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Severe Persistent Asthma

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4781. A Study to Evaluate the Safety of Xolair in Moderate to Severe Persistent Asthma Patients (ALTO)

A Study to Evaluate the Safety of Xolair in Moderate to Severe Persistent Asthma Patients (ALTO) A Study to Evaluate the Safety of Xolair in Moderate to Severe Persistent Asthma Patients (ALTO) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. A Study to Evaluate the Safety of Xolair in Moderate to Severe Persistent Asthma Patients (ALTO) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00401596 Recruitment Status : Completed First Posted : November 20, 2006 Last Update Posted : March 19, 2014 Sponsor

2006 Clinical Trials

4782. Persistent activation of nuclear factor-kappaB signaling pathway in severe uncontrolled asthma. (PubMed)

Persistent activation of nuclear factor-kappaB signaling pathway in severe uncontrolled asthma. The transcription factor nuclear factor-kappaB (NF-kappaB) is inactive when bound to its inhibitory protein IkappaBalpha. On cell stimulation with inflammatory signals, IkappaBalpha is phosphorylated by IkappaB kinases and subsequently degraded. Freed NF-kappaB then induces expression of cytokines such as granulocyte-macrophage colony-stimulating factor, interleukin-8, and regulated upon activation (...) that these mediators are markedly decreased by pyrrolidinedithiocarbamate, an inhibitor of NF-kappaB activation. To further characterize the persistent NF-kappaB activation in severe asthma, we analyzed the expression of various components of this activation pathway in healthy subjects and in asthmatics with mild controlled, and moderate and severe uncontrolled disease. We found high amounts of phosphorylated IkappaBalpha characterizing the three asthmatic groups. Western blot analyses indicated that in peripheral

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2003 American Journal of Respiratory and Critical Care Medicine

4783. Parameters associated with persistent airflow obstruction in chronic severe asthma. (PubMed)

Parameters associated with persistent airflow obstruction in chronic severe asthma. The significance of severe airflow obstruction in severe asthma is unclear. The current study determined whether severe airflow obstruction is related to inflammatory or structural changes in the airways. Patients with severe asthma from a tertiary referral clinic were divided into two groups according to their postbronchodilator forced expiratory volume in one second (FEV1): severe persistent airflow limitation (...) obstruction. Patients with severe asthma and irreversible airflow obstruction had longer disease duration, a greater inflammatory process and more high resolution computed tomography airway abnormalities suggestive of airway remodelling, despite being on similar treatments and experiencing equivalent impairment in quality of life.

2004 European Respiratory Journal

4784. Intercellular adhesion molecule 1 and tumor necrosis factor alpha in asthma and persistent allergic rhinitis: relationship with disease severity. (PubMed)

Intercellular adhesion molecule 1 and tumor necrosis factor alpha in asthma and persistent allergic rhinitis: relationship with disease severity. Tumor necrosis factor alpha (TNF-alpha) is involved in the up-regulation of intercellular adhesion molecule 1 (ICAM-1). Allergic rhinitis is often associated with bronchial hyperresponsiveness.We investigated the relationship between allergic airway disease severity and serum concentrations of soluble ICAM-1 (sICAM-1) and TNF-alpha and nasal (...) expression of ICAM-1.Serum concentrations of TNF-alpha and sICAM-1 were investigated in 85 adults with persistent rhinitis and 90 patients with asthma. Seventy patients with rhinitis were challenged with methacholine. Nasal biopsy for ICAM-1 expression was performed in 6 patients with moderate-severe rhinitis and in 6 patients with mild rhinitis.In patients with rhinitis, serum sICAM-1 concentrations were as follows: group without bronchial hyperresponsiveness (n = 29), 206.85 ng/mL; group with bronchial

