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Severe Persistent Asthma

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161. Child and Adolescent Asthma Guidelines

of a life-threatening attack requiring urgent admission to intensive care, and a severe asthma attack requiring hospital admission (Table 6 and Figure 6). Table 6: Criteria for acute referral to hospital and/or hospital admission in children and adolescents. • Child with any feature of life-threatening asthma • Child with any feature of an acute severe attack persisting a er initial treatment • Child in whom other considerations suggest that admission may be appropriate: - Still have significant (...) , especially due to disadvantages that arise from inadequate income for the basics needed for wellbeing, and unhealthy indoor environments (homes which are crowded, cold, damp, mouldy, 1 smoke-exposed or with un? ued gas heating 2 ). Children aged 13–17 years usually do not have free primary healthcare visits or prescriptions. Maori and Paci? c children with asthma are more likely to have severe asthma symptoms and be hospitalised, but are less likely to be prescribed inhaled corticosteroid (ICS), have

2017 Asthma and Respiratory Foundation NZ

162. Longitudinal analysis to better characterize Asthma-COPD Overlap Syndrome (ACOS): Findings from an adult asthma cohort in Korea (COREA). (PubMed)

function was lower in patients with ACOS. In the longitudinal analysis, the mean change in lung function was high, and a greater decline in FEV1 was observed in patients with ACOS. In addition, we compared ACOS and severe asthma, and we also performed a cluster analysis and compared the results with our definition of ACOS. According to our definition, ACOS is an independent subtype with distinctive characteristics. Finally, a genome-wide association study (GWAS) was performed to identify genetic (...) Longitudinal analysis to better characterize Asthma-COPD Overlap Syndrome (ACOS): Findings from an adult asthma cohort in Korea (COREA). Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS), which has received much attention, has not been unanimously defined.In this study, we tried to demonstrate that longitudinally defined ACOS is more useful in the real world than blending patients with asthma and COPD.The study patients had undergone two consecutive pulmonary function

2019 Clinical and Experimental Allergy

163. Occupational rhinitis affects occupational asthma severity (PubMed)

charts of 72 patients who received a diagnosis of allergic occupational asthma, with or without associated occupational rhinitis.Our findings suggested that persistent asthma tended to be more common in subjects with associated occupational asthma and rhinitis, and occupational asthma severity was associated with occupational rhinitis severity. Moderate-severe persistent occupational rhinitis is a risk factor for persistent occupational asthma.We demonstrated, for the first time in the occupational (...) Occupational rhinitis affects occupational asthma severity The strong interactions between asthma and rhinitis, and the influence of rhinitis in the severity and/or control of asthma, have clearly been demonstrated. Nevertheless, no specific study has been conducted in the occupational setting.The aim of the study was to assess the severity of occupational asthma and rhinitis and evaluate whether rhinitis is a predictor for increased asthma severity.We retrospectively reviewed the clinical

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2016 Journal of occupational health

164. Asthma Severity and the Controller Prescription in Children at 12 Tertiary Hospitals (PubMed)

categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated.A total of 840 cases were reviewed. Both GINA and JPGL revealed that 328 (39.0%) and 249 (29.6%) subjects had intermittent asthma whereas 24 (2.9%) and 21 (2.5%) subjects had severe persistent asthma, respectively. Although higher (...) Asthma Severity and the Controller Prescription in Children at 12 Tertiary Hospitals Guidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children.Twelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4

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2016 Allergy, asthma & immunology research

165. Epidemiology and Cytokines Analysis of Severe Asthma Patients in Taiwan

Epidemiology and Cytokines Analysis of Severe Asthma Patients in Taiwan Epidemiology and Cytokines Analysis of Severe Asthma Patients in Taiwan - 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. Epidemiology (...) and Cytokines Analysis of Severe Asthma Patients in Taiwan 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: NCT02871947 Recruitment Status : Unknown Verified March 2016 by vghtpe user, Taipei Veterans General Hospital, Taiwan. Recruitment status was: Recruiting First Posted : August 18, 2016 Last Update Posted

2016 Clinical Trials

166. Omalizumab to Mepolizumab Switch Study in Severe Eosinophilic Asthma Patients

Omalizumab to Mepolizumab Switch Study in Severe Eosinophilic Asthma Patients Omalizumab to Mepolizumab Switch Study in Severe Eosinophilic Asthma Patients - 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 to Mepolizumab Switch Study in Severe Eosinophilic Asthma Patients 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: NCT02654145 Recruitment Status : Completed First Posted : January 13, 2016 Results First Posted : January 31, 2018 Last Update Posted : August 6, 2018 Sponsor: GlaxoSmithKline

