Differentiating non-responders from responders in children with moderate and severe asthma exacerbations.
Differentiating non-responders from responders in children with moderate and severe asthma exacerbations. J Asthma. 2019 Feb 22;:1-5 Authors: Sneller H, Carroll CL, Welch K, Sturm J Abstract OBJECTIVE: Our goal was to assess factors associated with non-response to treatment in children presenting to the Emergency Department (ED) with moderate and severe asthma exacerbations. METHODS: A retrospective chart review was completed from 9/2014 to 2/2017 for patients with a discharge diagnosis of asthma exacerbation. The Modified Pulmonary Index Score (MPIS) was used to quantify illness acuity. The rate of change of MPIS per hour was calculated, and differentiated responders from non-responders. After examining a histogram of ΔMPIS/h, a threshold of ΔMPIS/h > 0 was used to define response for duration of ED stay. Children included were>2 years and had initial MPIS> 10. RESULTS: Eight hundred and fifty-two children were included. There were 178 (21%) non-responders and 674 (79%) responders. Non-responders were significantly older (7.0 ± 4.0 versus 5.6 ± 3.2 years; p
CONCLUSIONS: Families who were provided a written asthma action plan during their pediatric emergency department visit for an asthma exacerbation reported fewer unplanned visits during the subsequent three months. PMID: 32066290 [PubMed - as supplied by publisher]
Conclusions Inhaled corticosteroid use is not associated with a reduction in lung cancer incidence in patients with COPD. Observational studies reporting such reduction may have been affected by time-related biases and the inclusion of patients with asthma. The proposition of a randomised trial warrants some caution.
Condition: Asthma Interventions: Drug: Prednisone/ Prednisolone; Biological: Mepolizumab; Drug: Salbutamol Sponsors: GlaxoSmithKline; Tech Observer Not yet recruiting
Theophylline is still one of the most widely prescribed drugs for the treatment of asthma and COPD in developing countries because the majority of asthma and COPD medicines and are largely unavailable and also because it is a cheaper option. In any case, its anti-inflammatory effects and capacity to reverse corticosteroid resistance deserve consideration, but it can induce numerous side effects and drug-drug interactions and frequently requires measurement of drug levels in plasma. In order to overcome the problems posed by theophylline, other xanthines have been developed.
Publication date: Available online 14 February 2020Source: The Lancet Respiratory MedicineAuthor(s): Jonathan A Bernstein, J Christian Virchow, Kevin Murphy, Jorge Fernando Maspero, Joshua Jacobs, Yochai Adir, Marc Humbert, Mario Castro, Douglas A Marsteller, Jennifer McElhattan, Lisa Hickey, Margaret Garin, Rebecca Vanlandingham, Guy BrusselleSummaryBackgroundReslizumab 3 mg/kg administered intravenously is approved for the treatment of severe eosinophilic asthma. We assessed the safety and efficacy of subcutaneous reslizumab 110 mg in two trials in patients with uncontrolled severe asthma and increased blood eosinophils....
ConclusionsSpecialist-diagnosed CC was associated with considerable disease burden, particularly among those with both respiratory disease and GERD. Additionally, CC burden was more pronounced than in matched non-cough patients.
This JAMA Insights Clinical Update reviews management of asthma exacerbations, including the use of inhaled corticosteroids (ICS), azithromycin, magnesium sulfate, and nebulized bronchodilators vs metered-dose inhalers (MDIs), and discusses the potential future role of benralizumab and other biological therapies.
This JAMA Insights Clinical Update reviews recent evidence favoring use of inhaled corticosteroids (ICS)in all patients with asthma, regardless of frequency, and summarizes the SMART (single maintenance and reliever therapy) treatment approach, which uses an inhaler combining ICS and formoterol for control and relief of symptoms, and differences between SMART and symptom-driven therapy.
Córdova P Abstract INTRODUCTION AND OBJECTIVES: Functional and inflammatory measures have been recommended to corroborate asthma diagnosis in schoolchildren, but the evidence in this regard is conflicting. We aimed to determine, in real-life clinical situation, the value of spirometry, spirometric bronchial reversibility to salbutamol (BDR), bronchial responsiveness to methacholine (MCT) and fractional exhaled nitric oxide (FENO), to corroborate the diagnosis of asthma in children on regular inhaled corticosteroids (ICS) referred from primary care. METHODS: One hundred and seventy-seven schoolchildren...