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Fasenra - benralizumab - Asthma, severe eosinophilic benralizumab | CADTH.ca Find the information you need benralizumab benralizumab Last Updated: January 7, 2019 Result type: Reports Project Number: SR0561-000 Product Line: Generic Name: benralizumab Brand Name: Fasenra Manufacturer: AstraZeneca Canada Inc. Indications: Asthma, severe eosinophilic Manufacturer Requested Reimbursement Criteria 1 : For add-on maintenance treatment of adult patients with severe eosinophilic asthma who (...) are inadequately controlled with high-dose inhaled corticosteroids (ICS) and one or more additional asthma controller(s) (e.g., LABA), if one of the following clinical criteria are met: 1. Blood eosinophil count of 300 cells/L AND have experienced two or more clinically significant asthma exacerbations in the past 12 months, or 2. Blood eosinophil count of 150 cells/L and are treated chronically with oral corticosteroids (OCS). Submission Type: New Project Status: Active Biosimilar: No Date Recommendation
Benralizumab (Fasenra) - For add-on maintenance treatment of patients with severe asthma aged 12 years and older, and with an eosinophilic phenotype Fasenra (benralizumab) 30 mg/mL Injection U.S. Department of Health and Human Services Search FDA Submit search Fasenra (benralizumab) 30 mg/mL Injection Fasenra Company: AstraZeneca Pharmaceuticals LP Application No.: 761070 Approval Date: 11/14/2017 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634
Effect of an Intervention to Promote Breastfeeding on Asthma, Lung Function, and Atopic Eczema at Age 16 Years: Follow-up of the PROBIT Randomized Trial Atopic diseases, including asthma and atopic eczema, are the most common chronic conditions of childhood.To investigate whether an intervention to promote prolonged and exclusive breastfeeding protects against asthma, atopic eczema, and low lung function in adolescence.Follow-up of the Promotion of Breastfeeding Intervention Trial (PROBIT (...) outcomes; secondary outcomes were self-reported asthma diagnosis ever, and wheezing and flexural eczema symptoms in the previous year.A total of 13 557 (79.5%) participants were followed up from September 15, 2012 to July 15, 2015. The intervention (7064 [79.7%]) and control (6493 [79.4%]) groups were similar at follow-up (3590 [50.8%] and 3391 [52.2%] male; mean [SD] age, 16.2 [0.6] and 16.1 [0.5] years, respectively). In the intervention group, 0.3% (21 of 7064) had flexural eczema on skin
• Depending on the FeNO cutoff, the likelihood of having asthma in people ages 5 years and older increases by 2.8 to 7.0 times given a positive FeNO test result. • FeNO is modestly more accurate in diagnosing steroid-naïve asthmatics, children (ages 5-18), and nonsmokers than other patients suspected to have asthma. • FeNO results can predict which patients will respond to inhaled corticosteroid therapy. • Using FeNO to manage long-term control medications including dose titration, weaning, and monitoring (...) asthma in people ages 5 years and older. Test performance is modestly better in steroid-naïve asthmatics, children, and nonsmokers than the general population with suspected asthma. Algorithms that include FeNO measurements can help in monitoring response to anti-inflammatory or long-term control medications, including dose titration, weaning, or treatment adherence. At this time, there is insufficient evidence supporting the measurement of FeNO in children under the age of 5 as a means
Association Between Inhaled Corticosteroid Use and Bone Fracture in Children With Asthma Daily use of inhaled corticosteroids is a widely recommended treatment for mild persistent asthma in children. There is concern that, similar to systemic corticosteroids, inhaled corticosteroids may have adverse effects on bone health.To determine whether there is an increased risk of bone fracture associated with inhaled corticosteroid use in children with asthma.In this population-based nested case (...) -control study, we used health administrative databases to identify a cohort of children aged 2 to 18 years with a physician diagnosis of asthma between April 1, 2003, and March 31, 2014, who were eligible for public drug coverage through the Ontario Drug Benefit Program (Ontario, Canada). We matched cases of first fracture after asthma diagnosis to fracture-free controls (ratio of 1 to 4) based on date of birth (within 1 year), sex, and age at asthma diagnosis (within 2 years). We used a 1-year
be considered when evaluating a child with suspected asthma, especially in very young children or when high doses of inhaled corticosteroids are required. Definition Asthma is a chronic respiratory disorder characterised by variable airway inflammation, airway obstruction, and airway hyper-responsiveness. These features interact to determine the clinical symptom pattern of the individual. While the majority of asthmatic children have an intermittent symptom phenotype, the minority have persistent symptoms (...) Asthma in children Asthma in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Asthma in children Last reviewed: February 2019 Last updated: July 2018 Summary As paediatric asthma differs from adult asthma, child-specific asthma guidelines should be used and adult and adolescent guidelines should not be extrapolated to younger age groups. The prevalence of childhood asthma appears to have plateaued in many
