Inhaled mannitol for cystic fibrosis.
CONCLUSIONS: There is moderate-quality evidence to show that treatment with mannitol over a six-month period is associated with an improvement in some measures of lung function in people with cystic fibrosis compared to control. There is low to very low-quality evidence suggesting no difference in quality of life for participants taking mannitol compared to control. This review provides very low-quality evidence suggesting no difference in lung function or quality of life comparing mannitol to dornase alfa alone and to mannitol plus dornase alfa. The clinical implications from this review suggest that mannitol could be con...
Source: Cochrane Database of Systematic Reviews - April 30, 2020 Category: General Medicine Authors: Nevitt SJ, Thornton J, Murray CS, Dwyer T Tags: Cochrane Database Syst Rev Source Type: research
Protocol for TRAUMADORNASE: a prospective, randomized, multicentre, double-blinded, placebo-controlled clinical trial of aerosolized dornase alfa to reduce the incidence of moderate-to-severe hypoxaemia in ventilated trauma patients
Acute respiratory distress syndrome continues to drive significant morbidity and mortality after severe trauma. The incidence of trauma-induced, moderate-to-severe hypoxaemia, according to the Berlin definitio... (Source: Trials)
Source: Trials - March 18, 2020 Category: General Medicine Authors: Julien Pottecher, Eric Noll, Marie Borel, G érard Audibert, Sébastien Gette, Christian Meyer, Elisabeth Gaertner, Vincent Legros, Raphaël Carapito, Béatrice Uring-Lambert, Erik Sauleau, Walter G. Land, Seiamak Bahram, Alain Meyer, Bernard Geny and Pie Tags: Study protocol Source Type: research
Addition of Dornase to Intrapleural Fibrinolytic Therapy for Otherwise Healthy Children Hospitalized With Empyema
In this issue of JAMA Pediatrics, Livingston et al address the important question of whether a therapy demonstrated to improve the care of adult patients with empyema, the addition of dornase alfa (DNase) to tissue plasminogen activator (tPA) intrapleural therapy, has similar benefits in children. The utility of DNase in adults requiring pleural drainage for empyema has been established in a prior randomized clinical trial by Rahman et al. In that study, adult patients who received a combination of intrapleural DNase and tPA had improved pleural effusion size compared with patients receiving DNase alone, tPA alone, and dou...
Source: JAMA Pediatrics - February 3, 2020 Category: Pediatrics Source Type: research
Intrapleural Tissue Plasminogen Activator and Dornase Alfa in Pediatric Empyema
This randomized clinical trial investigates if intrapleural tissue plasminogen activator and dornase alfa is more effective than intrapleural tissue plasminogen activator alone at reducing hospital length of stay in children with pleural empyema. (Source: JAMA Pediatrics)
Source: JAMA Pediatrics - February 3, 2020 Category: Pediatrics Source Type: research
Sequential intrapleural administration of fibrinolytic drugs and dornase alfa for empyema management. Treatment protocol based on its physicochemical stability.
CONCLUSIONS: The physicochemical stability data obtained does not allow to ensure a simultaneous administration of both drugs in a safe and effective way, thus a sequential administration protocol is proposed.
PMID: 31901057 [PubMed - in process] (Source: Farmacia Hospitalaria)
Source: Farmacia Hospitalaria - December 25, 2019 Category: Drugs & Pharmacology Authors: Bastida C, Salazar-Santander C, Soy D, Sánchez D, Díez C, Badia JR Tags: Farm Hosp Source Type: research
A combined intrapleural administration of dornase alfa and tissue plasminogen activator is safe in children with empyema - a pilot study.
Conclusions: The intrapleural treatment of dornase alfa and tissue plasminogen activator as treatment of empyema was safe in ten children with empyema. If confirmed in further studies, this combination of intrapleural therapy may improve the management of paediatric empyema.
PMID: 31750793 [PubMed - as supplied by publisher] (Source: Acta Chirurgica Belgica)
Source: Acta Chirurgica Belgica - November 22, 2019 Category: Surgery Tags: Acta Chir Belg Source Type: research
Medical interventions for chronic rhinosinusitis in cystic fibrosis.
CONCLUSIONS: We identified no eligible trials assessing the medical interventions in people with cystic fibrosis and chronic rhinosinusitis. High-quality trials are needed which should assess the efficacy of different treatment options detailed above for managing chronic rhinosinusitis, preventing pulmonary exacerbations and improving quality of life in people with cystic fibrosis.