2006 Asthma & Immunology

4785. Should patients with persistent severe asthma be monitored for medication adherence? (PubMed)

Should patients with persistent severe asthma be monitored for medication adherence? Poor asthma outcomes often result from patients not following physician medication recommendations (ie, nonadherence). Estimates suggest that 50% of patients with asthma do not follow physician medication recommendations.To examine the rationale for making available objective medication adherence monitors for physicians to improve the quality of care for patients with severe persistent asthma.Review (...) adherence and reduce morbidity and the cost of asthma care. Without objective adherence monitoring, physicians may not accurately assess nonadherence as the cause of treatment failure. This may lead to inappropriate increases in therapy, diagnostic studies, and consultations and may leave the patient at risk for persistent symptoms, morbidity, and death.By correctly assessing nonadherence as the cause of treatment failure in patients with not only severe asthma but mild and moderate disease as well

2005 Asthma & Immunology

4786. Risk Factors Associated With Persistent Airflow Limitation in Severe or Difficult-to-Treat Asthma: Insights From the TENOR Study. (PubMed)

Risk Factors Associated With Persistent Airflow Limitation in Severe or Difficult-to-Treat Asthma: Insights From the TENOR Study. The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study is among the largest to assess persistent airflow limitation and the first to evaluate a wide range of potential risk factors in high-risk patients with severe or difficult-to-treat asthma. A better understanding is needed regarding factors associated with persistent airway (...) obstruction; this study was performed to determine demographic and clinical characteristics associated with persistent airflow limitation.Data from adult patients (>or= 18 years old) with severe or difficult-to-treat asthma were evaluated. Patients with COPD, obesity with a restrictive respiratory pattern, or a >or= 30 pack-year history of smoking were excluded. Patients with persistent airflow limitation (postbronchodilator FEV1/FVC ratio

2007 Chest

4787. Association between neutrophilic and eosinophilic inflammation in patients with severe persistent asthma. (PubMed)

Association between neutrophilic and eosinophilic inflammation in patients with severe persistent asthma. Eosinophils are generally recognized as effector cells in asthma. Recently, neutrophils have been suggested to contribute to the development of chronic severe asthma. The mechanisms by which neutrophils contribute to the pathophysiology of asthma remain to be elucidated; however, neutrophils may affect either accumulation or functional status of eosinophils via the generation (...) of inflammatory mediators. The objective of this study was to evaluate whether neutrophilic inflammation is associated with eosinophilic inflammation in severe asthma.Following the inhalation of hypertonic saline, induced sputum was obtained from 12 healthy controls, 10 mild persistent asthmatics who were treated with low-dose inhaled corticosteroids, and 8 severe persistent asthmatics who were treated with combinations of drugs including high-dose inhaled corticosteroids and oral prednisolone. Subsequently

2005 International Archives of Allergy and Immunology

4788. Inflammatory cell profiles and T-lymphocyte subsets in chronic obstructive pulmonary disease and severe persistent asthma. (PubMed)

Inflammatory cell profiles and T-lymphocyte subsets in chronic obstructive pulmonary disease and severe persistent asthma. Severe persistent asthma (SPA) and chronic obstructive pulmonary disease (COPD) are both associated with non-reversible airflow limitation and airway neutrophilia.To compare inflammatory cell profiles and T lymphocyte subsets between SPA and COPD patients with similar severity of airflow limitation.Sputum induction and lung function tests were performed in 15 COPD patients

2004 Clinical and Experimental Allergy

4789. Exhaled nitric oxide identifies the persistent eosinophilic phenotype in severe refractory asthma. (PubMed)

Exhaled nitric oxide identifies the persistent eosinophilic phenotype in severe refractory asthma. The fractional concentration of exhaled nitric oxide (FENO) is increased in asthma, correlates with eosinophilic inflammation, and decreases after steroid therapy.We sought to examine whether persistent eosinophilia would be accompanied by an increased FENO level despite steroid therapy in patients with severe refractory asthma (SRA) as manifestations of steroid resistance.Subjects with SRA (...) , subjects with mild-moderate asthma, and healthy control subjects had FENO measured, followed by endobronchial biopsy and bronchoalveolar lavage. Tissue and bronchoalveolar lavage inflammatory cells were assessed for all subjects, and eosinophil status (EOS+/EOS-) was determined for subjects with SRA.Twenty-four subjects with SRA, 15 subjects with moderate-mild asthma, and 17 healthy control subjects were studied. Subjects with EOS+ SRA had significantly higher median FENO levels compared with levels