Acute asthma exacerbation in adults Acute asthma exacerbation in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Acute asthma exacerbation in adults Last reviewed: February 2019 Last updated: June 2018 Summary Presents as an acute or subacute episode of progressive worsening of symptoms, such as shortness of breath, wheezing, cough, and chest tightness. Pulse rate, respiratory rate, subjective assessment (...) , mechanical ventilation. Pneumonia, pneumothorax, pneumomediastinum, and respiratory failure are complications. Definition An asthma exacerbation is an acute or subacute episode of progressive worsening of symptoms of asthma, including shortness of breath, wheezing, cough, and chest tightness. Exacerbations are marked by decreases from baseline in objective measures of pulmonary function, such as peak expiratory flow rate and FEV1. History and exam presence of risk factors cough wheezing shortness
, based on symptoms. Patients may need to monitor their peak expiratory flow daily and should be aware of the warning signs of a severe attack. Some patients may develop progressive, irreversible obstructive lung disease. Definition Asthma is a chronic inflammatory airway disease characterised by intermittent airway obstruction and hyper-reactivity. Many cellular components are involved in the asthmatic pathway, including mast cells, eosinophils, T lymphocytes, macrophages, neutrophils, and epithelial (...) Asthma in adults Asthma in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Asthma in adults Last reviewed: February 2019 Last updated: June 2018 Summary Patients present with recurrent episodes of shortness of breath, chest tightness, wheezing, or coughing. Examination typically demonstrates an expiratory wheeze; however, in severe asthma there is poor air entry and the chest is silent. Treatment is step-wise
Occupational asthma Occupational asthma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Occupational asthma Last reviewed: February 2019 Last updated: September 2018 Summary Should be suspected in all adult patients with asthma. An occupational history should be taken to identify work-related causes. Details of work exposures should be obtained from material safety data sheets and other material available (...) to the patient from their workplace. Objective evidence of asthma should be obtained from spirometry, a bronchodilator response, and/or a methacholine challenge. Tests should be performed when the patient is symptomatic and/or within days of having exposure to a suspected aetiological agent. If sensitiser-induced occupational asthma is suspected, additional testing of asthma should be done, preferably while the patient is still working. Whenever possible an immunological response to a suspected work
, intravenous bronchodilators, and intramuscular adrenaline (if anaphylaxis is present). Severe and life-threatening cases may require non-invasive ventilation or intubation, and the intensive care team should be involved as early as possible. In children not responding to standard asthmatic treatment, other differential diagnoses should be considered. On discharge from hospital, a clear asthma management plan and asthma education is essential to optimise asthma control and prevent future exacerbations (...) Acute asthma exacerbation in children Acute asthma exacerbation in children - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Acute asthma exacerbation in children Last reviewed: February 2019 Last updated: July 2018 Summary Asthma exacerbations present with acute or sub-acute onset of wheeze and respiratory distress, the symptoms and signs of which vary depending on the developmental and maturational age of the child
Breaking through Restricting Bottleneck for Better Asthma Control 29340274 2019 01 28 2450-131X 5 4 2017 Dec Journal of translational internal medicine J Transl Int Med Breaking through Restricting Bottleneck for Better Asthma Control. 192-193 10.1515/jtim-2017-0032 Zhu Ding D Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Institute of Respiratory Diseases, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China. Zhang Chao C Department (...) Diseases, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China. eng Journal Article 2017 12 29 Poland J Transl Int Med 101673826 2224-4018 Conflict of Interest: None declared. 2018 1 18 6 0 2018 1 18 6 0 2018 1 18 6 1 epublish 29340274 10.1515/jtim-2017-0032 jtim-2017-0032 PMC5767707 Am J Respir Crit Care Med. 2010 Jan 15;181(2):116-24 19815809 J Asthma. 2016;53(1):94-100 26383773 Respir Med. 2006 Jul;100(7):1139-51 16713224 J Pediatr Pharmacol Ther. 2017 Jul-Aug;22(4):293-299
