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Severe Persistent Asthma

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121. Duration of the efficacy of omalizumab after treatment discontinuation in 'real life' severe asthma. (Abstract)

Duration of the efficacy of omalizumab after treatment discontinuation in 'real life' severe asthma. Efficacy of omalizumab in severe asthma is well documented; however, the optimal duration of the treatment remains unclear. In an open prospective study, we sought to assess the persistence of response in subjects withdrawing from omalizumab treatment. We evaluated 49 patients who voluntarily accepted to discontinue omalizumab treatment after 6 years of therapy. Asthma relapse was defined as any (...) severe asthma exacerbation associated with loss of asthma control. Twelve patients relapsed in the first year of follow-up, and 7 within 13 and 48 months. These results suggest that the effects of 6 years of omalizumab may persist after discontinuation of therapy in 60% of patients for at least 4 years.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

2017 Thorax

122. Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study. Full Text available with Trip Pro

Association between respiratory syncytial viral disease and the subsequent risk of the first episode of severe asthma in different subgroups of high-risk Australian children: a whole-of-population-based cohort study. To determine the contribution of respiratory syncytial virus (RSV) to the subsequent development of severe asthma in different subgroups of children at risk of severe RSV disease.The study was conducted in New South Wales (NSW), Australia.The study comprised all children born (...) in NSW between 2000 and 2010 with complete follow-up till 31 December 2011. The cohort was divided into three subgroups: (1) non-Indigenous high-risk children: non-Indigenous children born preterm or born with a low birth weight; (2) Indigenous children: children of mothers whose Indigenous status was recorded as Aboriginal and/or Torres Strait Islander and (3) non-Indigenous standard risk children: all other non-Indigenous term children.Risk of development of severe asthma in different subgroups

2017 BMJ open

123. Spontaneous Pneumomediastinum Complicating Severe Acute Asthma Exacerbation in Adult Patients. (Abstract)

and December 31, 2016 for severe acute asthma exacerbation underwent a diagnostic protocol including a standard chest X-ray and continuous monitoring of arterial oxygen saturation (SaO2) during the first 24 hours following admission. The patients showing persistence or deterioration of oxyhemoglobin desaturation were prescribed a chest Computed Tomographic (CT) scan.Five out of the 45 patients (11.1%) with severe acute asthma exacerbation were diagnosed with PNM, in one case on the basis of an X-ray image (...) Spontaneous Pneumomediastinum Complicating Severe Acute Asthma Exacerbation in Adult Patients. The real incidence of pneumomediastinum (PNM) in adult patients with severe acute asthma exacerbation continues to be unknown. The current study aims to investigate the occurrence of PNM in an adult population of patients presenting a severe asthma attack and to evaluate the risk factors associated to its development.The 45 consecutive subjects who were admitted to our Division between January 1, 2015

2017 Journal of Asthma

124. Guiding principles for use of newer biologics and bronchial thermoplasty for patients with severe asthma. Full Text available with Trip Pro

Guiding principles for use of newer biologics and bronchial thermoplasty for patients with severe asthma. Severe asthma poses significant disease-related and economic burdens in the United States. Challenges in practice include how to define "severe asthma" for a given patient, knowing which are the right tests to perform and when, and having a better understanding of a patient's asthma phenotype. Furthermore, current guidelines do not address a clear, practical approach to treatment (...) that is based on a patient's asthma phenotype.To develop a consensus on the definition of severe asthma, the role of biomarkers and phenotyping severe asthma, and the use of newer biologic therapies and bronchial thermoplasty to help guide practicing clinicians.A roundtable meeting was convened with a panel of severe asthma experts to discuss areas in practice that are not adequately addressed by current guidelines, specifically phenotype-guided treatment.We describe a consensus on the definition of severe

2017 Asthma & Immunology

125. Natural killer cell–mediated inflammation resolution is disabled in severe asthma Full Text available with Trip Pro

had preserved functional responses. Together, our findings indicate that the immunology of the severe asthma airway is characterized by decreased NK cell cytotoxicity with increased numbers of target leukocytes, which is exacerbated by corticosteroids that further disable NK cell function. These failed resolution mechanisms likely contribute to persistent airway inflammation in severe asthma.Copyright © 2017, American Association for the Advancement of Science. (...) Natural killer cell–mediated inflammation resolution is disabled in severe asthma Severe asthma is typically characterized by chronic airway inflammation that is refractory to corticosteroids and associated with excess morbidity. Patients were recruited into the National Heart, Lung, and Blood Institute-sponsored Severe Asthma Research Program and comprehensively phenotyped by bronchoscopy. Bronchoalveolar lavage (BAL) cells were analyzed by flow cytometry. Compared with healthy individuals

