Predicting the response to bronchial thermoplasty

Publication date: Available online 8 November 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): David Langton, Wei Wang, Joy Sha, Alvin Ing, David Fielding, Nicole Hersch, Virginia Plummer, Francis ThienAbstractBackgroundWhilst it is established that not all patients respond to bronchial thermoplasty (BT), the factors that predict response/non-response are largely unknown.ObjectivesThe aim of this study was to identify baseline factors that predict clinical response.MethodsThe records of 77 consecutive patients entered into the Australian Bronchial Thermoplasty Register were examined for baseline clinical characteristics, and outcomes measured at 6 and 12 months post BT, such as change in the Asthma Control Questionnaire (ACQ), exacerbation frequency, the requirement for short acting reliever medication (SABA) and oral corticosteroids, and improvement in spirometry.ResultsThis was a cohort of severe asthmatics: aged 57.7±11.4 yrs, 57.1% female, 53.2% of patient taking maintenance oral steroids, 43% having been treated with a monoclonal antibody, mean FEV1 of 55.8±19.8%predicted.BT resulted in an improvement in ACQ from 3.2±1.0 at baseline to 1.6±1.1 at 6 months (p
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research

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This study suggests that a simple risk-assessment tool could potentially be created for emergency rooms in similar settings to identify higher-risk children on whom limited resources might be better focused.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Asthma and allergy Original Articles: Asthma Source Type: research
Publication date: Available online 11 November 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Marcello Cottini, Anita Licini, Carlo Lombardi, Alvise BertiAbstractBackgroundThe involvement of small airways has recently gained greater recognition in asthma. Impulse oscillometry (IOS) is a simple and noninvasive method based on the forced oscillation technique, for the detection of small airway dysfunction (SAD).ObjectiveWe aimed to identify the predictors of SAD in an unselected sample of 400 patients with physician-diagnosed asthma.MethodsAll patients underwent standard spirometry and IOS ...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
CONCLUSIONS: NAEB, CVA, and UACS are common causes of chronic cough in patients with AR. FeNO can first be used to discriminate patients with CVA/NAEB, then FEF25-75 (or combined with FeNO) can further discriminate patients with CVA from those with CVA/NAEB. PMID: 31552718 [PubMed]
Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res 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
Objective measures of lung function are important in the diagnosis and management of asthma. Spirometry, the pulmonary function test most widely used in asthma, requires respiratory maneuvers that may be difficult for preschoolers. Impulse oscillometry (IOS) is a noninvasive method of measuring lung function during tidal breathing; hence, IOS is an ideal test for use in preschool asthma. Fractional exhaled nitric oxide (FeNO) levels correspond to eosinophilic inflammation and predict responsiveness to corticosteroids. Basic concepts of IOS, methodology, and interpretation, including available normative values, and recent f...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: 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
Abstract BACKGROUND: Perennial allergic rhinitis (PAR) often coexists in asthmatic patients. Intranasal cellulose powder (ICP) was reportedly effective in ameliorating PAR. OBJECTIVE: We investigated whether ICP is equally effective compared with intranasal corticosteroids in improving asthma control as well as nasal symptoms among children with PAR and allergic asthma (AA). METHODS: Between July 2015 and September 2016, we did a single-center, randomized, placebo-controlled trial. Asthmatic children aged 6 to 11 years with mild-to-moderate PAR were randomly assigned to formoterol/budesonide inhalation (...
Source: American Journal of Rhinology and Allergy - Category: ENT & OMF Authors: Tags: Am J Rhinol Allergy Source Type: research
ConclusionsIn children with severe, therapy-resistant asthma, BAL granulocyte patterns and infectious species are associated with novel phenotypic features which can inform pathway-specific revisions in treatment. In 32% of children evaluated, BAL revealed corticosteroid-refractory eosinophilic infiltration amenable to anti-Th2 biological therapies, and in 12%, a treatable bacterial pathogen.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Conclusions: High levels of emotional distress are common in children with PSA and are associated with parental anxiety and depression. Attention to psychological morbidity in children and their families is a vital component of asthma care.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric asthma and allergy Source Type: research
Conclusion: ACT and miniPAQLQ are complemental to reveal long-standing characteristics: overweight, increased lung volumes and gas trapping, rather than current inflammation or airway obstruction in regularly treated patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric asthma and allergy Source Type: research
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