantly improved FEV1 (difference vs placebo [reslizumab 0.3 and 3.0 mg/kg], 115 mL [95% CI, 16-215; P = .0237] and 160 mL [95% CI, 60-259; P

2016 EvidenceUpdates

207. Phase 3 Study of Reslizumab in Patients With Poorly Controlled Asthma: Effects Across a Broad Range of Eosinophil Counts Full Text available with Trip Pro

Phase 3 Study of Reslizumab in Patients With Poorly Controlled Asthma: Effects Across a Broad Range of Eosinophil Counts IL-5, a mediator of eosinophil activity, is an important potential treatment target in patients with uncontrolled asthma. The efficacy of reslizumab, a humanized anti-human IL-5 monoclonal antibody, has been characterized in patients with blood eosinophils ≥ 400 cells/μL. This study further characterizes the efficacy and safety of reslizumab in patients with poorly-controlled (...) asthma, particularly those with eosinophils < 400 cells/μL.Patients were randomly assigned to intravenous reslizumab 3.0 mg/kg or placebo once every 4 weeks for 16 weeks. The primary end point was the change in FEV1 from baseline to week 16. Secondary measures included Asthma Control Questionnaire-7 (ACQ-7) scores, use of short-acting β-agonists (SABAs), and FVC.Four hundred ninety-two patients received ≥ 1 dose of placebo (n = 97) or reslizumab (n = 395). In the overall population, mean FEV1 change

2016 EvidenceUpdates

208. Randomized Trial of Once-Daily Fluticasone Furoate in Children with Inadequately Controlled Asthma Full Text available with Trip Pro

Randomized Trial of Once-Daily Fluticasone Furoate in Children with Inadequately Controlled Asthma To evaluate the dose-response, efficacy, and safety of fluticasone furoate (FF; 25 µg, 50 µg, and 100 µg), administered once daily in the evening during a 12-week treatment period to children with inadequately controlled asthma.This was a Phase IIb, multicenter, stratified, randomized, double-blind, double-dummy, parallel-group, placebo- and active-controlled study in children aged 5-11 years (...) with inadequately controlled asthma. The study comprised a 4-week run-in period, 12-week treatment period, and 1-week follow-up period. Children were randomized to receive either placebo once daily, fluticasone propionate (FP) 100 µg twice daily, FF 25 µg, FF 50 µg, or FF 100 µg each once daily in the evening. Primary endpoint was the mean change from baseline in daily morning peak expiratory flow (PEF) averaged over weeks 1-12. Adverse events (AEs) also were investigated.In total, 593 children were included

2016 EvidenceUpdates

209. A randomised, double-blind, placebo-controlled study to evaluate the efficacy of oral azithromycin as a supplement to standard care for adult patients with acute exacerbations of asthma (the AZALEA trial) Full Text available with Trip Pro

A randomised, double-blind, placebo-controlled study to evaluate the efficacy of oral azithromycin as a supplement to standard care for adult patients with acute exacerbations of asthma (the AZALEA trial) A randomised, double-blind, placebo-controlled study to evaluate the efficacy of oral azithromycin as a supplement to standard care for adult patients with acute exacerbations of asthma (the AZALEA trial) Journals Library An error occurred retrieving content to display, please try again (...) . >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} In adults with acute exacerbations of asthma, giving azithromycin in addition to standard care produced no statistically significant or clinically important benefit {{author}} {{($index

2016 NIHR HTA programme

210. A multi-strain Synbiotic may reduce viral respiratory infections in asthmatic children: a randomized controlled trial. Full Text available with Trip Pro

A multi-strain Synbiotic may reduce viral respiratory infections in asthmatic children: a randomized controlled trial. Asthma is a growing problem worldwide. Acute exacerbations impose considerable morbidity, mortality, and increased cost. Viral respiratory infections are the most common cause (80-85%) of pediatric asthma exacerbations and admissions to the hospital. The aim of this study was to determine the effect of a new synbiotic Lactocare® on viral respiratory infections and asthma (...) exacerbations in asthmatic children.In this double blind, placebo-controlled, randomized clinical trial, 72 children with mild persistent asthma, aged between 6 and 12 years, were randomized to receive either Lactocare®, a Synbiotic containing 1 billion CFU/Capsule of Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium infantis, Lactobacillus bulgaricus, and Fructooligosacharide (Zist Takhmir, Tehran, Iran) or placebo

2016 Electronic physician Controlled trial quality: predicted high

211. Leukotriene B4 levels in sputum from asthma patients Full Text available with Trip Pro

Leukotriene B4 levels in sputum from asthma patients Poor asthma control is associated with increased airway neutrophils. Leukotriene B4 (LTB4) is a potent neutrophil chemoattractant. We examined the levels of LTB4 levels in the sputum of asthma patients and the relationship with disease severity. 47 asthma patients (categorised according to Global Initiative for Asthma treatment stage) and 12 healthy controls provided sputum samples that were processed first with PBS to obtain supernatants (...) and secondly with dithiothreitol (DTT) to obtain supernatants. LTB4 levels were determined by ELISA. LTB4 levels were significantly higher in step 1 (steroid naïve) and step 3 (inhaled corticosteroid (ICS) plus long acting β-agonist) patients than step 2 patients (ICS alone) (p=0.02 and p=0.01, respectively). There was very good correlation when comparing PBS processed to DTT processed supernatants. High LTB4 levels were found in the sputum of asthmatics at step 3 despite ICS use.