2017 Science immunology

126. Paradoxical bronchospasm from benzalkonium chloride (BAC) preservative in albuterol nebulizer solution in a patient with acute severe asthma. A case report and literature review of airway effects of BAC Full Text available with Trip Pro

Paradoxical bronchospasm from benzalkonium chloride (BAC) preservative in albuterol nebulizer solution in a patient with acute severe asthma. A case report and literature review of airway effects of BAC Nebulized bronchodilator solutions are available in the United States as both nonsterile and sterile-filled products. Sulfites, benzalkonium chloride (BAC), or chlorobutanol are added to nonsterile products to prevent bacterial growth. Bronchoconstriction from inhaled BAC is cumulative (...) of 3.5 days that probably caused persistent bronchospasm evidenced by failure to improve clinically and to increase peak expiratory flow rate (PEFR) from 125 L/min (27% of predicted value) to 300 L/min (68% of predicted value) within 2 hours of withdrawing BAC. The patient's respiratory status and PEFR improved dramatically once the nebulization solution was switched to BAC free lev-albuterol solution. The pediatric providers, particularly the emergency department physicians, intensivists

2017 Respiratory Medicine Case Reports

127. Allergic sinusitis and severe asthma caused by occupational exposure to locust bean gum: Case report Full Text available with Trip Pro

was identified. His initial discrete episodes of sinusitis and acute bronchitis evolved into persistent asthma of increasing severity with exacerbations requiring repeated emergency room treatment. The case described in our report emphasizes the importance of clinician diagnosis of OA, and subsequent removal from exposure, such that asthma severity does not progress to near-fatal or fatal asthma in the sensitized worker. As demonstrated by this case report, identification of an occupational cause of asthma (...) Allergic sinusitis and severe asthma caused by occupational exposure to locust bean gum: Case report We present a case that highlights the difficulties with diagnosis and the dangers of occupational allergic sinusitis and asthma left unrecognized. We describe the case history of a man who experienced work-related symptoms 1 year after beginning work as a cheesemaker at a creamery, and whose respiratory symptoms progressively worsened over 16 years before an occupational cause of his asthma

2017 American Journal of Industrial Medicine

128. Severe asthma in humans and mouse model suggests a CXCL10 signature underlies corticosteroid-resistant Th1 bias Full Text available with Trip Pro

unresponsiveness. We show high levels of CXCL10 mRNA closely associated with IFNG levels in the BAL cells of 50% of severe asthmatics and also in the airways of mice subjected to a severe asthma model, both in the context of high-dose CS treatment. The inability of CS to dampen IFNG or CXCL10 expression was not because of impaired nuclear translocation of the glucocorticoid receptor (GR) or its transactivational functions. Rather, in the presence of CS and IFN-γ, STAT1 and GR were recruited on critical (...) Severe asthma in humans and mouse model suggests a CXCL10 signature underlies corticosteroid-resistant Th1 bias We previously showed that Th1/type 1 inflammation marked by increased IFN-γ levels in the airways can be appreciated in 50% of patients with severe asthma, despite high dose corticosteroid (CS) treatment. We hypothesized that a downstream target of IFN-γ, CXCL10, which recruits Th1 cells via the cognate receptor CXCR3, is an important contributor to Th1high asthma and CS

2017 JCI insight

129. Body Height of Children with Bronchial Asthma of Various Severities Full Text available with Trip Pro

Body Height of Children with Bronchial Asthma of Various Severities Influence of bronchial asthma (BA) severity on physical development in children patients was evaluated in comparison with healthy population. Materials and Methods. 1042 children and adolescents (768 boys) with atopic BA were evaluated. All children underwent standard examination in a clinical setting, including anthropometry. The control group included 875 healthy children of a comparable age (423 boys). Results. The fraction (...) of patients with the normal, lower, and increased height among the whole group of patients with BA is close to the corresponding values in the healthy population (χ2 = 3.32, p = 0.65). The fraction of BA patients with the reduced physical development is increased monotonically and significantly when the BA severity increases: healthy group, 8.2% (72/875), BA intermittent, 4.2% (6/144), BA mild persistent 9% (47/520), BA moderate persistent, 11.7% (36/308), and BA severe persistent, 24.3% (17/70) (χ2

2017 Canadian respiratory journal

130. Airway autoimmune responses in severe eosinophilic asthma following low-dose Mepolizumab therapy Full Text available with Trip Pro

