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Severe Persistent Asthma

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

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

162. Omalizumab Improves Quality of Life and Asthma Control in Chinese Patients With Moderate to Severe Asthma: A Randomized Phase III Study. Full Text available with Trip Pro

Omalizumab Improves Quality of Life and Asthma Control in Chinese Patients With Moderate to Severe Asthma: A Randomized Phase III Study. Omalizumab is the preferred add-on therapy for patients with moderate-to-severe persistent allergic asthma and has demonstrated efficacy and safety in various ethnicities. This study evaluated the efficacy and safety of omalizumab in Chinese patients with moderate-to-severe allergic asthma.This randomized, double-blind, parallel-group, placebo-controlled (...) with omalizumab vs placebo (LSM-TD=-0.21, P=0.048 and -0.12, P=0.011, respectively). Although the study was not powered to study differences in exacerbation rates (P=0.097), exacerbations in winter months were less frequent in the omalizumab vs placebo group (2 vs 21). Adverse event and severe adverse event rates were comparable between omalizumab and placebo.Omalizumab improves lung function, quality of life, and asthma control in Chinese patients with moderate-to-severe persistent allergic asthma and has

2016 Allergy, asthma & immunology research Controlled trial quality: predicted high

163. Protocol for a feasibility study to inform the development of a multicentre randomised controlled trial of asthma-tailored pulmonary rehabilitation versus usual care for individuals with severe asthma. Full Text available with Trip Pro

with severe asthma will be included if they have persistent symptoms despite being at step 4 or 5 of the British Thoracic Society guidelines. Stage 1: semistructured interviews will be used in a sample of 20-30 individuals with severe asthma to understand the experience and attitudes of this population towards exercise. Stage 2: eight focus groups of at least six healthcare professionals involved in the care of patients with severe asthma will be conducted to understand their attitudes towards exercise (...) Protocol for a feasibility study to inform the development of a multicentre randomised controlled trial of asthma-tailored pulmonary rehabilitation versus usual care for individuals with severe asthma. Pulmonary rehabilitation with core components of exercise training and multiprofessional education is an integral part of the management of patients with chronic lung disease. International guidelines for individuals with asthma recommend exercise as exercise improves symptoms, indices

2016 BMJ open Controlled trial quality: uncertain

164. Obesity increases the prevalence and the incidence of asthma and worsens asthma severity. (Abstract)

Obesity increases the prevalence and the incidence of asthma and worsens asthma severity. We aimed to explore the association between obesity and asthma prevalence, incidence and severity.The study included 32,644 adults, 52.6% female, from a representative sample of the 4th Portuguese National Health Survey. The following asthma definitions were used: ever asthma (ever medical doctor asthma diagnosis), current asthma (asthma within the last 12 months), current persistent asthma (required (...) asthma medication within the last 12 months), current severe asthma (attending an emergency department because of asthma within the last 12 months), and incident asthma (asthma diagnosis within the last 12 months). Body mass index was calculated based on self-reported weight and height and categorised according to WHO classification. Logistic regression models adjusted for confounders were performed.Prevalence of ever asthma was 5.3%, current asthma 3.5%, current persistent asthma 3.0%, current

2016 Clinical nutrition (Edinburgh, Scotland)

165. Vitamin D to Prevent Severe Asthma Exacerbations (Vit-D-Kids Asthma)

). On the basis of those findings, the investigators hypothesize that vitamin D reduces the incidence of severe asthma exacerbations in high-risk school-aged children who have a serum vitamin D level <30 ng/ml and who are being treated with ICS for persistent asthma. The investigators further hypothesize that this protective effect results from reduced incidence of common viral illnesses or enhanced response to ICS. These hypotheses will be tested in a 48-week randomized double-masked placebo-controlled trial (...) Vitamin D to Prevent Severe Asthma Exacerbations (Vit-D-Kids Asthma) Vitamin D to Prevent Severe Asthma Exacerbations (Vit-D-Kids 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. Vitamin D to Prevent

2016 Clinical Trials

166. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period

decreased because of a reduction in cerebral and respi- ratory complications (5, 6). Individuals and institu- tions should have mechanisms in place to initiate the prompt administration of medication when a patient presents with a hypertensive emergency. Treatment with first-line agents should be expeditious and occur as soon as possible within 30–60 minutes of confirmed severe hypertension (blood pressure greater than 160/ 110 mm Hg and persistent for 15 minutes) to reduce theriskofmaternalstroke(7–9 (...) or a hypertensive exacerba- tion with acutely worsening, difficult to control, severe hypertension. Acute-onset, severe hypertension that is accu- rately measured using standard techniques and is persistent for 15 minutes or more is considered a hypertensive emergency. It is well known that severe hypertension can cause central nervous system injury. As stated in the Confidential Enquiries report from the United Kingdom, two thirds of the maternal deaths during 2003–2005 resulted from cerebral hemorrhage

