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Severe Persistent Asthma

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61. Management of Severe Asthma: a European Respiratory Society/American Thoracic Society Guideline. (PubMed)

exacerbations in persistently symptomatic or uncontrolled patients on GINA step 5 or NAEPP step 5 therapies, irrespective of asthma phenotype; 6) Suggest using anti-IL4/13 for adult patients with severe eosinophilic asthma, and for those with severe corticosteroid-dependent asthma regardless of blood eosinophil levels. These recommendations should be reconsidered as new evidence becomes available.Copyright ©ERS 2019. (...) Management of Severe Asthma: a European Respiratory Society/American Thoracic Society Guideline. This document provides clinical recommendations for the management of severe asthma. Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach and the results were summarised in evidence

2019 European Respiratory Journal

62. Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review

to compare efficacy and safety of different doses of inhaled corticosteroids in children with persistent asthma, particularly higher dose ranges in patients with more severe asthma. Future trials require stratified randomisation to ensure comparability in dose groups for asthma severity and baseline corticosteroid use. Funding CAPES, Brazil. Bibliographic details Zhang L, Axelsson I, Chung M, Lau J. Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review (...) Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review Dose response of inhaled corticosteroids in children with persistent asthma: a systematic review Zhang L, Axelsson I, Chung M, Lau J CRD summary This review found that, compared with low doses, moderate doses of inhaled corticosteroids may not provide clinically relevant therapeutic advantages

2012 DARE.

63. Omalizumab for treating severe persistent allergic asthma (review of technology appraisal guidance 133 and 201) (TA278)

Omalizumab for treating severe persistent allergic asthma (review of technology appraisal guidance 133 and 201) (TA278) Overview | Omalizumab for treating severe persistent allergic asthma | Guidance | NICE Omalizumab for treating severe persistent allergic asthma Technology appraisal guidance [TA278] Published date: 24 April 2013 Share Guidance on omalizumab (Xolair) for treating severe persistent allergic asthma in people aged 6 and over. This guidance replaces NICE technology appraisal (...) guidance on omalizumab for the treatment of severe persistent allergic asthma in children aged 6–11 (TA201) and omalizumab for severe persistent asthma (TA133). Guidance development process Is this guidance up to date? . We found nothing new that affects the recommendations in this guidance. Next review : This guidance will be reviewed if there is new evidence that is likely to affect the recommendations. Your responsibility The recommendations in this guidance represent the view of NICE, arrived

2013 National Institute for Health and Clinical Excellence - Technology Appraisals

64. Alair bronchial thermoplasty system for adults with severe difficult to control asthma

severe persistent allergic asthma, prevalence is highest in children aged 5 to 15 years, and decreases in adulthood until age 55 to 64 years when it rises again. In adults, asthma is more common in women than men (Simpson 2010). Asthma exacerbations lead to costs of £800 million on pharmaceuticals, a direct cost to the NHS of £1 billion and indirect societal costs Alair bronchial thermoplasty system for adults with severe difficult to control asthma (MIB71) © NICE 2018. All rights reserved. Subject (...) therapeutic need (NHS England standard contract 2013). Current NHS standard therapy for severe asthma is inhaled high-dose corticosteroids, long-acting beta 2 agonists, leukotriene receptor antagonists, theophyllines, oral corticosteroids and smoking cessation if clinically appropriate (NICE asthma pathway 2016). NICE's technology appraisal guidance on omalizumab for treating severe persistent allergic asthma recommends the drug as an option when given as an add-on to optimised standard therapy in people

2016 National Institute for Health and Clinical Excellence - Advice

65. Investigate the Effect of the CREON2000A on Asthma Control in Children With Mild to Moderate Persistent Asthma

ratio of 1:1. The study population is children between the ages 6 to 17 years, with mild to moderate persistent asthma. The purpose of the study is to determine whether the CREON2000A, an environmental control device, will decrease asthma severity, as measured by the Composite Asthma Severity Index (CASI), in children with mild to moderate persistent allergic asthma over a twelve month period. Condition or disease Intervention/treatment Phase Asthma Device: CREON2000A Device: Sham Not Applicable (...) Investigate the Effect of the CREON2000A on Asthma Control in Children With Mild to Moderate Persistent Asthma Investigate the Effect of the CREON2000A on Asthma Control in Children With Mild to Moderate 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

