The relationship between real-world inhaled corticosteroids adherence and asthma outcomes: a multilevel approach

Publication date: Available online 18 September 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Marcia Vervloet, Liset van Dijk, Peter Spreeuwenberg, David Price, Alison Chisholm, Eric Van Ganse, Hilary Pinnock, Cynthia S. Rand, Michelle N. Eakin, Tjard Schermer, Patrick C. Souverein, Alexandra L. Dima, Respiratory Effectiveness Group’s Adherence Working GroupAbstractBackgroundLow inhaled corticosteroids (ICS) adherence is associated with increased asthma burden. This relationship is likely bidirectional, and may vary across adherence stages (initiation, implementation, persistence). Studies rarely examine reciprocal influences.ObjectiveTo investigate the relationship between ICS implementation and asthma-related outcomes across two years, considering bidirectionality and temporal sequence.MethodsPrimary care records (1987–2012) from the Optimum Patient Care Research Database, United Kingdom, were used. Eligible patients had ≥3 years continuous registration starting 1 year before ICS initiation (index date), physician-diagnosed asthma, ≥6 years, ≥2 ICS and/or short-acting beta-agonists (SABA) prescriptions each follow-up year, no long-acting beta-agonists, leukotriene receptor antagonists or maintenance oral corticosteroids in the preceding year . ICS implementation (percentage of days covered) and risk domain asthma control (RDAC; no asthma-related hospitalizations, emergency visits, or outpatient visits, no oral cortico...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research

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ConclusionsPatients may adapt their ICS use to their current needs without this impacting later RDAC.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Asthma and chronic obstructive pulmonary disease (COPD) are markedly different airway diseases, but sometimes they overlap, with some asthmatic patients showing some features of COPD (fixed airway obstruction, mixed neutrophilic/eosinophilic airway inflammation, and relatively poor response to corticosteroids) and some patients with COPD having features of asthma (atopy, history of asthma, greater airway reversibility, increased blood and sputum eosinophil counts, and a clinical response to corticosteroids).
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Editorial Source Type: research
Publication date: May–June 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 5Author(s): Richard H. Stanford, Carlyne Averell, Emily D. Parker, Cori Blauer-Peterson, Tyler K. Reinsch, Ami R. BuikemaBackgroundAlthough efficacy and safety of fluticasone furoate/vilanterol (FF/VI) and budesonide/formoterol (BUD/F) have been demonstrated in clinical studies, real-world comparisons of utilization have not been performed.ObjectiveTo compare similar patients with asthma initiating FF/VI or BUD/F on measures of adherence, persistence, and the asthma medication ratio (AMR).MethodsThis wa...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Mario Malerba1,2*, Valentina Foci1,2, Filippo Patrucco1,2, Patrizia Pochetti1,2, Matteo Nardin3, Corrado Pelaia4 and Alessandro Radaeli5 1Respiratory Medicine, Department of Translational Medicine, University of Eastern Piedmont, Vercelli, Italy 2Respiratory Unit, Sant’Andrea Hospital, Vercelli, Italy 3Department of Medicine, Spedali Civili di Brescia, Brescia, Italy 4Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University “Magna Græcia” of Catanzaro, Catanzaro, Italy 5Department of Emergency, Spedali Civili di Brescia, Brescia, Italy Chronic obstructiv...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
This study evaluated the effects of dried ginger and LGWWJX decoction on cold asthma at the metabolomics level. It provides a reference for the research on the compatibility of Chinese Medicine. Introduction Ginger is a Chinese medicine (CM) used as a food and as a medicine, and is often used to treat cold syndrome through the property of warming. Dried ginger (Zingiberis Rhizoma, GanJiang, GJ) is processed from fresh ginger and is also commonly used in CM. It is used to treat cold asthma by “warming the stomach to dispel cold, warming the lung to resolve fluid,” and it has significant anti-inflammatory...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
This study was supported by grants from GSK and the UK Medical Research Council (U105178805). Conflict of Interest Statement AM has grant funding from GSK and AstraZeneca/MedImmune. MB, DJ, AP, DT, and AvO are employees of GSK. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acknowledgments We are grateful to the Ares staff, genotyping facility, and flow cytometry core for their technical assistance. We thank Jen Walker for advice on the manuscript. Supplementary Material The Supplem...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionWhile most PCPs and respiratory/allergy specialists can reach a working diagnosis of ACO, there remains uncertainty around which diagnostic features are most important and what constitutes optimal management. It is imperative that clinical studies including patients with ACO are initiated, allowing the generation of evidence ‐based management strategies.This article is protected by copyright. All rights reserved.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research
Conclusion: GRNX effectively treated asthma and COPD patients with acute bacterial infection without severe adverse events. Further research with a larger study population is needed.Int Arch Allergy Immunol
Source: International Archives of Allergy and Immunology - Category: Allergy & Immunology Source Type: research
Publication date: Available online 10 January 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Richard H. Stanford, Carlyne Averell, Emily D. Parker, Cori Blauer-Peterson, Tyler K. Reinsch, Ami R. BuikemaAbstractBackgroundWhile efficacy and safety of fluticasone furoate/vilanterol (FF/VI) and budesonide/formoterol (BUD/F) have been demonstrated in clinical studies, real-world comparisons of utilization has not been performed.ObjectiveCompare similar asthma patients initiating FF/VI or BUD/F on measures of adherence, persistence, and the asthma medication ratio (AMR).MethodsThis was a retros...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
INTRODUCTIONUsually attributed to allergies or parasites (Seifert et. al Medline 2008) eosinophila is often overlooked. However hypereosinophilia (absolute eosinophil count>1.5 X 109/L on two separate exams one month apart or with pathologic confirmation) can have serious manifestations. When hypereosinophilia is associated with eosinophil-mediated organ damage or dysfunction, a hypereosinophilic syndrome (HES) exists.With an unpredictable course, eosinophilic infiltration commonly affects the skin (eczema), lung (dyspnea), &GIT (gastritis). However life-threatening damage to the CVS (myocarditis) or the CNS may occ...
Source: Blood - Category: Hematology Authors: Tags: 634. Myeloproliferative Syndromes: Clinical Source Type: research
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