2016 Clinical Trials

167. A Pragmatic Trial of Corticosteroid Optimisation in Severe Asthma

. Condition or disease Intervention/treatment Phase Severe Persistent Asthma Other: Biomarker based adjustment of corticosteroid dose Not Applicable Detailed Description: Asthma affects an estimated 300 million people worldwide with a population prevalence of ca 15% in the UK. The WHO has estimated UK disability adjusted life-years per 100,000 population for asthma to be greater than diabetes and breast cancer. Much of this excessive disability is in the 10-20% of patients with asthma which is difficult (...) A Pragmatic Trial of Corticosteroid Optimisation in Severe Asthma A Pragmatic Trial of Corticosteroid Optimisation in Severe 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 Pragmatic Trial

2016 Clinical Trials

168. Risk Factors for Early Remodelling in Severe Asthma in Children

ASMC may thus have great potential to stimulate airway remodeling. We thus hypothesized that remodeling is an early process and certain characteristics of ASMC in severe preschool asthma may predispose such children to persistent remodeling with airway obstruction later in life. Purpose: To investigate prognostic factors of airway remodeling in preschool children, with special attention to ASMC proliferation (mitochondrial mass & biogenesis). Methods: In the initial phase of the project, 75 severe (...) the child) who gave written informed consent. Affiliated with a social security scheme. Age from 1 to less than 5 years. Severe persistent asthma according to the criteria of the National Health Authority (Annex I) or NEW PROPOSED CRITERIA (adapted ATS (42)): Major criteria (> 1) Asthma control in mild to moderate level requiring A continuous or semi continuous (≥ 50% of the year) by oral corticosteroids A treatment with high doses of inhaled corticosteroids (> 500 micrograms / day of Beclomethasone

2016 Clinical Trials

169. Effects of Age and Disease Severity on Systemic Corticosteroid Responses in Asthma. (PubMed)

Effects of Age and Disease Severity on Systemic Corticosteroid Responses in Asthma. Phenotypic distinctions between severe asthma (SA) and nonsevere asthma (NONSA) may be confounded by differential adherence or incorrect use of corticosteroids.To determine if there are persistent phenotypic distinctions between SA (as defined by 2014 American Thoracic Society/European Respiratory Society guidelines) and NONSA after intramuscular triamcinolone acetonide (TA), and to identify predictors (...) of a corticosteroid response in these populations.A total of 526 adults age 18 years and older (315 SA) and 188 children age 6 to less than 18 years (107 SA) in the NHLBI Severe Asthma Research Program III were characterized before and 3 weeks after TA. The primary outcome for corticosteroid response was defined as greater than or equal to 10-point improvement in percent predicted FEV1.Adult asthma groups exhibited a small but significant mean FEV1% predicted improvement after TA (SA group mean difference, 3.4

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2016 American Journal of Respiratory and Critical Care Medicine

170. Safety, efficacy, and dose response of fluticasone propionate delivered via the novel MDPI in patients with severe asthma: A randomized, controlled, dose-ranging study. (PubMed)

Safety, efficacy, and dose response of fluticasone propionate delivered via the novel MDPI in patients with severe asthma: A randomized, controlled, dose-ranging study. Evaluate fluticasone propionate (Fp) using a novel, inhalation-driven, multidose dry powder inhaler (MDPI) in patients with severe persistent asthma, versus placebo MDPI and Fp dry powder inhaler (DPI).Patients with persistent asthma despite use of high-dose inhaled corticosteroids were randomized to Fp MDPI 50, 100, 200, or 400 (...) of Fp MDPI was similar to that of Fp DPI.Clinical benefit observed with Fp MDPI in patients with persistent asthma was comparable to Fp DPI. Safety was reassuring with no unexpected findings. These results support further evaluation of Fp MDPI in asthma. (ClinicalTrials.gov identifier NCT01576718; EudraCT number 2010-023601-35).