PMID: 31642064 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 22, 2019 Category: General Medicine Authors: Karanth TK, Karanth VKLK, Ward BK, Woodworth BA, Karanth L Tags: Cochrane Database Syst Rev Source Type: research
P352 “Mind the Gap”; variation in advice given to cystic fibrosis patients regarding the gap between inhalation of Dornase Alfa and inhaled antibiotics across the UK
(Source: Journal of Cystic Fibrosis)
Source: Journal of Cystic Fibrosis - May 27, 2019 Category: Respiratory Medicine Authors: C. Brown, M. Archer, L. Carson, T. Daniels, A. Gates, Z. Johnstone, R. Rashid, J.L. Whitehouse, E.F. Nash Tags: Posters Sessions Source Type: research
Exercising our options: comparing effects of exercise and positive expiratory pressure on mucociliary clearance
Cystic fibrosis (CF) lung disease is characterised by defective clearance of airway secretions that are hyperconcentrated, viscous, and serve as the nidus of chronic polymicrobial infection. The pathophysiological events that link CFTR channel dysfunction to mucus obstruction of airways are multifactorial, complex and an ongoing source of debate [1, 2]. Despite the availability of multiple "symptomatic therapies" that target mucus retention (hypertonic saline, mannitol, dornase alfa and mucolytics), mechanical clearance of airway secretions has continued to be a cornerstone of treatment across patient populations [3]. Inde...
Source: European Respiratory Journal - April 17, 2019 Category: Respiratory Medicine Authors: Donaldson, S. H. Tags: Editorials Source Type: research
Cost Effectiveness of Inhaled Mannitol (Bronchitol ® ) in Patients with Cystic Fibrosis
ConclusionBenchmarked against an implicit Australian willingness-to-pay threshold for life-threatening diseases, our model suggests inhaled mannitol provides a cost-effective addition to best supportive care in patients with cystic fibrosis, irrespective of concomitant dornase alfa use. (Source: PharmacoEconomics)
Source: PharmacoEconomics - January 22, 2019 Category: Health Management Source Type: research
Safety and efficacy of reduced dose intrapleural alteplase and DNAase for pleural infection
Conclusions: Our data suggest that 2.5mg alteplase and 5mg DNase is safe and effective even in high risk patients. A larger prospective study will be needed to confirm this. 90% of patients received 3 doses or less.References:1) Popowicz N et al. Dose De-escalation of Intrapleural Tissue Plasminogen Activator Therapy for Pleural Infection. Ann Am Thorac Soc. 2017 Jun;14(6):929-936. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Ip, H., West, A., Wallace, D., Noorzad, F., Ahmed, L. Tags: Respiratory infections Source Type: research
Intrapleural use of dornase alfa and tissue plasminogen activator are successful as treatment in pediatric empyema: a pilot study
Conclusions: This pilot study investigated the efficacy and safety of dornase alfa and tissue plasminogen activator as treatment of empyema in ten children with parapneumonic empyema. With this study, we can conclude that intrapleural fibrinolysis with dornase alfa and tissue plasminogen activator is safe and successful as demonstrated in adults. Therefore, the series will be expanded in preparation of comparative studies. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Slaats, M., De Dooy, J., Lauwers, P., Van Schil, P., Verhulst, S., Hendriks, J. Tags: Paediatric respiratory infection and immun. Source Type: research
Timing of dornase alfa inhalation for cystic fibrosis.
CONCLUSIONS: The current evidence derived from a small number of participants does not indicate that inhalation of dornase alfa after airway clearance techniques is more or less effective than the traditional recommendation to inhale nebulised dornase alfa 30 minutes prior to airway clearance techniques, for most outcomes. For children with well-preserved lung function, inhalation before airway clearance may be more beneficial for small airway function than inhalation after. However, this result relied on a measure with high variability and trials with variable follow-up. In the absence of strong evidence to indicate that ...
Source: Cochrane Database of Systematic Reviews - November 12, 2018 Category: General Medicine Authors: Dentice R, Elkins M Tags: Cochrane Database Syst Rev Source Type: research
Mucoactive agents for adults with acute lung conditions: A systematic review
ConclusionDornase alfa, hypertonic saline and NAC were ineffective for atelectasis/mucus plugging while intubated. More data are required to support using NAC, ambroxol and heparin during acute illness. (Source: Heart and Lung: The Journal of Acute and Critical Care)
Source: Heart and Lung: The Journal of Acute and Critical Care - November 6, 2018 Category: Respiratory Medicine Source Type: research
Dornase alfa for cystic fibrosis.
CONCLUSIONS: There is evidence to show that, compared with placebo, therapy with dornase alfa improves lung function in people with cystic fibrosis in trials lasting from one month to two years. There was a decrease in pulmonary exacerbations in trials of six months or longer. Voice alteration and rash appear to be the only adverse events reported with increased frequency in randomised controlled trials. There is not enough evidence to firmly conclude if dornase alfa is superior to other hyperosmolar agents in improving lung function.
PMID: 30187450 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 6, 2018 Category: General Medicine Authors: Yang C, Montgomery M Tags: Cochrane Database Syst Rev Source Type: research
