Management of Chronic Asthma in 2020

This JAMA Insights Clinical Update reviews recent evidence favoring use of inhaled corticosteroids (ICS)in all patients with asthma, regardless of frequency, and summarizes the SMART (single maintenance and reliever therapy) treatment approach, which uses an inhaler combining ICS and formoterol for control and relief of symptoms, and differences between SMART and symptom-driven therapy.
Source: JAMA - Category: General Medicine Source Type: research

Related Links:

Conclusions: Serum periostin production is significantly associated with treatment modality (omalizumab vs. conventional) and presence of CRSwNP. These variables need to be taken into account to interpret periostin levels accurately. PMID: 32489361 [PubMed]
Source: Advances in Dermatology and Allergology - Category: Dermatology Tags: Postepy Dermatol Alergol Source Type: research
There is a strong correlation between dysregulation of the gastrointestinal microbiota and development of allergic diseases. The most prevalent therapies for relieving asthma symptoms are associated with serious side effects, and therefore novel approaches are needed. Our objective was to elucidate whether oral administration of Lactobacillus rhamnosus GG (LGG) as a probiotic or turmeric powder (TP) as a prebiotic or both as a synbiotic mitigate allergic inflammation including lung function, airway inflammatory cell infiltration, Th2 cytokines/chemokine in a murine model of house dust mite (HDM)-induced asthma. BALB/c mice...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Oral corticosteroids (OCS) are used to manage asthma exacerbations and severe, uncontrolled asthma, but OCS use is associated with adverse effects. We aimed to describe the patterns of OCS use in the real-world management of patients with asthma in western Europe. We used electronic medical records from databases in France, Germany, Italy and the United Kingdom from July 2011 through February 2018. Patients aged ≥12 years with an asthma diagnosis, at least one non-OCS asthma medication within ±6 months of diagnosis, and available data ≥6 months prior to and ≥90 days after cohort entry we...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Asthma and allergy Original Articles: Asthma Source Type: research
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
CONCLUSION: Although uncommon, we must consider Aspergillus as the causative organism in apparently immunocompetent patients with history of recent systemic corticosteroids treatment, especially if they suffer a broncopulmonary disorder. Aspergillus is an aggressive organism so a high index of suspicion along with early diagnosis and prompt treatment is the key for better outcomes. We highlight A. nidulans as the causative agent as there are no other reported cases. PMID: 32486857 [PubMed - as supplied by publisher]
Source: European Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Eur J Ophthalmol 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
More News: Asthma | Corticosteroid Therapy | General Medicine