Effect of long-acting {beta}-agonist on bronchodilator response in children with asthma

Spirometry is the most common pulmonary function test (PFT) used to follow asthma patients. It is recommended to withhold short-acting β2-agonists (SABA) a few hours before pulmonary function testing and to withhold long-acting β2-agonists (LABA) for diagnosis purpose but not for the assessment of response to a current treatment [1]. In children with asthma, the addition of LABA to inhaled corticosteroids (ICS) has no clear clinical benefit, but it has proved to improve baseline forced expiratory volume in 1 s (FEV1) [2]. The maximal increase in FEV1 after a single dose of formoterol was measured 3 h after administration, but the remaining effect after 12 h would depend on the inhaled dose [3]. Finally, 25 or 50 µg of salmeterol inhaled at 22:00 h resulted in higher baseline pulmonary function and decrease in exercise-induced bronchoconstriction 10 and 12 h later [4]. In routine practice, children are tested with various delays since the last LABA inhalation, but LABA is usually inhaled on the morning of the test (24 h). It is thought that children with the most recent inhalation should have the best pulmonary function and the lowest reversibility, but the latter has not been studied.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Articles: Research letters Source Type: research

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Publication date: Available online 20 June 2019Source: The LancetAuthor(s): Kewu Huang, Ting Yang, Jianying Xu, Lan Yang, Jianping Zhao, Xiangyan Zhang, Chunxue Bai, Jian Kang, Pixin Ran, Huahao Shen, Fuqiang Wen, Yahong Chen, Tieying Sun, Guangliang Shan, Yingxiang Lin, Guodong Xu, Sinan Wu, Chaolong Wang, Ruiying Wang, Zhihong ShiSummaryBackgroundAsthma is a common chronic airway disease worldwide. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of asthma. We therefore aimed to estimate the national prevalence of asthma in a representative s...
Source: The Lancet - Category: General Medicine 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
Which inhaled corticosteroid and long-acting β-agonist combination is better in patients with moderate-to-severe asthma, a dry powder inhaler or a pressurized metered-dose inhaler? Drug Deliv. 2017 Nov;24(1):1395-1400 Authors: Muraki M, Gose K, Hanada S, Sawaguchi H, Tohda Y Abstract Two main types of devices are used to facilitate the administration of inhaled corticosteroid (ICS) and long-acting β-agonist (LABA) in combination, dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs). There are few reports comparing the effects of the two devices, and it is unknown which sho...
Source: Drug Delivery - Category: Drugs & Pharmacology Tags: Drug Deliv Source Type: research
Conclusions: Among children with asthma and chronic exposure to woodsmoke, an air-filter intervention that improved indoor air quality did not affect quality-of-life measures. Intent-to-treat analysis did show an improvement in the secondary measure of dPFV. Trial registration: ClincialTrials.gov NCT00807183. https://doi.org/10.1289/EHP849 Received: 21 July 2016 Revised: 13 June 2017 Accepted: 16 June 2017 Published: 13 September 2017 Address correspondence to C.W. Noonan, School of Public and Community Health Sciences, 32 Campus Dr., University of Montana, Missoula, MT 59812 USA. Telephone: (406) 243-4957; Fax: (406...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
Conclusion: BDR test widely used for initial diagnosis, could be also a reliable tool in follow up children with asthma. In children with continuously positive BDR despite good ACQ results a step-up therapy change evaluation probably would be necessary.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 7.2 Paediatric Asthma and Allergy Source Type: research
This study aimed to investigate whether airway obstruction could interfere with real FENO levels and if different FeNO changes after albuterol inhalation could assist in distinguishing asthma from chronic obstructive pulmonary disease (COPD). MethodsFeNO and spirometry measurements were performed before and after albuterol inhalation in the following three patient groups: 30 steroid‐naive asthmatics, 25 asthmatics inhaling corticosteroids/long‐acting β(2)‐adrenergic agonists for at least 1 month and 20 COPD patients. Bronchodilator test (BDT) results were positive in all patients enrolled. The correlations among...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
This study aimed to investigate whether airway obstruction could interfere with real FENO levels and if different FeNO changes after albuterol inhalation could assist in distinguishing asthma from chronic obstructive pulmonary disease (COPD). METHODS: FeNO and spirometry measurements were performed before and after albuterol inhalation in the following three patient groups: 30 steroid-naive asthmatics, 25 asthmatics inhaling corticosteroids/long-acting β(2)-adrenergic agonists for at least one month, and 20 COPD patients. Bronchodilator test (BDT) results were positive in all patients enrolled. The correlations a...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Clin Respir J Source Type: research
This study aimed to investigate whether airway obstruction could interfere with real FENO levels and if different FeNO changes after albuterol inhalation could assist in distinguishing asthma from chronic obstructive pulmonary disease (COPD). Methods: FeNO and spirometry measurements were performed before and after albuterol inhalation in the following three patient groups: 30 steroid‐naive asthmatics, 25 asthmatics inhaling corticosteroids/long‐acting β(2)‐adrenergic agonists for at least one month, and 20 COPD patients. Bronchodilator test (BDT) results were positive in all patients enrolled. The correlations ...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research
Summary BackgroundExhaled breath temperature (EBT) reflects airways (both eosinophilic and neutrophilic) inflammation in asthma and thus may aid the management of children with asthma that are treated with anti‐inflammatory drugs. A new EBT monitor has become available that is cheap and easy to use and may be a suitable monitoring device for airways inflammation. Little is known about how EBT relates to asthma treatment decisions, disease control, lung function, or other non‐invasive measures of airways inflammation, such as exhaled nitric oxide (ENO). ObjectiveTo determine the relationships between EBT and asthma trea...
Source: Pediatric Pulmonology - Category: Respiratory Medicine Authors: Tags: Original Article: Asthma Source Type: research
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