Airway autoimmune responses in severe eosinophilic asthma following low-dose Mepolizumab therapy Anti-interleukin (IL)-5 monoclonal antibodies as an eosinophil-depleting strategy is well established, with Mepolizumab being the first biologic approved as an adjunct treatment for severe eosinophilic asthma.A 62-year old woman diagnosed with severe eosinophilic asthma showed poor response to Mepolizumab therapy (100 mg subcutaneous dose/monthly) and subsequent worsening of symptoms. The treatment (...) in comparison to the target antigen. The resultant immune complexes could act as 'cytokine depots', protecting the potency of the 'bound' IL-5, thereby sustaining the eosinophilic inflammation within the target tissue. Molecular analysis of the sputum indicated the development of a polyclonal autoimmune response as well as an increase in group 2 innate lymphoid cells, two novel observations in severe eosinophilic asthma, which were associated with indices of disease severity and progression. This case

2017 Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

131. The Role of Imaging in the Assessment of Severe Asthma Full Text available with Trip Pro

clusters of asthmatics, and the use of co-registration to link CT images of airways with regional variation in ventilation in MRI. In addition, temporal studies have shown that some the ventilation defects found using MRI in asthmatics are intermittent and others are persistent, but both are associated with lower lung function.The role of imaging in severe asthma currently is primarily in the exclusion of comorbid or other conditions, or in the assessment for complications in the setting of acute (...) The Role of Imaging in the Assessment of Severe Asthma The present review aims to summarize the most recent evidence related to imaging and severe asthma, both with regard to advances in imaging research and to their current and potential clinical implications.Recent work in imaging in severe asthma has principally been using computed tomography (CT) and MRI, as well as the integration of the two. Some of the most notable findings include the use of CT imaging biomarkers to create unique

2017 Current Opinion in Pulmonary Medicine

132. Targeted therapy in severe asthma today: focus on immunoglobulin E Full Text available with Trip Pro

the widest and most easily recognized asthma phenotype, present in up to two-thirds of adults with asthma. Immunoglobulin E (IgE) production is the primary and key cause of allergic asthma leading to persistent symptoms, exacerbations and a poor quality of life. Therefore, limiting IgE activity upstream could stop the entire allergic inflammation cascade in IgE-mediated allergic asthma. The anti-IgE treatment omalizumab has an accepted place in the management of severe asthma (Global Initiative (...) trial data and a decade of use in clinical practice has established omalizumab as a safe and effective targeted therapy for the treatment of patients with severe persistent IgE-mediated allergic asthma.

2017 Drug design, development and therapy

133. BIOmarkers in Severe AsthMa Patients on Omalizumab Treatment

asthma. The aim of the study is to assess inflammatory biomarkers including: blood and sputum eosinophilia, periostin and IL-6 as long-term clinical outcomes of omalizumab therapy. Condition or disease Severe Asthma Detailed Description: Anti-IgE (omalizumab) has been shown to be an effective add-on therapy for patients with allergic severe asthma. In this observational study patients aged over 18 year with uncontrolled severe persistent asthma are selected for add-on therapy with omalizumab (...) BIOmarkers in Severe AsthMa Patients on Omalizumab Treatment BIOmarkers in Severe AsthMa Patients on Omalizumab Treatment - 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. BIOmarkers in Severe AsthMa Patients

2017 Clinical Trials

134. A Study of Reslizumab in Patients 12 Years of Age and Older With Severe Eosinophilic Asthma

A Study of Reslizumab in Patients 12 Years of Age and Older With Severe Eosinophilic Asthma A Study of Reslizumab in Patients 12 Years of Age and Older With Severe Eosinophilic 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 of Reslizumab in Patients 12 Years of Age and Older With Severe Eosinophilic 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: NCT03052725 Recruitment Status : Terminated (Parent Studies didn't meet their primary endpoint so study was terminated.) First Posted

2017 Clinical Trials

135. Acute Effect of Salbutamol on Heart Rate and Blood Pressure During Exercise in Patients With Moderate or Severe Asthma and Healthy Subjects

frequently they have to use Short-Acting Beta2-Agonists. However, the cardiovascular effects of salbutamol during and after exercise remain poorly known. Objective: To evaluate the effect of salbutamol on heart rate and blood pressure during exercise in patients with moderate or severe asthma and healthy individuals. Methods: A randomized, double-blind, crossover study will be conducted which 13 individuals with moderate or severe persistent asthma and 13 healthy individuals aged between 20 to 59 years (...) to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 20 Years to 59 Years (Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria for asthmatics: Have the diagnosis of moderate or severe asthma according to the clinical criteria described in the literature Be between 20 and 59 years