2019 American College of Obstetricians and Gynecologists

167. Asthma in adults: beclometasone/formoterol dry powder inhaler (Fostair NEXThaler)

reaction with beclometasone/formoterol dry powder inhaler is tremor. In an 8-week RCT, 6 severe asthma exacerbations were observed in the non-extrafine beclometasone group, 4 in the extrafine beclometasone/ formoterol dry powder inhaler group and 3 in the extrafine beclometasone/formoterol pressurised metered dose inhaler group. The proportion of people experiencing treatment emergent adverse events was low and similar across all 3 treatment groups. Adverse events included headache, nasopharyngitis (...) NEXThaler (75.4%) compared with an Accuhaler (16.9%; p<0.001) or a Turbohaler (7.7%; p<0.001). Asthma in adults: beclometasone/formoterol dry powder inhaler (Fostair NEXThaler) (ESNM53) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 26In Kanniess et al. (2014), 26 asthma exacerbations were reported during the trial, 13 of which were classed as severe. Of these, 6 were observed in the non-extrafine beclometasone

2015 National Institute for Health and Clinical Excellence - Advice

168. Asthma: tiotropium (Spiriva Respimat)

controlled trials (RCTs; total n=912) of identical design evaluated tiotropium (Spiriva Respimat) in adults with poorly controlled asthma and persistent airflow obstruction who were already treated with an inhaled corticosteroid (ICS) and a long-acting beta-2 agonist (LABA). Tiotropium improved peak and trough forced expired volume in 1 second (FEV1) and lengthened the time to first severe exacerbation compared with placebo. Differences between add-on therapy with tiotropium and placebo in patient (...) control despite daily therapy with an ICS (at least 800 micrograms of budesonide per day or equivalent [median dose 800 microgram/day]) and a LABA were enrolled. Participants were required to have an Asthma Control Questionnaire 7 (ACQ-7) score of 1.5 or higher (scores on ACQ-7 range between 0 [totally controlled] and 6 [severely uncontrolled], with a minimal clinically important difference of 0.5) and show persistent airflow limitation (defined as a post-bronchodilator forced expired volume in 1

2015 National Institute for Health and Clinical Excellence - Advice

169. Randomised controlled trial: In children and adolescents with mild persistent asthma, daily beclomethasone reduces treatment failure compared with rescue beclomethasone plus albuterol

persistent asthma (TREXA): a randomised, double-blind, placebo-controlled trial . Context Many studies have shown that regular use of inhaled corticosteroids improves asthma control in children with asthma. However, intermittent therapy with inhaled corticosteroids is common practice in the community 1 as many physicians and families are reluctant to administer inhaled corticosteroids long term. Several previous studies have examined this approach and have generally not found it to be convincingly (...) Randomised controlled trial: In children and adolescents with mild persistent asthma, daily beclomethasone reduces treatment failure compared with rescue beclomethasone plus albuterol In children and adolescents with mild persistent asthma, daily beclomethasone reduces treatment failure compared with rescue beclomethasone plus albuterol | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via

2011 Evidence-Based Medicine

170. Effectiveness and Safety of Bronchial Thermoplasty in Management of Asthma

. This was one of the six high-priority topics within asthma identified by an National Heart, Lung, and Blood Institute Advisory Council Asthma Expert Working Group. 1 The objective of the systematic review is to assess the effectiveness and safety of bronchial thermoplasty (BT) in adults with asthma. Background Patients with severe, persistent asthma are managed with multiple medications that may include inhaled, orally administered, and biologic therapeutics. Some of these patients might be eligible for BT (...) , an interventional treatment option that involves the delivery of controlled radiofrequency thermal energy to the walls of accessible proximal airways with the intent of reducing excess airway smooth muscle tissue in the airways and reducing the frequency of severe asthma exacerbations on a long-term basis. In April 2010, the U.S. Food and Drug Administration approved the Alair BT system for use in patients 18 years of age or older with severe, persistent asthma. This report’s main objective is to conduct

2017 Effective Health Care Program (AHRQ)

171. Omalizumab for the treatment of severe persistent allergic asthma Full Text available with Trip Pro

, Hartwell D, Harris P, Cooper K, Takeda A, Davidson P. Omalizumab for the treatment of severe persistent allergic asthma. Health Technology Assessment 2009; 13(Suppl 2 Article 5): 31-39 Final publication URL Additional data URL Indexing Status Subject indexing assigned by NLM MeSH Anti-Asthmatic Agents /economics /therapeutic use; Antibodies, Anti-Idiotypic; Antibodies, Monoclonal /economics /therapeutic use; Antibodies, Monoclonal, Humanized; Asthma /drug therapy; Cost-Benefit Analysiss; Omalizumab (...) Omalizumab for the treatment of severe persistent allergic asthma Omalizumab for the treatment of severe persistent allergic asthma Omalizumab for the treatment of severe persistent allergic asthma Jones J, Shepherd J, Hartwell D, Harris P, Cooper K, Takeda A, Davidson P Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Jones J, Shepherd J