2016 Journal of Asthma

171. DNA Methylation Levels Associate with Race and Childhood Asthma Severity. (PubMed)

. DNA methylation levels were quantified by an immunoassay that assessed the percentage of 5-methylcytosine.Our results indicate that overall, African American children had higher levels of global DNA methylation than children of other races/ethnicities (p = 0.029). This difference was more pronounced when socioeconomic status and asthma severity were coupled with race/ethnicity (p = 0.042) where low-income, African American children with persistent asthma had significantly elevated methylation (...) DNA Methylation Levels Associate with Race and Childhood Asthma Severity. Asthma is a common chronic childhood disease worldwide. Socioeconomic status, genetic predisposition and environmental factors contribute to its incidence and severity. A disproportionate number of children with asthma are economically disadvantaged and live in substandard housing with potential indoor environmental exposures such as cockroaches, dust mites, rodents and molds. These exposures may manifest through

2016 Journal of Asthma

172. Omalizumab Treatment Response in a Severe Allergic Asthma Population with Overlapping COPD. (PubMed)

Omalizumab Treatment Response in a Severe Allergic Asthma Population with Overlapping COPD. Asthma and COPD are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairment and severe disease exacerbations. Efficacious treatment options are required for this population. Omalizumab (anti-IgE) therapy is effective in patients with severe persistent asthma, but limited data are available on efficacy in populations with overlapping asthma and COPD.Data (...) from the Australian Xolair Registry were used to compare treatment responses in individuals with asthma-COPD overlap with responses in patients with severe asthma alone. Participants were assessed at baseline and after 6 months of omalizumab treatment. We used several different definitions of asthma-COPD overlap. First, we compared participants with a previous physician diagnosis of COPD to participants with no COPD diagnosis. We then made comparisons based on baseline lung function, comparing

2016 Chest

173. Reduced epithelial suppressor of cytokine signalling 1 in severe eosinophilic asthma. (PubMed)

Reduced epithelial suppressor of cytokine signalling 1 in severe eosinophilic asthma. Severe asthma represents a major unmet clinical need. Eosinophilic inflammation persists in the airways of many patients with uncontrolled asthma, despite high-dose inhaled corticosteroid therapy. Suppressors of cytokine signalling (SOCS) are a family of molecules involved in the regulation of cytokine signalling via inhibition of the Janus kinase-signal transducers and activators of transcription pathway. We (...) examined SOCS expression in the airways of asthma patients and investigated whether this is associated with persistent eosinophilia.Healthy controls, mild/moderate asthmatics and severe asthmatics were studied. Whole genome expression profiling, quantitative PCR and immunohistochemical analysis were used to examine expression of SOCS1, SOCS2 and SOCS3 in bronchial biopsies. Bronchial epithelial cells were utilised to examine the role of SOCS1 in regulating interleukin (IL)-13 signalling in vitroSOCS1

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2016 European Respiratory Journal

174. Investigation of asthma comorbidity in children with different severities of allergic rhinitis. (PubMed)

evaluated.A total of 299 of the patients were boys (58.7%) the mean age was 7.2 ± 3.5 years (range, 1.5-18 years). Patients with moderate-severe persistent rhinitis (40.5% of all patients) were the most common rhinitis subgroup. Mild intermittent rhinitis was diagnosed in 17.7%, mild persistent rhinitis in 11.2%, and moderate-severe intermittent rhinitis in 30.6% of the patients. Two hundred seventy-one children with AR (53.2%) also had concomitant asthma. The patients were categorized into two groups: AR (...) Investigation of asthma comorbidity in children with different severities of allergic rhinitis. Allergic rhinitis (AR) and asthma comorbidity is widely seen. However, the effects of AR on asthma are more likely to be studied in the literature.To investigate the prevalence of asthma in children with AR who are followed-up and to evaluate the effect of asthma on the severity of AR.A total of 509 children with AR who were followed-up in the pediatric allergy-immunology department between January

2016 American journal of rhinology & allergy

175. Exacerbation risk in severe asthma is stratified by inflammatory phenotype using longitudinal measures of sputum eosinophils. (PubMed)

among the neutrophilic phenotypes.The persistent eosinophilic phenotype is associated with increased exacerbation risk compared with the non-eosinophilic phenotype in severe asthma. No differences in time to first exacerbation or exacerbation risk over a 1-year period were detected among neutrophilic phenotypes.© 2016 John Wiley & Sons Ltd. (...) Exacerbation risk in severe asthma is stratified by inflammatory phenotype using longitudinal measures of sputum eosinophils. Airway inflammatory phenotyping is increasingly applied to subjects with asthma. However, its relationship to clinical outcomes in difficult asthma is incompletely elucidated.The goal of our study was to determine the relationship between exacerbation rates and phenotypes of difficult asthma based on the longitudinal measures of sputum eosinophils

