Serious Asthma Outcomes and Asthma Exacerbations with Maintenance on Inhaled Corticosteroid (Mometasone Furoate)/Long-Acting Beta Agonist (Formoterol) Combination Compared to Step Down to Mometasone Monotherapy

Publication date: Available online 23 January 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Cindy L.J. Weinstein, Nicholas Ryan, Xiaoli Zhang, Tulin Shekar, Davis Gates, Stephen J. Lane, Ioana Agache, Robert A. Nathan, SPIRO InvestigatorsAbstractBackgroundDue to historical safety concerns with use of long-acting beta agonists in asthma, step-down from inhaled corticosteroid/long-acting beta agonist (ICS/LABA) combination therapy to ICS monotherapy is recommended once asthma control is achieved.ObjectiveTo evaluate the benefit/risk question about whether asthma patients who achieve disease control on fixed-dose ICS/LABA combination therapy, such as MF/F, should continue with this therapy or be stepped down to ICS monotherapy, such as MF.MethodsUsing data from 8,447 clinically stable patients with persistent asthma in the SPIRO trial who had been receiving a stable dose of ICS/LABA for ≥ 4 weeks, this post-hoc analysis evaluated the risk of SAOs (adjudicated hospitalization, intubation, or death) and AEX (composite of hospitalizations ≥ 24 h, emergency visits
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research

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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.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Publication date: February 2020Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 8, Issue 2Author(s): Anne M. Fitzpatrick, Bradley E. Chipps, Fernando Holguin, Prescott G. WoodruffAlthough the term “asthma” has been applied to all patients with airway lability and variable chest symptoms for centuries, phenotypes of asthma with distinct clinical and molecular features that may warrant different treatment approaches are well recognized. Patients with type 2 (T2)-“high” asthma are characterized by upregulation of T2 immune pathways (ie, IL-4 and IL-13 gene sets) and eosinophi...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Options to achieve oral corticosteroid (OCS)-sparing have been triggering increasing interest since the 1970s because of the side-effects of OCSs, and this has now become achievable with biologics. The Société de Pneumologie de Langue Francaise workshop on OCSs aimed to conduct a comprehensive review of the basics for OCS use in asthma and issue key research questions. Pharmacology and definition of regular use were reviewed by the first working group (WG1). WG2 examined whether regular OCS use is associated with T2 endotype. WG3 reported on the specificities of the paediatric area. Key "research stateme...
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: Asthma and allergy Review Source Type: research
Publication date: Available online 30 January 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Jian Guo Hong, Gustavo Wandalsen, Kevin R. Murphy, Désirée Larenas-Linnemann, Ahmed El Beleidy, Olga Vitalievna Zaytseva, Søren E. PedersenAbstractAlthough nebulized corticosteroids (NebCS) are a key treatment option for young children with asthma or viral-induced wheezing (VIW), there are no uniform recommendations on their best use. This systematic review aims to clarify the role of NebCS in children aged ≤5 years for the management of acute asthma exacerbations, asthma m...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Publication date: Available online 15 January 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Yong Suk Jo, Yong Il Hwang, Kwang Ha Yoo, Tae-Hyung Kim, Myung Goo Lee, Sang Haak Lee, Kyeong-Cheol Shin, Kwang Ho In, Hyoung Kyu Yoon, Chin Kook Rhee, Korean Asthma Research Group &KOCOSS cohortBackgroundFew reports have investigated the efficacy of using inhaled corticosteroid (ICS)-containing inhalers to treat patients with asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO).ObjectiveTo investigate the effect of ICS treatment on patients with ACO using 5 sets of diagnostic cri...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Are asthma patients who use inhaled corticosteroids at an increased risk for pneumonia and hospitalization?BMC Pulmonary Medicine
Source: Medscape Allergy Headlines - Category: Allergy & Immunology Tags: Pulmonary Medicine Journal Article Source Type: news
CONCLUSION: The meta-analysis demonstrated the positive clinical improvements TAA has on total ocular allergy symptoms, especially tearing, in addition to its recognized nasal symptom efficacy in SAR. PMID: 32004698 [PubMed - as supplied by publisher]
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Ann Allergy Asthma Immunol Source Type: research
Aspirin-exacerbated respiratory disease (AERD) is characterized by eosinophilic chronic rhinosinusitis with nasal polyps, asthma, and upper-/lower-respiratory tract reactions to nonsteroidal antiinflammatory drugs. Persistent, severe disease, anosmia, and alcohol sensitivity is typical. AERD is mediated by multiple pathways, including aberrant arachidonic acid metabolism leading to elevated leukotriene E4 and decreased prostaglandin E2. Mast cell mediators (prostaglandin D2) and unique properties of eosinophils and type 2 innate lymphoid cells, along with receptor-mediated signaling, also contribute to AERD pathogenesis. P...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
AbstractAsthma is a heterogeneous disease, with the immune processes behind the chronic inflammation underlying this disorder differing between the various identified asthma endotypes. In addition to heterogeneity in underlying disease pathophysiology, asthmatics fall across a broad spectrum of disease severity and can vary greatly in their response to convention asthma therapies. A small percentage of patients with severe persistent asthma will remain uncontrolled despite treatment with high-dose inhaled corticosteroids and a long-acting beta-agonist. Less than two decades ago, there were few options for these treatment-r...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
Abstract BACKGROUND: The long-term clinical course of asthma in patients with Eosinophilic Granulomatosis with Polyangiitis (EGPA) remains unclear. We aimed to characterize long-term asthma in EGPA and to identify baseline predictors of long-term asthma severity. METHODS: Retrospective cohort study of patients who fulfilled standardized criteria for EGPA that were followed in a single referral center between 1990-2017. Baseline and 3 (±1) years of follow-up clinical, laboratory and pulmonary function data were analyzed. RESULTS: Eighty-nine patients with EGPA, and a documented asthma assessment at...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
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