A comparison of leukotriene receptor antagonists to low-dose inhaled corticosteroids in elderly mild asthmatics
ConclusionThe effectiveness of LTRAs was not different from that of low-dose ICSs regarding the risk of asthma exacerbation in elderly asthma patients in real-world settings. Given the practical benefits gained from convenient administration, LTRA can be considered a reasonable alternative first-line therapy for elderly patients with mild asthma.
CONCLUSIONS: The rate of anaphylaxis in patients with ColdU in a tropical country was lower than those reported by other studies conducted intemperate climates. On the other hand, the number of female patients, mean age at symptom onset, atopy rate, rate of concomitant chronic spontaneous urticaria and mean CTT were higher. PMID: 31172722 [PubMed]
This study aimed to assess the efficacy and safety of tiotropium in Chinese patients with moderate symptomatic asthma. METHODS: A post hoc subgroup analysis was conducted on 430 Chinese patients pooled from two 24-week, replicate phase 3 trials (NCT01172808 and NCT01172821), in which they received once-daily tiotropium 2.5 μg (Tio R2.5) or 5 μg (Tio R5) (n = 106 or 109, respectively), twice-daily salmeterol 50 μg (Sal 50) (n = 110), or placebo (n = 105), while maintaining inhaled corticosteroids (ICS). The co-primary endpoints assessed in week 24 were forced expiratory volume in 1 second (FEV1) peak0-3h respon...
Authors: Park HS, Lee SH, Lee SY, Kim MK, Lee BJ, Werkström V, Barker P, Zangrilli JG Abstract PURPOSE: In the Phase III SIROCCO trial (NCT01928771), benralizumab significantly reduced asthma exacerbations and improved lung function and symptoms for patients with severe, uncontrolled eosinophilic asthma. The aim of this subgroup analysis was to evaluate efficacy and safety of benralizumab for Korean patients in SIROCCO. METHODS: SIROCCO was a randomized, double-blind, parallel-group, placebo-controlled trial of 1,204 patients aged 12-75 years with severe asthma uncontrolled by high-dosage inhaled corticost...
Authors: Zhang Y, Lou H, Wang Y, Li Y, Zhang L, Wang C Abstract PURPOSE: Corticosteroids are regarded as the mainstay of medical treatment of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP). To date, a head-to-head comparison of the efficacy and safety of glucocorticoid preparations administered via different routes for the treatment of chronic rhinosinusitis with nasal polyps has not been reported. To compare the efficacy and safety of steroids administered via the oral, intranasal spray and transnasal nebulization routes in the management of ECRSwNP over a short course. METHODS: Overall, 91 pa...
ConclusionsBlood eosinophils and other noninvasive markers of type 2 inflammation may be useful in the clinical assessment of children and adolescents with asthma. However, features of type 2 inflammation vary by age. Whether children and adolescents also respond differently to management of type 2 inflammation is unclear and warrants further evaluation.
Conclusions: The quality of asthma management in the Czech Republic is comparable to that of other developed countries and better in some respects (frequent BDT, phenotyping, and use of preventive treatment). Nevertheless, there is unnecessary delay in diagnosis and lack of research on possible environmental causes (workplace, molds). Pharmacotherapy shows good adherence to guidelines. Although 10% of patients show poor control, there is concurrently a trend for overtreatment. PMID: 31144543 [PubMed - as supplied by publisher]
This case underscores that patients with apparent severe asthma exacerbation warrant careful evaluation before the initiation of corticosteroids, as not all wheezing is due to asthma.Journal of Medical Case Reports
Despite the development of novel treatments, improvement in the design of delivery devices, and new technologies for monitoring and improving adherence, the burden of asthma is not decreasing. Predicting individual patient ’s response to asthma drugs remains challenging, and the provision of personalized treatment elusive. Although biomarkers such as allergic sensitization and blood eosinophilia may be important predictors of response to inhaled corticosteroids in pre-school children, these relatively cheap and avai lable investigations are seldom used in clinical practice to select patients for corticosteroid prescription.
ConclusionsPrompt epinephrine treatment is crucial. Use of antihistamines in conjunction with epinephrine may reduce the risk of uncontrolled reactions (administration of 2 or more doses of epinephrine in the ED), although our findings do not support the use of corticosteroids.
A possible explanation for the poor response to inhaled corticosteroids (ICS) in approximately 45% of asthmatic children1 may be the weak association between guideline-based criteria for asthma control and ongoing allergic airway inflammation,2, 3 which may, if unrecognized in asymptomatic patients, result in serious sequelae, including airway remodeling.4 Thus, assessing airway inflammation has the potential to provide additional information to guidelines alone, which could be clinically useful in managing asthma.