2016 Clinical Trials

66. A primary care based asthma program improves recognition and treatment of persistent asthma in inner-city children compared to routine care. (PubMed)

A primary care based asthma program improves recognition and treatment of persistent asthma in inner-city children compared to routine care. To examine whether a primary care-based asthma program that applies the Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-2007 criteria to classify asthma severity increases detection of persistent asthma in inner-city children and affects "step of care" compared to routine care.A retrospective chart review was conducted (...) . 53% were male. The majority of children were Latino (45.6%) or African American (35.4%). At the asthma program visit, more children were identified with moderate or severe persistent asthma based upon clinical questions (47.9%), spirometry (56.9%) or combined criteria (75.3%) than had been identified during routine care (15.2%); all p < .05. After the asthma program visit, more children were prescribed controller medications (82.3% vs 63.3%; p < .05) and 40.6% had their medication plan stepped

2016 Journal of Asthma

67. Omalizumab for the treatment of severe persistent allergic asthma in children aged 6 to 11 years

Omalizumab for the treatment of severe persistent allergic asthma in children aged 6 to 11 years Omalizumab for the treatment of severe persistent allergic asthma in children aged 6 to 11 years Omalizumab for the treatment of severe persistent allergic asthma in children aged 6 to 11 years National Institute for Health and Clinical Excellence Citation National Institute for Health and Clinical Excellence. Omalizumab for the treatment of severe persistent allergic asthma in children aged 6 to 11 (...) years. London: National Institute for Health and Clinical Excellence (NICE). Technology Appraisal Guidance 201. 2010 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Anti-Allergic Agents; Antibodies, Monoclonal; Asthma; Childs Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence National Institute for Health and Clinical Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA, UK

2010 Health Technology Assessment (HTA) Database.

68. Bronchial thermoplasty for treatment of inadequately controlled severe asthma

thermoplasty for treatment of inadequately controlled severe asthma . Chicago: BlueCross BlueShield Association (BCBS). TEC Assessment 29(12). 2014 Authors' objectives To determine whether relevant evidence demonstrates that BT improves the net health outcome — including asthma control, exacerbations, quality of life, medication use, lung function, and adverse events — in patients with inadequately controlled severe persistent asthma compared with best medical care. Authors' conclusions There is a sizeable (...) population with severe persistent asthma that could be considered for BT. Evidence from the 3 trials of BT applicable to individuals with severe persistent and inadequately controlled asthma—a single trial incorporated a sham control—is accompanied by uncertainty concerning the net health outcome. For FDA approval, superiority with respect to the primary outcomes (albeit changed in AIR2) must be considered together with safety. To judge impact on the net health outcome requires considering a set

2014 Health Technology Assessment (HTA) Database.

69. A Study to Assess Jia Wei Yang He Formula as a Plus Therapy in the Treatment of Persistent Asthma

A Study to Assess Jia Wei Yang He Formula as a Plus Therapy in the Treatment of Persistent Asthma A Study to Assess Jia Wei Yang He Formula as a Plus Therapy in the Treatment of 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. A Study to Assess Jia Wei Yang He Formula as a Plus Therapy in the Treatment of 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03299322 Recruitment Status

2017 Clinical Trials

70. Correlation of induced sputum eosinophil levels with clinical parameters in mild and moderate persistent asthma in children aged 7-18 years. (PubMed)

Correlation of induced sputum eosinophil levels with clinical parameters in mild and moderate persistent asthma in children aged 7-18 years. Treatment decisions in asthma are currently based on clinical assessment and spirometry. Sputum eosinophil, being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients.To measure eosinophil percentage in induced sputum in children with asthma and correlate it with clinical asthma (...) parameters.A prospective observational study was performed at tertiary care hospital on 91 children aged 7-18 years with newly diagnosed mild or moderate persistent asthma. Theinduced sputum eosinophil percentage was obtained at the time of enrollment and three months after treatment with inhaled budesonide. Patients were specifically evaluated for five clinical parameters of asthma, i.e., days of acute exacerbations, use of salbutamol as rescue medication, emergency visits, nighttime cough and days

