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Quadrupling Inhaled Glucocorticoid Dose to Abort Asthma Exacerbations. Asthma exacerbations are frightening for patients and are occasionally fatal. We tested the concept that a plan for patients to manage their asthma (self-management plan), which included a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control started to deteriorate, would reduce the incidence of severe asthma exacerbations among adults and adolescents with asthma.We conducted a pragmatic, unblinded (...) , randomized trial involving adults and adolescents with asthma who were receiving inhaled glucocorticoids, with or without add-on therapy, and who had had at least one exacerbation in the previous 12 months. We compared a self-management plan that included an increase in the dose of inhaled glucocorticoids by a factor of 4 (quadrupling group) with the same plan without such an increase (non-quadrupling group), over a period of 12 months. The primary outcome was the time to a first severe asthma
Effectiveness of Indoor Allergen Reduction in Management of Asthma Comparative Effectiveness Review Number 201 Effectiveness of Indoor Allergen Reduction in Management of Asthma e12 Comparative Effectiveness Review Number 201 Effectiveness of Indoor Allergen Reduction in Management of Asthma Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00005-I Prepared by: ECRI (...) Institute–Penn Medicine Evidence-based Practice Center Plymouth Meeting, PA Investigators: Brian F. Leas, M.S., M.A., and Kristen E. D’Anci, Ph.D.* Andrea J. Apter, M.D., M.Sc. Tyra Bryant-Stephens, M.D. Karen Schoelles, M.D., S.M. Craig A. Umscheid, M.D., M.S.C.E. *Mr. Leas and Dr. D’Anci contributed equally to this report. AHRQ Publication No. 18-EHC002-EF February 2018 ii Key Messages Purpose of Review To evaluate the effectiveness of indoor allergen reduction interventions on asthma outcomes. Key
Budesonide/formoterol maintenance and reliever therapy in adolescent patients with asthmaAsthma control is often suboptimal in adolescents, but few studies have evaluated asthma treatments in this population.This post hoc analysis assessed the efficacy and safety of budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (MART) for treatment of persistent asthma in adolescent (age 12-17 years) subgroups within six randomised, double-blind trials. The primary end-point was time (...) to first severe exacerbation. Secondary end-points included number of severe exacerbations, asthma-related symptoms, night-time awakenings, morning peak expiratory flow, forced expiratory volume in 1 s, as-needed medication use and five-item asthma control questionnaire scores.In adolescents (n=1847), BUD/FORM MART was similar to or more effective than comparators across each of the studies in reducing the risk of a first severe exacerbation (hazard ratios (HR) BUD/FORM MART versus comparators 0.15
, or asthma symptoms. However treatment with both daily and twice daily dosing was associated with a small improvement in the forced expiratory volume in 1 minute (FEV1) (mean difference, +0.09 L, P = .0039 and +0.12L, P < .0001 respectively). Again the clinical significance of these results are unclear due to the small treatment effect. The above studies only included asthmatics with symptomatic GERD. Up until this point a large randomized controlled trial (RCT) of patients with poorly controlled asthma (...) and no symptoms of GERD had never been performed. In addition these studies did not incorporate objective confirmation of acid reflux, usually measured using the gold standard 24-hour esophageal pH monitoring. However, it should be noted that this method has notoriously poor correlation with symptoms, with 1 study finding that only 51% of asthmatics endorsing symptomatic GERD had abnormal acid reflux on pH monitoring. 6 18 randomized 412 subjects with poorly controlled asthma despite ICS and no reported
G460(P) Interventions for autumn exacerbations of asthma in children: a systematic review G460(P) Interventions for autumn exacerbations of asthma in children: a systematic review | Archives of Disease in Childhood Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers (...) of institutional accounts Username * Password * your user name or password? You are here G460(P) Interventions for autumn exacerbations of asthma in children: a systematic review Article Text British Paediatric Respiratory Society and British Society for Paediatric and Adolescent Rheumatology G460(P) Interventions for autumn exacerbations of asthma in children: a systematic review Free M Akhbari , D Kneale , KM Harris , KC Pike Statistics from Altmetric.com Request Permissions If you wish to reuse any or all