Evaluation of anxiety and depression in mothers of children with asthmaAsthma is the most common chronic disease in childhood. Parents have an important role in managing asthma in children. Studies have shown a higher degree of depression and anxiety and lower family performance in mothers of asthmatic children in comparison with the control group.The aim of this study was to evaluate the parenting styles and also depression, anxiety and stress parameters in mothers of children (...) with asthma.This case-control study was performed on 45 mothers of 3 to 15 years old asthmatic children in the allergy clinic of Mashhad University of Medical Sciences, Mashhad, Iran, during the years of 2014 to 2016. The control group was 45 mothers of non-asthmatic children who were matched for the age of their children with the case group in the same population. The parenting styles, as well as depression and anxiety of mothers were evaluated using parenting scales, and the depression-anxiety-stress scales
Asthma. Asthma-one of the most common chronic, non-communicable diseases in children and adults-is characterised by variable respiratory symptoms and variable airflow limitation. Asthma is a consequence of complex gene-environment interactions, with heterogeneity in clinical presentation and the type and intensity of airway inflammation and remodelling. The goal of asthma treatment is to achieve good asthma control-ie, to minimise symptom burden and risk of exacerbations. Anti-inflammatory (...) and bronchodilator treatments are the mainstay of asthma therapy and are used in a stepwise approach. Pharmacological treatment is based on a cycle of assessment and re-evaluation of symptom control, risk factors, comorbidities, side-effects, and patient satisfaction by means of shared decisions. Asthma is classed as severe when requiring high-intensity treatment to keep it under control, or if it remains uncontrolled despite treatment. New biological therapies for treatment of severe asthma, together
Stormy weather: a retrospective analysis of demand for emergency medical services during epidemic thunderstorm asthma. To describe the demand for emergency medical assistance during the largest outbreak of thunderstorm asthma reported globally, which occurred on 21 November 2016.A time series analysis was conducted of emergency medical service caseload between 1 January 2015 and 31 December 2016. Demand during the thunderstorm asthma event was compared to historical trends for the overall (...) November, compared with a daily average of 52 during the historical period. After adjustment for temporal trends, thunderstorm asthma was associated with a 42% (95% confidence interval 40% to 44%) increase in overall caseload for the emergency medical service and a 432% increase in emergency medical attendances for acute respiratory distress symptoms. Emergency transports to hospital increased by 17% (16% to 19%) and time critical referrals from general practitioners increased by 47% (21% to 80
Breathing training for dysfunctional breathing in asthma: taking a multidimensional approach Various breathing training programmes may be helpful for adults with asthma. The main therapeutic aim for many of these programmes is the correction of dysfunctional breathing. Dysfunctional breathing can be viewed practically as a multidimensional entity with the three key dimensions being biochemical, biomechanical and psychophysiological. The objectives of this review are to explore how each (...) of these dimensions might impact on asthma sufferers, to review how various breathing therapy protocols target these dimensions and to determine if there is evidence suggesting how breathing therapy protocols might be optimised. Databases and reference lists of articles were searched for peer-reviewed English language studies that discussed asthma or dysfunctional breathing and various breathing therapies. Biochemical, biomechanical and psychophysiological aspects of dysfunctional breathing can all potentially
International Variation in Asthma and Bronchiolitis Guidelines Guideline recommendations for the same clinical condition may vary. The purpose of this study was to determine the degree of agreement among comparable asthma and bronchiolitis treatment recommendations from guidelines.National and international guidelines were searched by using guideline databases (eg, National Guidelines Clearinghouse: December 16-17, 2014, and January 9, 2015). Guideline recommendations were categorized as (1 (...) ) recommend, (2) optionally recommend, (3) abstain from recommending, (4) recommend against a treatment, and (5) not addressed by the guideline. The degree of agreement between recommendations was evaluated by using an unweighted and weighted κ score. Pairwise comparisons of the guidelines were evaluated similarly.There were 7 guidelines for asthma and 4 guidelines for bronchiolitis. For asthma, there were 166 recommendation topics, with 69 recommendation topics given in ≥2 guidelines. For bronchiolitis