2017 Clinical Trials

136. Prevalence of Severe Asthma in Spanish Hospitals

Software of big data is a powerful data treatment algorithm works closely with Spanish Data Protection Agency as an example on how to reuse clinical information without conflicting with necessary data privacy. The system will process a vast amount of information (big data), so that the impact of random errors will be minimized. Non-Severe Asthmatic Subjects Subjects with intermittent, persistent mild or moderate asthma. Other: Questionnaire Subjects will be given an Electronic Case Report Form (eCRF (...) by (Responsible Party): GlaxoSmithKline Study Details Study Description Go to Brief Summary: Asthma is a chronic disease. Prevalence of asthma in 2014 among Spanish population was 5%, of which 10% were diagnosed with severe asthma. According to Spanish National Guideline for the Management of Asthma (GEMA) 4.1 criteria, asthma can be classified according to its severity (intermittent, mild persistent, moderate persistent or severe persistent) or level of asthma control (controlled, partly controlled

2017 Clinical Trials

137. Patterns of Neurocircuitry Activation In Severe Asthma

Institute (NHLBI) Information provided by (Responsible Party): University of Wisconsin, Madison Study Details Study Description Go to Brief Summary: The overall purpose of the study is to compare the patterns of neurocircuitry activation in severe asthmatics vs. mild to moderate and healthy controls. The Investigators hypothesize that neurocircuitry activation increases with asthma severity, producing different neurocircuitry patterns for severe asthmatics than those of mild to moderate asthmatics (...) or non-asthmatics. Condition or disease Intervention/treatment Lung Diseases Other: functional Magnetic Resonance Imaging (research grade) Other: Cognitive Function Testing (non-diagnostic) Other: Asthma and Psychological Questionnaires (non-diagnostic) Detailed Description: To begin to further address possible relationships of asthma and brain function, the investigators propose the following hypothesis, "patients with defined characteristics of severe asthma will have distinct patterns

2017 Clinical Trials

138. Effects of CPAP in Severe Therapy-resistant Asthma

Effects of CPAP in Severe Therapy-resistant Asthma Effects of CPAP in Severe Therapy-resistant 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. Effects of CPAP in Severe Therapy-resistant Asthma (CPAP (...) Fagundes Donadio, Pontificia Universidade Católica do Rio Grande do Sul Study Details Study Description Go to Brief Summary: The purpose of this study is to verify the effects of continuous positive airway pressure (CPAP) on exercise capacity of children and adolescents with severe therapy-resistant asthma (STRA). A randomized, controlled, crossover clinical trial will be conducted. We expect the use of CPAP to increase exercise capacity in children and adolescents with STRA. Condition or disease

2017 Clinical Trials

139. Diagnostic Value of Serum Baseline Tryptase Levels in Childhood Asthma and Its Correlation with Disease Severity. Full Text available with Trip Pro

Diagnostic Value of Serum Baseline Tryptase Levels in Childhood Asthma and Its Correlation with Disease Severity. The aim of this study was to explore whether serum baseline tryptase (sBT) levels might be a useful marker not only for the accurate diagnosis of childhood asthma, but also for the prediction of disease severity.A total of 114 asthmatic children were enrolled in this study, 36 of whom had mild intermittent asthma, 38 had mild persistent asthma, and 40 had moderate to severe (...) persistent asthma. Additionally, 34 age-matched healthy children were enrolled as controls. The sBT levels of these populations were measured using a fluoroenzymeimmunoassay kit. The diagnostic performance of sBT levels and their correlation with asthma severity were systematically investigated using receiver operating characteristic (ROC) analysis and correlation analysis.Children with mild and moderate to severe persistent asthma had significantly increased sBT levels as compared to those with mild

2017 International Archives of Allergy and Immunology

140. Efficacy and safety of omalizumab in children and adolescents with moderate-to-severe asthma: A systematic literature review. (Abstract)

and safety as add-on treatment in children 6 to 11 years old with moderate-to-severe persistent allergic asthma. RWS data confirmed these findings in an extended patient population of children and adolescents that is more generalizable to the actual day-to-day management of these patients. (...) Efficacy and safety of omalizumab in children and adolescents with moderate-to-severe asthma: A systematic literature review. There are limited pediatric data about the use of omalizumab, especially the effectiveness and safety of omalizumab in the real-world management of allergic asthma.The objective of this study was to summarize the safety and efficacy of omalizumab in both randomized clinical trials (RCT) used for U.S. Food and Drug Administration registration and real-world studies (RWS

2017 Allergy and Asthma Proceedings

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