2005 Journal of Allergy and Clinical Immunology

4790. Omalizumab in Adult and Adolescent Patients With Severe Persistent Allergic Asthma

Omalizumab in Adult and Adolescent Patients With Severe Persistent Allergic Asthma Omalizumab in Adult and Adolescent Patients With Severe Persistent Allergic Asthma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Omalizumab in Adult and Adolescent Patients With Severe Persistent Allergic Asthma The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00264849 Recruitment Status : Completed First Posted : December 13, 2005 Results First Posted : July 25, 2011 Last Update Posted : June 29, 2018 Sponsor

2005 Clinical Trials

4791. Relationships between duration of asthma and asthma severity among children in the Childhood Asthma Management Program (CAMP) (PubMed)

was also found to be significantly associated with physician/nurse assessment of asthma severity and other historical measures of medication use.These data demonstrate that asthma duration is associated with lower lung function, greater methacholine responsiveness, more asthma symptomatology, and greater use of as-needed albuterol, which are all measures of asthma severity. As such, early diagnosis and intervention may be necessary to ameliorate these adverse effects of persistent asthma. (...) Relationships between duration of asthma and asthma severity among children in the Childhood Asthma Management Program (CAMP) Many factors, including heredity, atopic status, and environment, have been implicated in the determination of asthma severity. Relatively little is known about the degree to which asthma duration influences asthma severity.The Childhood Asthma Management Program (CAMP), consisting of 1041 children (age 8. 9 +/- 2.1 years at enrollment) with mild-to-moderate asthma

1999 The Journal of allergy and clinical immunology

4792. Omalizumab Use and Asthma-Related Quality of Life in Patients With Severe Persistent Allergic Asthma

Omalizumab Use and Asthma-Related Quality of Life in Patients With Severe Persistent Allergic Asthma Omalizumab Use and Asthma-Related Quality of Life in Patients With Severe Persistent Allergic Asthma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Omalizumab Use and Asthma-Related Quality of Life in Patients With Severe Persistent Allergic Asthma The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00567476 Recruitment Status : Completed First Posted : December 5, 2007 Results First Posted : May 23

2007 Clinical Trials

4793. The effect of treatment with omalizumab, an anti-IgE antibody, on asthma exacerbations and emergency medical visits in patients with severe persistent asthma. (PubMed)

The effect of treatment with omalizumab, an anti-IgE antibody, on asthma exacerbations and emergency medical visits in patients with severe persistent asthma. Patients with severe persistent asthma who are inadequately controlled despite treatment according to current asthma management guidelines have a significant unmet medical need. Such patients are at high risk of serious exacerbations and asthma-related mortality.Here, we pooled data from seven studies to determine the effect of omalizumab (...) , an anti-immunoglobulin E (IgE) monoclonal antibody, on asthma exacerbations in patients with severe persistent asthma. Omalizumab was added to current asthma therapy and compared with placebo (in five double-blind studies) or with current asthma therapy alone (in two open-label studies). The studies included 4308 patients (2511 treated with omalizumab), 93% of whom had severe persistent asthma according to the Global Initiative for Asthma (GINA) 2002 classification. Using the Poisson regression model

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2005 Allergy

4794. Efficacy and Safety of Omalizumab in Patients With Severe Persistent Asthma

Efficacy and Safety of Omalizumab in Patients With Severe Persistent Asthma Efficacy and Safety of Omalizumab in Patients With Severe Persistent Asthma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more (...) . Efficacy and Safety of Omalizumab in Patients With Severe Persistent Asthma The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00046748 Recruitment Status : Completed First Posted : October 4, 2002 Last Update Posted : August 2, 2017 Sponsor: Novartis Pharmaceuticals Information provided by: Novartis Study

2002 Clinical Trials

4795. Dose-related efficacy of budesonide administered via a dry powder inhaler in the treatment of children with moderate to severe persistent asthma. (PubMed)

Dose-related efficacy of budesonide administered via a dry powder inhaler in the treatment of children with moderate to severe persistent asthma. To determine the efficacy and safety of budesonide delivered by an inhalation-driven dry powder inhaler (Turbuhaler) in children with moderate to severe persistent asthma.In our randomized, double-blind, placebo-controlled, parallel-group, multicenter study, a total of 404 children with asthma, who were aged 6 to 18 years and who had been receiving (...) ) with moderate to severe persistent asthma.

