Latest & greatest articles for asthma

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Top results for asthma

1061. Cost effectiveness of fluticasone and budesonide in patients with moderate asthma

Cost effectiveness of fluticasone and budesonide in patients with moderate asthma Cost effectiveness of fluticasone and budesonide in patients with moderate asthma Cost effectiveness of fluticasone and budesonide in patients with moderate asthma Steinmetz K O, Volmer T, Trautmann M, Kielhorn A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions (...) followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Inhaled fluticasone (metered dose inhaler) was compared to inhaled budesonide (Turbuhaler(R) in corticosteroid-naive patients with moderate asthma. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population The authors did not define the study population. The study sample comprised patients enrolled in a multi-centre trial, who were aged between

1998 NHS Economic Evaluation Database.

1062. A pediatric asthma unit staffed by respiratory therapists demonstrates positive clinical and financial outcomes

with a reduced LOS and care path variances and lower costs of care compared to standard treatment by RNs. These outcomes are realised with no increase in post-discharge functional morbidity. CRD COMMENTARY - Selection of comparators The reason for the choice of the comparator is clear. The effects of an asthma care unit, staffed primarily by respiratory therapist (RTs), on the acute management of hospitalised asthmatics have been analysed mainly with reference to an adult population. Therefore (...) A pediatric asthma unit staffed by respiratory therapists demonstrates positive clinical and financial outcomes A pediatric asthma unit staffed by respiratory therapists demonstrates positive clinical and financial outcomes A pediatric asthma unit staffed by respiratory therapists demonstrates positive clinical and financial outcomes Myers T R, Chatburn R L, Kercsmar C M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each

1998 NHS Economic Evaluation Database.

1063. Influence of an interventional program on resource use and cost in pediatric asthma

Influence of an interventional program on resource use and cost in pediatric asthma Influence of an interventional program on resource use and cost in pediatric asthma Influence of an interventional program on resource use and cost in pediatric asthma Higgins J C, Kiser W R, McClenathan S, Tynan N L Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Patient education and assignment to primary care provider in the management of paediatric asthma. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population Paediatric asthma patients admitted to a US military hospital. Setting Hospital setting. The study was carried out at the Naval Hospital, Jacksonville, Florida, USA. Dates to which

1998 NHS Economic Evaluation Database.

1064. Antileukotrienes: an emerging generation of drug therapies for asthma

to moderate asthmatics. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Anti-Asthmatic Agents /pharmacology; Asthma /drug therapy; Leukotrienes Language Published English, French Country of organisation Canada Address for correspondence 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392; Email: jills@ccohta.ca AccessionNumber 31998008432 Date bibliographic record published 30/06/1998 Date abstract record published 30/06/1998 Health (...) Antileukotrienes: an emerging generation of drug therapies for asthma Antileukotrienes: an emerging generation of drug therapies for asthma Antileukotrienes: an emerging generation of drug therapies for asthma Canadian Coordinating Office for Health Technology Assessment 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 Canadian

1998 Health Technology Assessment (HTA) Database.

1065. One-year economic evaluation of intensive vs conventional patient education and supervision for self-management of new asthmatic patients

. Bibliographic details Kauppinen R, Sintonen H, Tukiainen H. One-year economic evaluation of intensive vs conventional patient education and supervision for self-management of new asthmatic patients. Respiratory Medicine 1998; 92(2): 300-307 PubMedID Other publications of related interest Liljas B, Lahdensuo A. Is asthma self-management cost-effective? Patient Education & Counseling 1997;32(Supplement 1):S97-S104. Indexing Status Subject indexing assigned by NLM MeSH Adolescent; Adult; Aged; Asthma /drug (...) One-year economic evaluation of intensive vs conventional patient education and supervision for self-management of new asthmatic patients One-year economic evaluation of intensive vs conventional patient education and supervision for self-management of new asthmatic patients One-year economic evaluation of intensive vs conventional patient education and supervision for self-management of new asthmatic patients Kauppinen R, Sintonen H, Tukiainen H Record Status This is a critical abstract