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
Randomized Trial of Dexamethasone Versus Prednisone for Children with Acute Asthma Exacerbations To determine whether 2 doses of dexamethasone is as effective as 5 days of prednisolone/prednisone therapy in improving symptoms and quality of life of children with asthma exacerbations admitted to the emergency department (ED).We conducted a randomized, noninferiority trial including patients aged 1-14 years who presented to the ED with acute asthma to compare the efficacy of 2 doses (...) of dexamethasone (0.6 mg/kg/dose, experimental treatment) vs a 5-day course of prednisolone/prednisone (1.5 mg/kg/d, followed by 1 mg/kg/d on days 2-5, conventional treatment). Two follow-up telephone interviews were completed at 7 and 15 days. The primary outcome measures were the percentage of patients with asthma symptoms and quality of life at day 7. Secondary outcomes were unscheduled returns, admissions, adherence, and vomiting.During the study period, 710 children who met the inclusion criteria were
Effect of the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) Program on Asthma Morbidity: A Randomized Clinical Trial Poor adherence to recommended preventive asthma medications is common, leading to preventable morbidity. We developed the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program to build on school-based supervised therapy programs by incorporating telemedicine at school to overcome barriers to preventive asthma care.To evaluate the effect of the SB (...) -TEAM program on asthma morbidity among urban children with persistent asthma.In this randomized clinical trial, children with persistent asthma aged 3 to 10 years in the Rochester City School District in Rochester, New York, were stratified by preventive medication use at baseline and randomly assigned to the SB-TEAM program or enhanced usual care for 1 school year. Participants were enrolled at the beginning of the school year (2012-2016), and outcomes were assessed through the end of the school
Prospective Open-Label Study of 48-Week Subcutaneous Administration of Mepolizumab in Japanese Patients with Severe Eosinophilic Asthma. The long-term efficacy and safety of mepolizumab in patients with severe eosinophilic asthma has been evaluated in large-scale double-blind placebo-controlled trials. However, a prospective open-label trial of long-term subcutaneous administration of mepolizumab has not been performed in Japanese patients with severe eosinophilic asthma.This study (...) was a prospective, 48-week, open-label trial in 32 Japanese patients with severe eosinophilic asthma who received subcutaneous mepolizumab 100 mg every 4 weeks. Nine patients required oral corticosteroids daily despite receiving high-dose inhaled corticosteroids. Six patients had aspirin-exacerbated respiratory disease.All patients took mepolizumab throughout the study period. No patients experienced adverse events during the treatment. None of the patients experienced asthma exacerbations during the trial
The effect of self-care education on the quality of life in children with allergic asthma. Asthma is a condition where the airways become tiny and swollen producing extra mucus. This can cause breathing difficulty and wheezing, coughing, and shortness of breath. Self-care education affects the quality of life of children. This study examined the effect of self-care education on quality of life for children between 8 and 11 years with allergic asthma. This study was a randomized controlled trial (...) . Study sample included 70 children between 8 and 11 years with asthma allergy referred to Children's Hospital Clinic of Khorramabad, Lorestan Province in 2015; they were selected by possible non-consecutive sampling method. Children were divided by random sampling of blocks, and classified into two groups of 35 patients each in the experimental and control groups. Both groups were matched for age and sex of children's and parents' educational level and initial quality of life scores were analyzed