2016 ERJ open research

212. Are We Too Clean or Too Dirty? The Hygiene Hypothesis in Asthma

Are We Too Clean or Too Dirty? The Hygiene Hypothesis in Asthma Are We Too Clean or Too Dirty? The Hygiene Hypothesis in Asthma – Clinical Correlations Search Are We Too Clean or Too Dirty? The Hygiene Hypothesis in Asthma September 21, 2016 9 min read By James Barger Peer Reviewed Asthma, an obstructive pulmonary disease characterized by bronchospasm and chronic airway inflammation, has afflicted mankind for millennia. In the 1 st century AD, the Greek physician Aretaeus of Cappadocia (...) described an attack thus: “the cheeks are ruddy, eyes protuberant, as if from strangulation…voice liquid and without resonance…they breathe standing, as if desiring to draw in all the air which they possibly can inhale, and, in their want of air they also open the mouth as if thus to enjoy the more of it…cough incessant and laborious, expectoration small, thin…and if these ” 1 At the dawn of modern medicine in the 19 th century, many physicians believed that asthma had an infectious source; others, like

2016 Clinical Correlations

213. Cognitive behavioural therapy (CBT) for adults and adolescents with asthma. Full Text available with Trip Pro

Cognitive behavioural therapy (CBT) for adults and adolescents with asthma. People with asthma have a higher prevalence of anxiety and depression than the general population. This is associated with poorer asthma control, medication adherence, and health outcomes. Cognitive behavioural therapy (CBT) may be a way to improve the quality of life of people with asthma by addressing associated psychological issues, which may lead to a lower risk of exacerbations and better asthma control.To assess (...) the efficacy of CBT for asthma compared with usual care.We searched the Cochrane Airways Group Specialised Register, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). We also searched reference lists of all primary studies and review articles and contacted authors for unpublished data. The most recent searches were conducted in August 2016.We included parallel randomised controlled trials (RCTs) comparing any cognitive behavioural

2016 Cochrane

214. Vitamin D – Can the sunshine vitamin help reduce asthma attacks?

Vitamin D – Can the sunshine vitamin help reduce asthma attacks? Vitamin D - Can the sunshine vitamin help reduce asthma atttacks? Search and hit Go By September 6, 2016 // Cochrane UK’s Senior Fellow in General Practice Lynda Ware looks at the new Cochrane review on Vitamin D for the management of asthma. A new Cochrane review looked at precisely this question and found high quality evidence suggesting that it does! What’s the story? It seems to me that vitamin D – also known as the ‘sunshine (...) vitamin’ – is very much in the limelight (or should that be sunlight?) right now. Its role in main taining a healthy skeleton is well known but it may have other important ac tions. Low levels of vitamin D have been linked to an increased risk of asthma attacks in children and adults with asthma. It is thought that vitamin D has anti-inflammatory and antimicrobial functions in the lungs, which may explain why it could be beneficial. What is Vitamin D? Vitamin D is a fat-soluble vitamin. It’s present

2016 Evidently Cochrane

215. Vitamin D for the management of asthma. Full Text available with Trip Pro

Vitamin D for the management of asthma. Several clinical trials of vitamin D to prevent asthma exacerbation and improve asthma control have been conducted in children and adults, but a meta-analysis restricted to double-blind, randomised, placebo-controlled trials of this intervention is lacking.To evaluate the efficacy of administration of vitamin D and its hydroxylated metabolites in reducing the risk of severe asthma exacerbations (defined as those requiring treatment with systemic (...) corticosteroids) and improving asthma symptom control.We searched the Cochrane Airways Group Trial Register and reference lists of articles. We contacted the authors of studies in order to identify additional trials. Date of last search: January 2016.Double-blind, randomised, placebo-controlled trials of vitamin D in children and adults with asthma evaluating exacerbation risk or asthma symptom control or both.Two review authors independently applied study inclusion criteria, extracted the data, and assessed

2016 Cochrane

216. Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial. (Abstract)

Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial. Benralizumab is a humanised, afucosylated, anti-interleukin-5 receptor α monoclonal antibody that induces direct, rapid, and nearly complete depletion of eosinophils. We aimed to assess the efficacy and safety of benralizumab as add-on therapy for patients with severe (...) , uncontrolled asthma and elevated blood eosinophil counts.In this randomised, double-blind, parallel-group, placebo-controlled, phase 3 study (CALIMA) undertaken at 303 sites in 11 countries, we enrolled patients aged 12-75 years with severe asthma uncontrolled by medium-dosage to high-dosage inhaled corticosteroids plus long-acting β₂-agonists (ICS plus LABA) and a history of two or more exacerbations in the previous year. Patients were randomly assigned (1:1:1) to receive 56 weeks of benralizumab 30 mg

2016 Lancet Controlled trial quality: predicted high

217. Exhaled nitric oxide levels to guide treatment for adults with asthma. Full Text available with Trip Pro

Exhaled nitric oxide levels to guide treatment for adults with asthma. Asthma guidelines aim to guide health practitioners to optimise treatment for patients so as to minimise symptoms, improve or maintain good lung function, and prevent acute exacerbations or flare-ups. The principle of asthma guidelines is based on a step-up or step-down regimen of asthma medications to maximise good health outcomes using minimum medications. Asthma maintenance therapies reduce airway inflammation (...) that is usually eosinophilic. Tailoring asthma medications in accordance with airway eosinophilic levels may improve asthma outcomes such as indices of control or reduce exacerbations or both. Fractional exhaled nitric oxide (FeNO) is a marker of eosinophilic inflammation, and as it is easy to measure, has an advantage over other measurements of eosinophilic inflammation (for example sputum eosinophils).To evaluate the efficacy of tailoring asthma interventions based on exhaled nitric oxide (FeNO

2016 Cochrane

218. Vilanterol and fluticasone furoate for asthma. Full Text available with Trip Pro

Vilanterol and fluticasone furoate for asthma. Vilanterol (VI) is a long-acting beta2-agonist (LABA) that binds to the beta2-adrenoceptor on the airway smooth muscle, producing bronchodilation. LABA therapy, which is well established in adults as part of the British Thoracic Society (BTS) Guidelines for the Management of Asthma, leads to improvement in symptoms and lung function and reduction in exacerbations. At present, the commonly used LABAs licensed for use in asthma management (formoterol (...) and salmeterol) require twice-daily administration, whereas VI is a once-daily therapy.Fluticasone furoate (FF) is an inhaled corticosteroid (ICS), and ICS therapy is recommended by the BTS asthma guidelines. ICSs, the mainstay of asthma treatment, lead to a reduction in both airway inflammation and airway hyper-responsiveness. Regular use leads to improvement in symptoms and lung function. ICSs are currently recommended as 'preventer' therapy for patients who use a 'reliever' medication (e.g. short-acting

2016 Cochrane Controlled trial quality: predicted high

219. Safety of Adding Salmeterol to Fluticasone Propionate in Children with Asthma. Full Text available with Trip Pro

Safety of Adding Salmeterol to Fluticasone Propionate in Children with Asthma. Long-acting beta-agonists (LABAs) have been shown to increase the risk of asthma-related death among adults and the risk of asthma-related hospitalization among children. It is unknown whether the concomitant use of inhaled glucocorticoids with LABAs mitigates those risks. This trial prospectively evaluated the safety of the LABA salmeterol, added to fluticasone propionate, in a fixed-dose combination in children.We (...) randomly assigned, in a 1:1 ratio, children 4 to 11 years of age who required daily asthma medications and had a history of asthma exacerbations in the previous year to receive fluticasone propionate plus salmeterol or fluticasone alone for 26 weeks. The primary safety end point was the first serious asthma-related event (death, endotracheal intubation, or hospitalization), as assessed in a time-to-event analysis. The statistical design specified that noninferiority would be shown if the upper boundary

2016 NEJM Controlled trial quality: predicted high

220. Serious Asthma Events with Budesonide plus Formoterol vs. Budesonide Alone. Full Text available with Trip Pro

Serious Asthma Events with Budesonide plus Formoterol vs. Budesonide Alone. Concerns remain about the safety of adding long-acting β2-agonists to inhaled glucocorticoids for the treatment of asthma. In a postmarketing safety study mandated by the Food and Drug Administration, we evaluated whether the addition of formoterol to budesonide maintenance therapy increased the risk of serious asthma-related events in patients with asthma.In this multicenter, double-blind, 26-week study, we randomly (...) assigned patients, 12 years of age or older, who had persistent asthma, were receiving daily asthma medication, and had had one to four asthma exacerbations in the previous year to receive budesonide-formoterol or budesonide alone. Patients with a history of life-threatening asthma were excluded. The primary end point was the first serious asthma-related event (a composite of adjudicated death, intubation, and hospitalization), as assessed in a time-to-event analysis. The noninferiority of budesonide

2016 NEJM Controlled trial quality: predicted high