1998 NHS Economic Evaluation Database.

1066. Randomised placebo-controlled trial of inhaled sodium cromoglycate in 1-4-year-old children with moderate asthma. (Abstract)

Randomised placebo-controlled trial of inhaled sodium cromoglycate in 1-4-year-old children with moderate asthma. Inhalation therapy with sodium cromoglycate is recommended as the first-line prophylactic treatment for moderate asthma in children. The availability of spacer devices with face-masks has extended the applicability of metered-dose inhalers to younger children. We studied the feasibility and effects of this therapy compared with placebo in children aged 1-4 years.218 children aged 1 (...) -4 years with moderate asthma were recruited through 151 general practitioners between March, 1995, and March, 1996. They were randomly assigned sodium cromoglycate (10 mg three times daily) or placebo, given by inhaler with spacer device and face-mask for 5 months. Rescue medication (ipratropium plus fenoterol aerosol) was available during the baseline period of 1 month and the intervention period. Parents completed a daily symptom-score list. The primary outcome measure was the proportion

1997 Lancet Controlled trial quality: predicted high

1067. A comparison of beclomethasone, salmeterol, and placebo in children with asthma. Canadian Beclomethasone Dipropionate-Salmeterol Xinafoate Study Group. (Abstract)

A comparison of beclomethasone, salmeterol, and placebo in children with asthma. Canadian Beclomethasone Dipropionate-Salmeterol Xinafoate Study Group. An inhaled glucocorticoid is currently the medication of choice for long-term control of persistent asthma in children. The role of long-acting beta2-adrenergic-receptor agonists, such as salmeterol, needs to be defined.We conducted a randomized, double-blind, placebo-controlled, parallel-group, one-year study of 241 children (mean [+/-SD] age (...) , 9.3+/-2.4 years) with clinically stable asthma and less than one month of prior glucocorticoid use. We compared inhaled beclomethasone dipropionate (200 microg twice daily) with salmeterol xinafoate (50 microg twice daily) and placebo (lactose). The primary outcome measure, airway responsiveness (as assessed with a methacholine challenge) was evaluated before treatment; after 3, 6, 9, and 12 months of treatment (12 and 36 hours after study medications had been withheld); and 2 weeks after the end

1997 NEJM Controlled trial quality: predicted high

1068. A controlled trial of immunotherapy for asthma in allergic children. (Abstract)

A controlled trial of immunotherapy for asthma in allergic children. Injections of allergens are widely prescribed for patients with asthma, but little is known about the effectiveness of immunotherapy.We conducted a double-blind, placebo-controlled trial of multiple-allergen immunotherapy in 121 allergic children with moderate-to-severe, perennial asthma. The children, who required daily medication for their asthma, were randomly assigned to receive subcutaneous injections of either a mixture (...) in the immunotherapy group (P<0.001) and from 5.2 to 5.0 in the placebo group (P<0.001), but there was no significant difference between the groups (P>0.6). The number of days on which oral corticosteroids were used was similar in the two groups. Partial or complete remission of asthma occurred in 31 percent of the immunotherapy group and in 28 percent of the placebo group (P>0.5). There was no difference between the groups in the use of medical care, symptoms, or peak flow rates. The median PC20 increased

1997 NEJM Controlled trial quality: predicted high

1069. Randomised trial of intravenous salbutamol in early management of acute severe asthma in children. (Abstract)

Randomised trial of intravenous salbutamol in early management of acute severe asthma in children. The mainstay of treatment for acute asthma in children is nebulised beta 2-adrenergic agents such as salbutamol, given with corticosteroids. However, penetration of the drug to the small airways is impeded by obstruction so intravenous salbutamol may be more effective. We assessed the use of intravenous salbutamol in the management of children with acute severe asthma in a double-blind randomised (...) study.Children who presented to the Emergency Department of Westmead Hospital, Sydney, Australia with asthma were assessed with a clinical assessment scale, and those with severe acute asthma were given nebulised salbutamol at a dose of 2.5 mg (age < or = 2 years) or 5.0 mg (age > 2 years), made up to 4 mL with saline. Children who did not improve were eligible to enter phase one of the study. In this phase (0 h-2 h) treatment was by a standard protocol: nebulised salbutamol at the above dose: 4 L/min or 6 L