Nucala - mepolizumab - Asthma, severe eosinophilic mepolizumab | CADTH.ca Find the information you need mepolizumab mepolizumab Last Updated: April 23, 2019 Result type: Reports Project Number: SF0593-000 Product Line: Generic Name: mepolizumab Brand Name: Nucala Manufacturer: GlaxoSmithKline Inc. Indications: Asthma, severe eosinophilic Manufacturer Requested Reimbursement Criteria 1 : Not applicable. Submission Type: Request For Advice Project Status: Complete Biosimilar: No Companion (...) Asthma Canada and The Ontario Lung Association Patient input summary sent for review to patient input groups December 17, 2018 Patient group comments on input summary closed December 20, 2018 Clarification: - Patient input summary feedback received Request for Advice received October 24, 2018 Manufacturer informed of request for advice October 24, 2018 Manufacturer information or comments due November 07, 2018 Request for Advice initiated October 29, 2018 Draft CDR Request for Advice report sent
Fasenra - benralizumab - Asthma, severe eosinophilic benralizumab | CADTH.ca Find the information you need benralizumab benralizumab Last Updated: April 23, 2019 Result type: Reports Project Number: SF0592-000 Product Line: Generic Name: benralizumab Brand Name: Fasenra Manufacturer: AstraZeneca Canada Inc. Indications: Asthma, severe eosinophilic Manufacturer Requested Reimbursement Criteria 1 : Not applicable. Submission Type: Request For Advice Project Status: Complete Biosimilar (...) received from Asthma Canada and The Ontario Lung Association Patient input summary sent for review to patient input groups December 17, 2018 Patient group comments on input summary closed December 20, 2018 Clarification: - Patient input summary feedback received Request for Advice received October 24, 2018 Manufacturer informed of request for advice October 24, 2018 Manufacturer information or comments due November 07, 2018 Request for Advice initiated October 29, 2018 Draft CDR Request for Advice
Cinqair - reslizumab - Asthma, eosinophilic reslizumab | CADTH.ca Find the information you need reslizumab reslizumab Last Updated: April 23, 2019 Result type: Reports Project Number: SF0591-000 Product Line: Generic Name: reslizumab Brand Name: Cinqair Manufacturer: TEVA Canada Innovation Indications: Asthma, eosinophilic Manufacturer Requested Reimbursement Criteria 1 : Not applicable Submission Type: Request For Advice Project Status: Complete Biosimilar: No Date Recommendation Issued: March (...) 27, 2019 Recommendation Type: Reimburse with clinical criteria and/or conditions The requested reimbursement criteria are provided by the applicant and do not necessarily reflect the views of CADTH. Reimbursement criteria from CADTH will be documented in the final recommendation, if applicable. Key Milestones 1 Call for patient input posted October 24, 2018 Patient group input closed December 12, 2018 Clarification: - Patient input submission received from Asthma Canada and The Ontario Lung
Asthma CHRONIC ASTHMA Clinical Practice Guideline | April 2018 These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making. OBJECTIVE Alberta clinicians will adopt a comprehensive patient-centred interdisciplinary team approach to asthma management including diagnosis, assessing control, treating and preventing (...) exacerbation and ongoing follow-up. TARGET POPULATION Adults and children >6 years old, with important considerations for preschool aged children. EXCLUSIONS Asthma in acute care settings; asthma-COPD overlap; detailed management for preschool ages. RECOMMENDATIONS HISTORY AND EXAM ? Patients with asthma present with a range of clinical findings, arising from a shared core of intermittent inflammation and bronchoconstriction (Table 1). ? It is important to determine the appropriate diagnosis, as other
AsthmaAsthma | Topics A to Z | CKS | NICE Search CKS… Menu AsthmaAsthma Last revised in April 2020 Asthma is a chronic inflammatory condition of the airways.The airways are hyper-responsive and constrict easily in response to a wide range of stimuli Diagnosis Management Prescribing information Background information Asthma: Summary Asthma is a chronic inflammatory condition of the airways. The airways are hyper-responsive and constrict easily in response to a wide range of stimuli. This may (...) result in coughing, wheezing, chest tightness, and shortness of breath. Asthma is a common condition. The British Lung Foundation states that 5.4 million people in the UK are receiving treatment for asthma. A diagnosis of asthma should be suspected in a person with: Wheeze, breathlessness, chest tightness, and cough, particularly if symptoms are worse at night and in the early morning; occur in response to exercise, allergen exposure, and cold air; occur after taking non-steroidal anti-inflammatory
, 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