Measuring the effects of bronchial thermoplasty using oscillometry

ABSTRACTBackground and objectiveBronchial thermoplasty (BT) has been consistently shown to reduce symptoms, exacerbations and the need for reliever medication in patients with severe asthma. Paradoxically, no consistent improvement in spirometry has been demonstrated. It has been suggested that this is due to a reduction in peripheral resistance in small airways, not captured by spirometry. Therefore, in this study, we evaluate the response to BT using oscillometry.MethodsA total of 43 patients with severe asthma from two centres were evaluated at baseline, 6  weeks and 6 months post BT, using spirometry, plethysmography and oscillometry, in addition to medication usage, exacerbation frequency and the Asthma Control Questionnaire (5‐item version) (ACQ‐5).ResultsThe mean age was 58.4  ± 11.2 years, forced expiratory volume in 1 s (FEV1) 55.5  ± 20.1% predicted, forced expiratory ratio 53.0 ± 14.5% and FEV1 response to salbutamol was 14.0  ± 14.5%. Following BT, the group responded to treatment with an improvement in ACQ‐5 from 2.9 ± 0.9 at baseline to 1.7 ± 1.1 at 6 months (P
Source: Respirology - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research

Related Links:

We present a 48 year-old active duty physician who initially presented in 2007 with dyspnea and cough. Despite the absence of variable obstruction on spirometry, a clinical diagnosis of asthma was made. The patient's symptoms were temporized with inhaled corticosteroids and bronchodilators, titrated to his symptoms, until eventual therapeutic failure resulted in re-referral to pulmonary. Chest computed tomography (CT) showed ground-glass nodules and patchy airspace opacities with evidence of thoracic lymphadenopathy. A positron emission tomography CT (PET CT) showed diffuse adenopathy throughout his thorax and abdomen with...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Respir Med Case Rep Source Type: research
Conclusion: In this group of pulmonologists confirmed COPD or ACO patients, a substantial proportion would be considered to have signs of asthma. In the personalized approach of airway disease management, these patients might benefit from ICS containing treatment. Prospective studies are needed to guide personalized care in this patient group.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: General practice and primary care Source Type: research
Introduction: there are no studies in steroid-dependent allergic asthma patients that demonstrate the oral corticosteroid (OC) sparing capacity of omalizumab or its histological benefits.Methodology: Open randomized study with two groups: OC + omalizumab (OMA G.) and OC alone (CG). At every monthly visit we recorded: accumulated and daily OC dose, exacerbations, spirometry, FeNO and adverse events. IgE measurement and bronchial biopsies were performed at baseline and after 12 months (immunohistochemical and EM).Results: 31 patients (17 OMA; 14 CG) without baseline differences. OC dose was reduced by 83% in OMA G. and by 9....
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
Conclusion: Using a clinical algorithm with mannitol challenge for assessment of fitness to dive in patients with possible asthma allowing re-challenge testing after stepping-up asthma therapy increased the proportion of individuals classified as fit for recreational SCUBA diving.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Epidemiology Source Type: research
Background and Objective: Inhaled corticosteroids (ICS) might be overprescribed for COPD in general practice. Our aim was to identify predictors for prescribing ICS for COPD patients with or without asthma in general practice.Methods: Participating general practitioners (GPs) (n=144) recruited patients with COPD (ICPC 2nd ed. code R95) and currently prescribed ICS (ACT code R03AK and R03BA). Data on demographics, smoking habits, spirometry, dyspnea score, and exacerbation history were retrieved from medical records. Pearson Chi-Square test was used for comparison of categorical variables and logistic regression analysis wa...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: General practice and primary care Source Type: research
Conclusions: The difference, in commonly reported ICS sensitive parameters, was minimal between subjects with sustained AHR to mannitol and those whose AHR was abolished after 18wks of ICS. These findings suggest that measurements of asthma control, airway calibre and FeNO are not adequate to confirm optimal ICS therapy and the measurement of AHR to mannitol is a more useful guide to treatment with ICS.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research
Conclusion: Difficult to control asthma is more predominant in asthmatic patients with elder age, obesity, smoking history and poor pulmonary functions.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
Conclusion: A high proportion of COPD/Asthma patients are treated with oral medications in India. Even though 34% of patients are prescribed inhaled medications before they reach tertiary care, there is a preference for a ICS over LAMA in COPD and only 30% of Asthma patients were prescribed an ICS.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: General practice and primary care Source Type: research
Conclusion: In older non-smoking asthmatics with FAO, VH has a large effect on dynamic respiratory mechanics at a higher than normal breathing rate. Furthermore, Xrs at 5Hz may predominantly reflect VH rather than static lung compliance in this population.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research
VR475 has been developed for the treatment of severe asthma consisting of budesonide suspension administered by a breath-actuated nebuliser that enhances lung drug deposition through guiding slow flow and deep inhalation.Objectives: To evaluate efficacy, safety and tolerability of 2 VR475 doses administered BID for 52 weeks vs placebo (pbo) in uncontrolled asthmatics despite high dose inhaled corticosteroids and a second controller.Methods: A 52-week double-blind, parallel-group, pbo-controlled, study was conducted. Eligible patients were randomised 2:1:1:2 to VR475 1mg (n=238) or 0.5mg (n=119), pbo (n=119), or budesonide ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
More News: Asthma | Corticosteroid Therapy | Respiratory Medicine | Spirometry | Study