1997 Lancet Controlled trial quality: predicted high

1070. Effect of long-term treatment with salmeterol on asthma control: a double blind, randomised crossover study. Full Text available with Trip Pro

Effect of long-term treatment with salmeterol on asthma control: a double blind, randomised crossover study. To determine the effect of adding salmeterol 50 micrograms twice daily for six months to current treatment in subjects with asthma who control their inhaled corticosteroid dose according to a management plan.A double blind, randomised crossover study.Nottingham.101 subjects with mild or moderate asthma taking at least 200 micrograms twice daily of beclomethasone dipropionate (...) or budesonide.Salmeterol 50 micrograms twice daily and placebo for six months each, with a one month washout. Subjects adjusted inhaled steroid dose according to guidelines.Reduction in inhaled steroid use, exacerbations of asthma, and use of oral steroids.Data were available for 87 subjects. When compared with placebo salmeterol treatment was associated with a 17% reduction in inhaled steroid use (95% confidence interval 12% to 22%) with no significant difference in the number of subjects who had an exacerbation

1997 BMJ Controlled trial quality: predicted high

1071. Association between beta 2-adrenoceptor polymorphism and susceptibility to bronchodilator desensitisation in moderately severe stable asthmatics. (Abstract)

Association between beta 2-adrenoceptor polymorphism and susceptibility to bronchodilator desensitisation in moderately severe stable asthmatics. In-vitro studies have suggested that polymorphisms of the beta 2-adrenoceptor may influence the desensitisation induced by beta 2-agonists. We investigated the influence of beta 2-AR polymorphism on the development of bronchodilator desensitisation in asthma patients.We carried out an analysis of 22 moderately severe stable asthmatics, mean age 38 (...) greater desensitisation with Glu 27 than with Gln 27 for maximal FEF25-75 response: -7% (Gln 27) vs 68% (Glu 27), p = 0.05; and for 6 h FEF25-75 response: 43% (Gln 27) vs 93% (Glu 27), p < 0.05 (95% CI 2-147% and 5-94%, respectively). All patients who were homozygous Glu 27 were also homozygous Gly 16.We have found preliminary evidence that beta 2-adrenoceptor polymorphism is associated with altered beta 2-adrenoceptor expression in asthma patients. The homozygous Gly-16 form was significantly more

1997 Lancet Controlled trial quality: uncertain

1072. Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. (Abstract)

Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. The role of long-acting, inhaled beta2-agonists in treating asthma is uncertain. In a double-blind study, we evaluated the effects of adding inhaled formoterol to both lower and higher doses of the inhaled glucocorticoid budesonide.After a four-week run-in period of treatment with budesonide (800 microg twice daily), 852 patients being (...) treated with glucocorticoids were randomly assigned to one of four treatments given twice daily by means of a dry-powder inhaler (Turbuhaler): 100 microg of budesonide plus placebo, 100 microg of budesonide plus 12 microg of formoterol, 400 microg of budesonide plus placebo, or 400 microg of budesonide plus 12 microg of formoterol. Terbutaline was permitted as needed. Treatment continued for one year; we compared the frequency of exacerbations of asthma, symptoms, and lung function in the four groups

1997 NEJM Controlled trial quality: predicted high

1073. A comparison of low-dose inhaled budesonide plus theophylline and high-dose inhaled budesonide for moderate asthma. (Abstract)