1998 The Journal of pediatrics

4796. Increased peak expiratory flow variation in asthma: severe persistent increase but not nocturnal worsening of airway inflammation. (PubMed)

Increased peak expiratory flow variation in asthma: severe persistent increase but not nocturnal worsening of airway inflammation. Asthma at night is characterized by a nocturnal increase in airway obstruction. It has been hypothesized that nocturnal asthma results from an increase in airway wall inflammation at night. However, studies on inflammatory cells in bronchoalveolar lavage (BAL) fluid and bronchial biopsies have produced conflicting data. This study assessed inflammatory cell numbers (...) in the bronchial submucosa at night. Apparently, asthmatic patients with a peak expiratory flow variation >15% suffer from a higher overall severity of bronchial inflammation at night and during the day.

1998 The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology

4797. Inhaled mometasone furoate reduces oral prednisone requirements while improving respiratory function and health-related quality of life in patients with severe persistent asthma. (PubMed)

Inhaled mometasone furoate reduces oral prednisone requirements while improving respiratory function and health-related quality of life in patients with severe persistent asthma. Inhaled corticosteroid therapy in severe persistent asthma has been shown to reduce or eliminate oral corticosteroid (OCS) use while retaining effective asthma control.We sought to evaluate the ability of mometasone furoate (MF) delivered by means of dry powder inhaler to reduce daily oral prednisone requirements (...) by 164.4% (P <.01). Oral steroids were eliminated in 40%, 37%, and 0% of patients in the MF 400 and 800 mg twice daily and placebo groups, respectively. Pulmonary function and quality of life significantly increased for MF-treated patients. Further reductions in OCS requirements were achieved with long-term MF treatment in the open-label phase.MF inhaled orally as a dry powder is an effective alternative to systemic corticosteroids in patients with severe persistent asthma.

2000 The Journal of allergy and clinical immunology

4798. Therapeutic effect of zafirlukast as monotherapy in steroid-naive patients with severe persistent asthma. (PubMed)

Therapeutic effect of zafirlukast as monotherapy in steroid-naive patients with severe persistent asthma. We evaluated the efficacy of the leukotriene receptor antagonist zafirlukast (Accolate), 20 mg twice daily, as monotherapy in patients with severe persistent asthma (defined by an FEV1 < 60% of predicted before treatment and frequent night-time symptoms).Data were analyzed from a subgroup of 261 steroid-naive patients (zafirlukast, n = 149; placebo, n = 112) from four randomized, double (...) in the morning and evening PEF of approximately 40 and 11 L/min, respectively. For patients who take zafirlukast and who have a PEF variability of < 20%, the morning and evening PEF increased by 25 and 30 L/min, respectively. Regardless of the degree of PEF variability, zafirlukast significantly (p < 0.05) increased morning and evening PEF compared with placebo.Patients with severe persistent asthma who received zafirlukast as monotherapy had clinically significant improvements across all efficacy measures

1999 Chest

4799. Effects of high doses of inhaled corticosteroids on adrenal function in children with severe persistent asthma. (PubMed)

Effects of high doses of inhaled corticosteroids on adrenal function in children with severe persistent asthma. Childhood asthma generally responds well to inhaled corticosteroids within the dosage range recommended by the manufacturers, but it is sometimes necessary to use higher doses--that is, above 400 micrograms/day--a practice which has become more widespread recently. Whereas the lack of adrenal suppression in children given inhaled corticosteroids in normal doses is well documented

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1993 Thorax

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