2016 Clinical and Experimental Allergy

176. Development of New Therapies for Severe Asthma (PubMed)

Development of New Therapies for Severe Asthma Persistent asthma has long been treated with inhaled corticosteroids (CSs), as the mainstay of therapy. However, their efficacy in patients with more severe disease is limited, which led to the incorporation of poor response to ICSs (and thereby use of high doses of ICS) into recent definitions of severe asthma. Several studies have suggested that severe asthma might consist of several different phenotypes, each with ongoing symptoms and health (...) care utilization, despite the use of high doses of ICS, usually in combination with a second or third controller. Several new therapies have been approved for severe asthma. Long-acting muscarinic agents have recently been approved as an additional controller agent and appear to improve lung function, although their effect on symptoms and exacerbations is less. Although bronchial thermoplasty (BT) has emerged as a therapy for severe asthma, little is understood regarding the appropriate selection

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2016 Allergy, asthma & immunology research

177. Benralizumab: a unique IL-5 inhibitor for severe asthma (PubMed)

Benralizumab: a unique IL-5 inhibitor for severe asthma The presence of eosinophilic inflammation is a characteristic feature of chronic and acute inflammation in asthma. An estimated 5%-10% of the 300 million people worldwide who suffer from asthma have a severe form. Patients with eosinophilic airway inflammation represent approximately 40%-60% of this severe asthmatic population. This form of asthma is often uncontrolled, marked by refractoriness to standard therapy, and shows persistent

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2016 Journal of asthma and allergy

178. Indoor microbial communities: Influence on asthma severity in atopic and nonatopic children. (PubMed)

symptoms and medication or moderate to severe persistent) and atopic status (determined by serum IgE levels). Microbial community structure and concentrations in house dust were determined by using next-generation DNA sequencing and quantitative PCR. Logistic regression was used to explore associations between asthma severity and exposure metrics, including richness, taxa identification and quantification, community composition, and concentration of total fungi and bacteria.Among all children (...) Indoor microbial communities: Influence on asthma severity in atopic and nonatopic children. Allergic and nonallergic asthma severity in children can be affected by microbial exposures.We sought to examine associations between exposures to household microbes and childhood asthma severity stratified by atopic status.Participants (n = 196) were selected from a cohort of asthmatic children in Connecticut and Massachusetts. Children were grouped according to asthma severity (mild with no or minimal

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2016 Journal of Allergy and Clinical Immunology

179. A protocol for a randomised clinical trial of the effect of providing feedback on inhaler technique and adherence from an electronic device in patients with poorly controlled severe asthma. (PubMed)

A protocol for a randomised clinical trial of the effect of providing feedback on inhaler technique and adherence from an electronic device in patients with poorly controlled severe asthma. In clinical practice, it is difficult to distinguish between patients with refractory asthma from those with poorly controlled asthma, where symptoms persist due to poor adherence, inadequate inhaler technique or comorbid diseases. We designed an audio recording device which, when attached to an inhaler (...) , objectively identifies the time and technique of inhaler use, thereby assessing both aspects of adherence. This study will test the hypothesis that feedback on these two aspects of adherence when passed on to patients improves adherence and helps clinicians distinguish refractory from difficult-to-control asthma.This is a single, blind, prospective, randomised, clinical trial performed at 5 research centres. Patients with partially controlled or uncontrolled severe asthma who have also had at least one

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2016 BMJ open

180. Efficacy of omalizumab (Xolair®) in patients with moderate to severe predominately chronic oral steroid dependent asthma in Taiwan: a retrospective, population-based database cohort study. (PubMed)

Efficacy of omalizumab (Xolair®) in patients with moderate to severe predominately chronic oral steroid dependent asthma in Taiwan: a retrospective, population-based database cohort study. Omalizumab (Xolair®), a recombinant monoclonal anti-IgE antibody, has demonstrated efficacy in clinical trials conducted in patients with moderate to severe persistent allergic asthma. We aimed to investigate the efficacy, discontinuation and medical resource utilization of omalizumab in the real-life setting (...) in Taiwan.This study was a retrospective, population-based database cohort study using the Taiwan NHIRD from 2007 to 2011 assessing the efficacy of omalizumab therapy over 4 months on changes in asthma medication, asthma control, frequency of exacerbations and hospitalization rates at baseline and after omalizumab discontinuation.There was a reduction in asthma medication post omalizumab therapy and severe exacerbations and hospitalizations from baseline (31.2%, n = 282) to the end of follow-up (11.8%, n

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2016 BMC pulmonary medicine

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