2017 Journal of Asthma

71. Predictors of emergency department use in children with persistent asthma in metropolitan Atlanta, Georgia. (Full text)

Predictors of emergency department use in children with persistent asthma in metropolitan Atlanta, Georgia. Racial disparities are evident among children with asthma in the United States, with non-Hispanic black children at particularly high risk for poor asthma outcomes, including frequent emergency department (ED) use for asthma exacerbations.To compare asthma features in non-Hispanic black vs white children in Atlanta, Georgia, and determine what clinical features predict future ED use (...) for asthma.Self-reported black and white children 6 to 17 years of age with persistent asthma treated with controller medications completed medical history questionnaires, lung function testing, aeroallergen sensitization testing, and venipuncture. Medical records were reviewed for asthma-related ED visits for 12 months after the initial study visit.A total of 276 children were enrolled. Black children, compared with white children, resided in more disadvantaged zip code areas and were more likely to have

2017 Asthma & Immunology PubMed

72. Clinical predictors of remission and persistence of adult-onset asthma. (PubMed)

(15.9%) experienced asthma remission. Patients with asthma persistence were older, had worse asthma control, required higher doses of inhaled corticosteroids, had more severe airway hyperresponsiveness, more often nasal polyps, and higher levels of blood neutrophils as compared to patients who experienced clinical remission. In a multivariable logistic regression analysis, only moderate to severe bronchial hyperresponsiveness and nasal polyps were independent predictors of asthma persistence (...) Clinical predictors of remission and persistence of adult-onset asthma. Adult-onset asthma is an important but relatively understudied asthma phenotype and little is known about its natural course and prognosis. The remission rate is believed to be low, and it is still obscure which factors predict remission or persistence of the disease.This study sought to determine the remission rate and identify predictors of persistence and remission of adult-onset asthma.Two hundred adult patients

2017 Journal of Allergy and Clinical Immunology

73. Persistent asthma phenotype related with late-onset, high atopy, and low socioeconomic status in school-aged Korean children. (Full text)

Persistent asthma phenotype related with late-onset, high atopy, and low socioeconomic status in school-aged Korean children. Treatment guidelines for asthma have been established based on asthma severity; there are limitations in the identification of underlying pathophysiology and prediction of prognosis in heterogeneous phenotypes of asthma. Although the complex interactions between environmental and genetic factors affect the development and progression of asthma, studies on asthma (...) , and low socioeconomic status are associated with troublesome persistent asthma phenotype in school-age children. Environmental factors might be implicated in the clinical heterogeneity of asthma. Asthma phenotypes considering diverse factors might be more helpful in the identification of asthma pathogenesis and its prevention.

2017 BMC pulmonary medicine PubMed

74. Efficacy and Safety of PT001 to Placebo and Open-label Spiriva® Respimat® in Subjects With Persistant Asthma

Efficacy and Safety of PT001 to Placebo and Open-label Spiriva® Respimat® in Subjects With Persistant Asthma Efficacy and Safety of PT001 to Placebo and Open-label Spiriva® Respimat® in Subjects With Persistant 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 PT001 to Placebo and Open-label Spiriva® Respimat® in Subjects With Persistant 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier

2017 Clinical Trials

75. Clinical Study on Treatment of Chronic Persistent Bronchial Asthma

Clinical Study on Treatment of Chronic Persistent Bronchial Asthma Clinical Study on Treatment of Chronic Persistent Bronchial 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. Clinical Study (...) on Treatment of Chronic Persistent Bronchial 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. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03228134 Recruitment Status : Not yet recruiting First Posted : July 24, 2017 Last Update Posted : December 20, 2017 See Sponsor

2017 Clinical Trials

76. Omalizumab Is Equally Effective in Persistent Allergic Oral Corticosteroid-Dependent Asthma Caused by Either Seasonal or Perennial Allergens: A Pilot Study (Full text)

Omalizumab Is Equally Effective in Persistent Allergic Oral Corticosteroid-Dependent Asthma Caused by Either Seasonal or Perennial Allergens: A Pilot Study Omalizumab is marketed for chronic severe asthma patients who are allergic to perennial allergens. Our purpose was to investigate whether omalizumab is also effective in persistent severe asthma due to seasonal allergens. Thirty patients with oral corticosteroid-dependent asthma were treated with Omalizumab according to the dosing table (...) prednisolone consumption but no differences were detected in the intergroup comparison. Omalizumab offered the same clinical benefits in the two cohorts regardless of whether the asthma was caused by a seasonal or a perennial allergen. These results strongly suggest that allergens are the trigger in chronic asthma but that it is the persistent exposure to IgE that causes the chronicity.