2009 Health Technology Assessment (HTA) Database.

172. Bronchial Thermoplasty Failure in Severe Persistent Asthma: A Case Report. Full Text available with Trip Pro

Bronchial Thermoplasty Failure in Severe Persistent Asthma: A Case Report. Bronchial thermoplasty (BT) is an emerging therapy for patients with severe persistent asthma who remain poorly controlled despite standard maximal medical therapy. Thermoplasty elicits asthma control over time by applying thermal radiofrequency energy to airways to ablate underlying smooth muscle. While this therapy is suggested to eliminate such smooth muscle permanently, no human studies have examined the possibility (...) of treatment failure.We present a 62-year-old female with severe, refractory asthma symptoms who underwent BT without apparent complications. However, severe symptoms including multiple clinical exacerbations persisted despite BT treatment. Repeat endobronchial biopsy done six months after BT treatment demonstrated persistent smooth muscle hyperplasia in multiple airways that previously had been treated. The patient continued to have uncontrolled, refractory asthma despite multiple therapies.This case

2013 Journal of Asthma

173. Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. Full Text available with Trip Pro

Bronchial thermoplasty: Long-term safety and effectiveness in patients with severe persistent asthma. Bronchial thermoplasty (BT) has previously been shown to improve asthma control out to 2 years in patients with severe persistent asthma.We sought to assess the effectiveness and safety of BT in asthmatic patients 5 years after therapy.BT-treated subjects from the Asthma Intervention Research 2 trial (ClinicalTrials.govNCT01350414) were evaluated annually for 5 years to assess the long-term (...) from baseline to 5 years after BT showed no structural abnormalities that could be attributed to BT.These data demonstrate the 5-year durability of the benefits of BT with regard to both asthma control (based on maintained reduction in severe exacerbations and ED visits for respiratory symptoms) and safety. BT has become an important addition to our treatment armamentarium and should be considered for patients with severe persistent asthma who remain symptomatic despite taking inhaled

2013 The Journal of allergy and clinical immunology Controlled trial quality: uncertain

174. Identifying Which Urban Children With Asthma Benefit Most From Clinician Prompting: Subgroup Analyses From the Prompting Asthma Intervention in Rochester-Uniting Parents and Providers (PAIR-UP) Trial. Full Text available with Trip Pro

Identifying Which Urban Children With Asthma Benefit Most From Clinician Prompting: Subgroup Analyses From the Prompting Asthma Intervention in Rochester-Uniting Parents and Providers (PAIR-UP) Trial. Clinician prompts increase the likelihood of guideline-recommended corrective actions (preventive medication prescription, dose change, and/or adherence promotion) for symptomatic children with poorly controlled or persistent asthma in the primary care setting, but it is unclear if all children (...) equally benefit. The objectives of this study were to identify whether asthma severity, visit type, and current preventive medication use were predictive of corrective actions during visits for children with symptomatic asthma, and determine whether these factors modified the effect of a prompting intervention.We conducted prespecified subgroup analyses of a cluster randomized controlled trial of physician prompting that promoted guideline-based asthma management for urban children with symptomatic

2018 Academic pediatrics Controlled trial quality: uncertain

175. The Detroit Young Adult Asthma Project: Proposal for a Multicomponent Technology Intervention for African American Emerging Adults With Asthma Full Text available with Trip Pro

to controller medication in African American youth (ages 18-29) with asthma. All elements of the protocol were piloted in a National Heart, Lung, and Blood Institute (NHLBI)-funded pilot study (1R34HL107664 MacDonell). Results suggested feasibility and acceptability of the protocol as well as proof of concept. We are now ready to test the intervention in a larger randomized clinical trial.The proposed study will include 192 African American emerging adults with moderate to severe persistent asthma and low (...) The Detroit Young Adult Asthma Project: Proposal for a Multicomponent Technology Intervention for African American Emerging Adults With Asthma Racial and ethnic minority youth have poorer asthma status than white youth, even after controlling for socioeconomic variables. Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity. The clinical consequences of poor asthma management include increased illness complications, excessive functional morbidity