A comparison of low-dose inhaled budesonide plus theophylline and high-dose inhaled budesonide for moderate asthma. Inhaled glucosteroids and oral theophylline are widely used to treat asthma. We compared the benefits of adding theophylline to inhaled glucosteroid with those of doubling the dose of inhaled glucosteroid in patients with persistent symptoms despite the use of inhaled glucosteroid.In a double-blind, placebo-controlled trial, we randomly assigned 62 patients to receive either 400 (...) the study. As compared with treatment with high-dose budesonide, treatment with low-dose budesonide plus theophylline resulted in greater improvements in forced vital capacity (P=0.03) and forced expiratory volume in one second (P= 0.03). There were significant and similar reductions in beta2-agonist use and the variability of peak expiratory flow, a correlate of bronchial hyperresponsiveness and the severity of asthma. Serum cortisol concentrations were significantly reduced in the group given high

1997 NEJM Controlled trial quality: predicted high

1074. Effects of antihistamines in adult asthma: a meta-analysis of clinical trials

Effects of antihistamines in adult asthma: a meta-analysis of clinical trials Effects of antihistamines in adult asthma: a meta-analysis of clinical trials Effects of antihistamines in adult asthma: a meta-analysis of clinical trials Van Ganse E, Kaufman L, Derde M P, Yernault J C, Delaunois L, Vincken W Authors' objectives To investigate the positive and negative effects of antihistamines in asthma. Searching MEDLINE, Ringdoc, and Excerpta Medica: DRUGS, were searched for studies published (...) to other asthma medication were not used. Participants included in the review Patients with mild, moderate or severe asthma were included in the review. All asthma definitions given by the authors were accepted; these usually defined asthma as a history of reversible airflow obstruction, with impaired lung function that improved considerably after the use of inhaled bronchodilators. The age of the participants in the included studies ranged from 7 to 74 years, and over 50% of the patients in each study

1997 DARE.

1075. Effectiveness of prophylactic inhaled steroids in childhood asthma: a systematic review of the literature

Effectiveness of prophylactic inhaled steroids in childhood asthma: a systematic review of the literature Effectiveness of prophylactic inhaled steroids in childhood asthma: a systematic review of the literature Effectiveness of prophylactic inhaled steroids in childhood asthma: a systematic review of the literature Calpin C, Macarthur C, Stephens D, Feldman W, Parkin P C Authors' objectives To evaluate the effectiveness of prophylactic inhaled steroids in childhood asthma. Searching MEDLINE (...) was searched from January 1966 to December 1996 using the following MeSH terms: 'asthma', 'drug therapy', 'glucocorticoid', 'inhaled corticosteroid', 'inhaled steroid', 'clinical trial' and 'randomised controlled trial' (RCT). In addition, Current Contents and selected paediatric and respiratory journals were searched manually, and the reference lists of the retrieved papers were examined. Only publications in the English language were retrieved. Study selection Study designs of evaluations included

1997 DARE.

1076. Cost effectiveness of an allergy consultation in the management of asthma

The evidence for final outcomes was based on a single study. Link between effectiveness and cost data The costing was retrospectively performed on the same patient sample as that used in the effectiveness analysis. Study sample Power calculations were not used to determine the sample size. A total of 70 patients (from 300 asthmatic referrals to the Allergy/Asthma Department) fulfilled the study criteria and had an age range from 3 to 70 years. The age distribution of the study patients was as follows: 20 (...) asthmatic patients should have an allergy/asthma consultation. Source of funding None stated. Bibliographic details Westley C R, Spiecher B, Starr L, Simons P, Sanders B, Marsh W, Comer C, Harvey R. Cost effectiveness of an allergy consultation in the management of asthma. Allergy and Asthma Proceedings 1997; 18(1): 15-18 PubMedID Other publications of related interest Kritz S E, Meyer L C. Improving patient outcomes for severe asthma through comprehensive specialized treatment: a report

