Management of Acute Asthma in Adults in 2020

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.
Source: JAMA - Category: General Medicine Source Type: research

Related Links:

AbstractNew recommendations from the Global Initiative for Asthma (GINA) were released in a pocket guide form on April 12, 2019. These recommendations provide very important changes to the management of asthma, especially regarding the treatment of intermittent and mild asthma. Due to safety concerns, GINA experts no longer recommend treatment with a short-acting β2 agonist alone. Henceforth, all adults and adolescents (but not yet children) with mild asthma should receive either symptom-driven or daily low-dose ICS. The main goal of this new approach is to reduce the risk of serious asthma exacerbations and asthma-re...
Source: Clinical and Translational Allergy - Category: Allergy & Immunology Source Type: research
Publication date: June 2020Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 8, Issue 6Author(s): Kevin R. Murphy, Jian Guo Hong, Gustavo Wandalsen, Désirée Larenas-Linnemann, Ahmed El Beleidy, Olga V. Zaytseva, Søren E. Pedersen
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Pressurised metered dose inhalers (pMDIs) are effective drug delivery devices prescribed in obstructive airway diseases due to their convenience, portability, ease of enabling multiple doses in a single formulation, and storage in any orientation. For the management of asthma, the fixed-dose combination of a long-acting β2-agonist (LABA) and an inhaled corticosteroid (ICS) has been recommended by Global Initiative for Asthma guideline as a preferred treatment option for patients who are uncontrolled with only ICS doses.
Source: Respiratory Medicine - Category: Respiratory Medicine Authors: Tags: Review article Source Type: research
Authors: Bernatowicz PL, Golec P, Bielecki P, Kowal K Abstract Introduction: The CD163 is exclusively expressed by mononuclear phagocytes as a transmembrane protein, which synthesis is regulated by anti- and pro-inflammatory signals. After shedding from the cell surface it exists in body fluids as a soluble protein (sCD163) which exerts anti-inflammatory effects. Aim: To evaluate serum concentration and ex vivo production of sCD163 by peripheral blood mononuclear cells (PBMC) in asthmatic patients treated with inhaled (ICS) or oral corticosteroids (OCS). Material and methods: The study was performed on 35 a...
Source: Advances in Dermatology and Allergology - Category: Dermatology Tags: Postepy Dermatol Alergol Source Type: research
Conclusion: This study confirmed the poor level of control patients have over their asthma, and how this affects their lifestyle and daily activities. Our results also confirmed that the patients' perception of both the disease and treatment plays a key role in SABA reliance and ICS underuse. PMID: 32469667 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
Authors: Vatrella A, Maglio A, Pelaia C, Pelaia G, Vitale C Abstract INTRODUCTION: 'Critical Asthma Syndrome' (CAS) is an umbrella term proposed to include several forms of asthma, responsible for acute and life-threatening exacerbations. CAS requires urgent and adequate supportive and pharmacological treatments to prevent serious outcomes. AREAS COVERED: The purpose of this review is to discuss current knowledge on the pharmacotherapeutic strategies for treatment of CAS. EXPERT OPINION: Airflow limitation, airway wall edema, and mucus plugs are the pathophysiological targets of pharmacological therapies. S...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
Abstract PURPOSE: Psychological stress shifts the immune system toward the production of T-helper (Th)-2-mediated cytokines and eosinophilia, increases the risks for both asthma and depression, and can precipitate asthma exacerbations. Th2-mediated inflammation is a characteristic of allergic asthma. We have shown that the levels of CD4+ Th2 cells in the peripheral blood of patients with asthma are associated with severity and/or control of the disease. To improve our understanding of the interactions between stress and asthma symptoms, we evaluated the effects of psychological comorbidity on Th2-mediated inf...
Source: Clinical Therapeutics - Category: Drugs & Pharmacology Authors: Tags: Clin Ther Source Type: research
AbstractThe growing recognition of eosinophilic gastrointestinal disorders has revealed the limitations of current treatment (mainly based on dietary modification and corticosteroids), and include refractoriness, high recurrence rates, and the need for long-term therapy. Research efforts, mainly in eosinophilic esophagitis (EoE), have unveiled essential pathophysiological mechanisms leading to these disorders, which bear some similarities to those of atopic manifestations and are shared by eosinophilic gastroenteritis (EGE) and eosinophilic colitis (EC). Novel targeted therapies, some imported from bronchial asthma and ato...
Source: BioDrugs - Category: Drugs & Pharmacology Source Type: research
AbstractCoronavirus disease 2019 (COVID-19) is a global pandemic infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and abnormal, overactivated innate immunity and “cytokine storms” have been proposed as potential pathological mechanisms for rapid COVID-19 progression. Theoretically, asthmatic patients should have increased susceptibility and severity for SARS-CoV-2 infection due to a deficient antiviral immune response and the tendency for exacerbation el icited by common respiratory viruses. However, existing studies have not shown an expected prevalence of asthmatic in...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
Abstract INTRODUCTION: Resistance to corticosteroid is an essential mechanism in uncontrolled asthma as the corticosteroid is the mainstay of therapy. There are recent reports that epigenetic factors play a crucial role in the regulation of steroid action. Overexpression of P glycoprotein (P-gp) and reduce expression of Histone deacetylase 2 (HDAC2) has been linked to regulating the steroid action in other diseases like Nephrotic Syndrome (NS). However, their role in uncontrolled asthma is still not clear and warrant further investigation. We evaluated the expression and activity of P-gp and HDAC2 in patients with...
Source: Current Pharmaceutical Biotechnology - Category: Biotechnology Authors: Tags: Curr Pharm Biotechnol Source Type: research
More News: Asthma | Azithromycin | Corticosteroid Therapy | General Medicine | Magnesium | Zithromax