2018 JMIR Research Protocols Controlled trial quality: uncertain

176. Clinical Effect of Endoscopic Vidian Neurectomy on Bronchial Asthma Outcomes in Patients with Coexisting Refractory Allergic Rhinitis and Asthma. (Abstract)

in patients with coexisting refractory allergic rhinitis and asthma. Methods A total of 109 patients with moderate to severe persistent intractable allergic rhinitis and mild/moderate asthma were allocated to the bilateral endoscopic vidian neurectomy group (group 1) or conservative medication group (group 2) according to the patients' self-selection. The Rhinoconjunctivitis Quality of Life Questionnaire, Visual Analog Scale, Asthma Quality of Life Questionnaire, Total Asthma Symptom Score, and medication (...) Clinical Effect of Endoscopic Vidian Neurectomy on Bronchial Asthma Outcomes in Patients with Coexisting Refractory Allergic Rhinitis and Asthma. Background The prevalence of both allergic rhinitis and bronchial asthma is high throughout the world; their mutual influence on each other has been documented in many studies. However, studies regarding surgical intervention are limited. Objective To evaluate the clinical significance of endoscopic vidian neurectomy on bronchial asthma outcomes

2018 American journal of rhinology & allergy

177. Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial. (Abstract)

μL (71·2-80·7%), and the subgroup with fewer than 300 eosinophils per μL (59·9-67·6%). The most common adverse events with dupilumab compared with placebo were upper respiratory tract infections (33-41% vs 35%) and injection-site reactions (13-26% vs 13%).Dupilumab increased lung function and reduced severe exacerbations in patients with uncontrolled persistent asthma irrespective of baseline eosinophil count and had a favourable safety profile, and hence in addition to inhaled corticosteroids (...) Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial. Dupilumab, a fully human anti-interleukin-4 receptor α monoclonal antibody, inhibits interleukin-4 and interleukin-13 signalling, key drivers of type-2-mediated inflammation. Adults with uncontrolled persistent asthma who are receiving medium-to-high

2016 Lancet (London, England) Controlled trial quality: predicted high

178. [Influences of inhaling glucocorticoid on sIgA and HBD-2,3 in pharyngeal mucosa of and T cell subsets in blood of patients with chronic persistent asthma]. (Abstract)

[Influences of inhaling glucocorticoid on sIgA and HBD-2,3 in pharyngeal mucosa of and T cell subsets in blood of patients with chronic persistent asthma]. Objective:The aim of this study was to investigate the inhaled glucocorticoid therapy affects sIgA and HBD 2,3 secreted by mucous membrane of throat and T lymphocyte subsets in patients with chronic persistent asthma. Method:One hundred patients diagnosed with chronic persistent asthma were randomly divided into control group (submitted (...) to conventional non-hormonal therapy) and treatment group (submitted to inhaled glucocorticoid therapy) with 50 cases in each group. Ventolin aerosol had been promised in on demand use and the dosage of nonhormonal drugs should be adjusted according to the severity of illness in each group. No matter if asthma was fully under control or not, the observation would be terminated in 3 months. The secretion samples of pharyngeal mucosa and venous blood samples had been collected before and after treatment

2016 Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery Controlled trial quality: uncertain

179. DUOX1 mediates persistent epithelial EGFR activation, mucous cell metaplasia, and airway remodeling during allergic asthma Full Text available with Trip Pro

DUOX1 mediates persistent epithelial EGFR activation, mucous cell metaplasia, and airway remodeling during allergic asthma Chronic inflammation with mucous metaplasia and airway remodeling are hallmarks of allergic asthma, and these outcomes have been associated with enhanced expression and activation of EGFR signaling. Here, we demonstrate enhanced expression of EGFR ligands such as amphiregulin as well as constitutive EGFR activation in cultured nasal epithelial cells from asthmatic subjects (...) related to persistent EGFR activation and suggest that DUOX1 targeting may represent an attractive strategy in asthma management.

2016 JCI insight

180. Cost of persistent asthma in Italy Full Text available with Trip Pro

of visits; drug use and duration, and indirect costs) were recorded.The cohort consisted of 817 patients with persistent asthma of different severity. They had a 42.96% male prevalence; a mean (±SE) age of 49.06 (±0.64) years; a mean 87.47% (±0.81) FEV1% pred. in baseline, and 69.16% of subjects had comorbidities. The mean (±SE) number of relapses was 0.91 (±0.09) per patient/year before the enrolment. After 12 months, FEV1% significantly improved by +6.31% (±0.45) from the corresponding baseline value (...) Cost of persistent asthma in Italy Asthma is a common disease of the airways with a significant burden for the society and for patients' quality of life. The Social Impact of Respiratory Integrated Outcomes (SIRIO) study estimated a mean cost of 1,177.40 € per patient/year in Italy, in 2007. The aim of the present study was to update the cost of persistent asthma patients in Italy.An observational, retrospective, bottom-up analysis was carried out starting from the data base operating

2016 Multidisciplinary respiratory medicine

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