1997 NHS Economic Evaluation Database.

1077. Zafirlukast: the first leukotriene-receptor antagonist approved for the treatment of asthma

be compared with other anti-asthma medications in further research. Bibliographic details Kelloway JS. Zafirlukast: the first leukotriene-receptor antagonist approved for the treatment of asthma. Annals of Pharmacotherapy 1997; 31(9): 1012-1021 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Animals; Anti-Asthmatic Agents /adverse effects /pharmacokinetics /therapeutic use; Asthma /drug therapy; Clinical Trials as Topic; Humans; Leukotriene Antagonists; Tosyl Compounds /adverse effects (...) Zafirlukast: the first leukotriene-receptor antagonist approved for the treatment of asthma Zafirlukast: the first leukotriene-receptor antagonist approved for the treatment of asthma Zafirlukast: the first leukotriene-receptor antagonist approved for the treatment of asthma Kelloway JS Authors' objectives To review the pharmacology, pharmacokinetics, clinical efficacy, and adverse effects of zafirlukast for the treatment of asthma. Searching MEDLINE was searched, but no details of the search

1997 DARE.

1078. Metered-dose inhaler accessory devices in acute asthma. Efficacy and comparison with nebulizers: a literature review

Metered-dose inhaler accessory devices in acute asthma. Efficacy and comparison with nebulizers: a literature review Metered-dose inhaler accessory devices in acute asthma. Efficacy and comparison with nebulizers: a literature review Metered-dose inhaler accessory devices in acute asthma. Efficacy and comparison with nebulizers: a literature review Amirav I, Newhouse M T Authors' objectives To evaluate the efficacy of metered-dose inhalers (MDIs) and accessory devices (ADs) in the management (...) of acute asthma in children, and to compare the outcome with small volume nebulisers (SVNs), which represent the current standard of care. Searching MEDLINE was searched from 1980 to 1996 for publications in the English language, using the keywords 'acute asthma', 'children', 'aerosols' and 'nebulizers'. The reference lists of the retrieved studies were examined, and citation searches were made using the Science Citation Index. The authors of the primary studies were also contacted for additional

1997 DARE.

1079. Low-dose methotrexate spares steroid usage in steroid-dependent asthmatic patients: a meta-analysis

in steroid-dependent asthmatic patients: a meta-analysis. Chest 1997; 112(1): 29-33 PubMedID Original Paper URL Other publications of related interest 1. Davies H, Olson L, Gibson P. Methotrexate as a steroid sparing agent in adult asthma (Cochrane Review). In: The Cochrane Library. Issue 3, 1998. Oxford: Update Software. Indexing Status Subject indexing assigned by NLM MeSH Adult; Anti-Asthmatic Agents /administration & Anti-Inflammatory Agents /administration & Asthma /drug therapy /etiology; Humans (...) Low-dose methotrexate spares steroid usage in steroid-dependent asthmatic patients: a meta-analysis Low-dose methotrexate spares steroid usage in steroid-dependent asthmatic patients: a meta-analysis Low-dose methotrexate spares steroid usage in steroid-dependent asthmatic patients: a meta-analysis Marin M G Authors' objectives To determine if treatment with low-dose methotrexate spares oral steroids in adult, steroid-dependent, asthmatic patients. Searching MEDLINE (1966 to November 1996

1997 DARE.

1080. Cost-effective management of malignant potentially fatal asthma

Cost-effective management of malignant potentially fatal asthma Cost-effective management of malignant potentially fatal asthma Cost-effective management of malignant potentially fatal asthma Levenson T, Grammar L C, Yarnold P R, Patterson R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment (...) on the reliability of the study and the conclusions drawn. Health technology Asthma management intervention programme tailored for specific patients with malignant potentially fatal asthma. The programme included regular clinic visits, patient and family education, 24-hour telephone access, simplified medical regimens, adequate anti-inflammatory medication and, if indicated, psychiatric referral. These measures included the building of doctor/patient relations and, for some, the use of depot injections

1997 NHS Economic Evaluation Database.