2017 International journal of molecular sciences PubMed

77. Pharmacoeconomic review of medical management of persistent asthma. (PubMed)

has shown that salmeterol/fluticasone is a cost-effective treatment option for moderate persistent asthma management, when compared with fluticasone with or without the addition of leukotriene modifiers. Leukotriene modifiers are less cost-effective than inhaled corticosteroids or combined inhaled steroids and long-acting beta(2)-agonists for mild or moderate persistent asthma. Anti-IgE antibody has been shown inconsistently, to be cost-effective in patients with moderate to severe allergic asthma (...) Pharmacoeconomic review of medical management of persistent asthma. Asthma affects 20 million Americans and causes a substantial loss of productivity. Medications help to increase symptom-free days and improve quality of life. Examining the cost-effectiveness of different treatments, in addition to their clinical efficacy, allows us to choose the optimal strategy in managing patients. This study reviews published pharmacoeconomic analyses of different medications used for asthma management

2017 Allergy and Asthma Proceedings

78. Emergency department utilization by patients not meeting Health Plan and Employer Data and Information Set (HEDIS) criteria for persistent asthma. (PubMed)

and diagnostic coding records were obtained from consecutive adults (aged 19-56 years) treated for asthma in the ED of a closed-network health maintenance organization between April and July of 2002. Subjects were stratified into asthma severity categories (persistent or non-persistent) based on the National Committee for Quality Assurance 2006 Health Plan and Employer Data and Information Set (HEDIS) criteria for persistent asthma. Eighty-one unique patients made a total of 89 ED visits for asthma during (...) Emergency department utilization by patients not meeting Health Plan and Employer Data and Information Set (HEDIS) criteria for persistent asthma. Emergency hospital utilization rates for asthma remain high despite advances in asthma controller medications and the presence of widely accepted asthma treatment guidelines. To explore this phenomenon, we analyzed administrative data to determine characteristics of patients seen in the emergency department (ED) for asthma. Complete pharmacy

2017 Allergy and Asthma Proceedings

79. Altered Epithelial Gene Expression in Peripheral Airways of Severe Asthma. (Full text)

of disease in severe asthma unadressed by current therapies. A transcriptomic approach to understand epithelial activation in severe asthma has thus highlighted the need for better-targeted therapy to the peripheral airways in severe asthma, where the IL-13 disease signature persists despite treatment with currently available therapy. (...) Altered Epithelial Gene Expression in Peripheral Airways of Severe Asthma. Management of severe asthma remains a challenge despite treatment with glucocorticosteroid therapy. The majority of studies investigating disease mechanisms in treatment-resistant severe asthma have previously focused on the large central airways, with very few utilizing transcriptomic approaches. The small peripheral airways, which comprise the majority of the airway surface area, remain an unexplored area in severe

2017 PLoS ONE PubMed

80. Adult Asthma Care: Promoting Control of Asthma

a BACKGROUND Adult Asthma Care: Promoting Control of Asthma — Second Edition For optimal effectiveness, recommendations in these three areas should be implemented together. The scope of this Guideline includes effective assessment and management interventions for adults (defined as persons aged 18 and older) who have a diagnosis of asthma. Several populations and conditions are beyond the scope of this Guideline. These include: ? Assessment and management recommendations specific to children (...) ? Oxygen to maintain O2 saturation =92% WORSENING30 REGISTERED NURSES’ ASSOCIATION OF ONTARIO RECOMMENDATIONS Adult Asthma Care: Promoting Control of Asthma — Second Edition RECOMMENDATION 1.3: At every encounter, assess the person’s risk of future asthma exacerbations according to the following criteria: ? Current control of asthma, ? Severe exacerbations experienced, ? Exacerbations requiring systemic corticosteroids, and ? Use of emergency care or hospitalizations for asthma. Level of Evidence = V

2017 Registered Nurses' Association of Ontario

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