Latest & greatest articles for asthma

The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on asthma or other clinical topics then use Trip today.

This page lists the very latest high quality evidence on asthma and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

What is Trip?

Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.

As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.

For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com

Top results for asthma

1. Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma

Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma 30442714 2019 02 14 1399-3003 53 2 2019 Feb The European respiratory journal Eur. Respir. J. Tralokinumab did not demonstrate oral corticosteroid-sparing effects in severe asthma. 1800948 10.1183/13993003.00948-2018 Long-term oral corticosteroid (OCS) use in patients with severe asthma is associated with significant adverse effects.This 40-week, randomised, double-blind trial evaluated the OCS-sparing (...) potential of tralokinumab in patients with severe, uncontrolled asthma requiring maintenance OCS treatment plus inhaled corticosteroids/long-acting β 2 -agonists. Overall, 140 patients were randomised to tralokinumab 300 mg or placebo (n=70 in each group) administered subcutaneously every 2 weeks. The primary end-point was percentage change from baseline in average OCS dose at week 40, while maintaining asthma control. Secondary end-points included proportion of patients with a prescribed maintenance

2019 EvidenceUpdates

2. Less puffing, more breathing? Intermittent inhaled steroids for asthma

Less puffing, more breathing? Intermittent inhaled steroids for asthma March 4, 2019 (en français) Less puffing, more breathing? Intermittent inhaled steroids for asthma Clinical Question: In patients with mild persistent asthma, is intermittent use of inhaled corticosteroids (ICS) as effective as daily use? Bottom Line: In patients with mild persistent asthma, intermittent use of ICS or ICS/LABA is similar to daily ICS in preventing exacerbations but is associated with ~5 fewer weeks per year (...) of well-controlled asthma. Overall adverse events are similar. Evidence: • Focusing on two large (~4000 patients each), industry managed, randomized, double- blind, placebo-controlled trials (RCTs) in mild persistent asthma (controlled on low- dose daily ICS or uncontrolled with Short-Acting Beta-Agonist alone). 1,2 Mean age ~40; ~20% had severe exacerbation in preceding year. Included patients randomized to budesonide/formoterol PRN or budesonide 200mcg BID + terbutaline PRN after a 2- 4-week run

2019 Tools for Practice

3. Benralizumab for treating severe eosinophilic asthma

Benralizumab for treating severe eosinophilic asthma Benr Benralizumab for treating se alizumab for treating sev vere ere eosinophilic asthma eosinophilic asthma T echnology appraisal guidance Published: 6 March 2019 nice.org.uk/guidance/ta565 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guidance represent the view of NICE, arrived at after (...) and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Benralizumab for treating severe eosinophilic asthma (TA565) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 23Contents Contents 1 Recommendations 4 2 Information about benralizumab 7 3 Committee discussion 8

2019 National Institute for Health and Clinical Excellence - Technology Appraisals

4. Serious asthma events with mometasone furoate plus formoterol compared with mometasone furoate

Serious asthma events with mometasone furoate plus formoterol compared with mometasone furoate 30537475 2019 01 22 1097-6825 2018 Dec 08 The Journal of allergy and clinical immunology J. Allergy Clin. Immunol. Serious asthma events with mometasone furoate plus formoterol compared with mometasone furoate. S0091-6749(18)31740-8 10.1016/j.jaci.2018.10.065 The safety of long-acting β-agonists added to inhaled corticosteroids for the treatment of persistent asthma has been controversial. We sought (...) to determine whether administering formoterol in combination with mometasone furoate increases the risk of serious asthma outcomes (SAOs) compared with mometasone furoate alone. This clinical trial is registered as NCT01471340. We conducted a 26-week, randomized, double-blind trial in adolescent and adult patients (≥12 years) with persistent asthma in 35 countries with the primary objective of evaluating whether mometasone furoate-formoterol increases the risk of SAOs (adjudicated hospitalization

2019 EvidenceUpdates

5. Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT

Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT 30659063 2019 03 07 1098-4275 143 2 2019 Feb Pediatrics Pediatrics Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT. e20181723 10.1542/peds.2018-1723 Few trials have been conducted to address the psychological difficulties of parents in managing their child's asthma. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help (...) parents to accept these psychological difficulties and improve their management of childhood asthma. In this randomized controlled trial, a 4-session, group-based ACT plus asthma education (ACT group) was compared with an asthma education talk plus 3 telephone follow-ups (control group) to train parents of children diagnosed with asthma. The use of health care services due to asthma exacerbations in children and the psychological well-being of their parents were assessed before, immediately after

2019 EvidenceUpdates

6. Increasing inhaled steroids for short periods reduces asthma exacerbations

Increasing inhaled steroids for short periods reduces asthma exacerbations Asthma exacerbations can be reduced by increasing inhaled steroids for short periods Dissemination Centre Discover Portal NIHR DC Discover Increasing inhaled steroids for short periods reduces asthma exacerbations Published on 17 July 2018 doi: Taking four times the usual dose of inhaled corticosteroids for up to two weeks can modestly reduce the chance of asthma worsening. This NIHR-funded trial assessed increasing (...) the inhaled corticosteroid dose compared with staying on the usual dose, as part of a self-management plan. Participants were adults and adolescents with uncontrolled asthma and had at least one exacerbation needing additional medical attention in the year before the trial. Quadrupling the inhaled corticosteroid dose when asthma worsens is already recommended by NICE guidance, but previously there was little research evidence to support the clinical practice. What there was, suggested that doubling

2019 NIHR Dissemination Centre

7. Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children

Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Signal - Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Dissemination Centre Discover Portal NIHR DC Discover Intermittent inhaled steroids reduce asthma attacks in wheezing preschool children Published on 22 November 2016 Regular daily steroid inhalers reduce the number of severe asthma exacerbations requiring soluble tablets or injections in wheezing preschool children (...) by about a third. Intermittent high-dose steroid inhalers, given only when symptoms of a cold begin, were also effective for children with occasional asthma or wheezing triggered by a virus. This strategy may reduce the overall dose of steroids given to these children, though adverse effects may still occur. Wheezing is initially treated with a β2 agonist inhaler which opens up the airways. UK guidelines recommend adding in a daily low-dose steroid inhaler if symptoms are persistent, which

2019 NIHR Dissemination Centre

8. Vitamin D supplements can reduce risk of asthma attacks

Vitamin D supplements can reduce risk of asthma attacks Signal - Vitamin D supplements can reduce risk of asthma attacks Dissemination Centre Discover Portal NIHR DC Discover Vitamin D supplements can reduce risk of asthma attacks Published on 6 December 2016 People with mild to moderate asthma experience fewer severe asthma attacks if they take vitamin D supplements. This review found that the average number of asthma attacks was equivalent to about one every four years in those taking vitamin (...) D, compared to nearly one every two years in those taking a placebo. Half as many people attended hospital for asthma treatment each year when taking vitamin D (3%) compared with those not taking vitamin D (6%). These reductions were clinically and statistically significant. There are a few unknowns still. It’s not clear if these results apply to everyone or just those with low levels of vitamin D. Also, these results apply to adults with mild to moderate asthma when taken alongside their usual

2019 NIHR Dissemination Centre

9. Study shows no benefit of an antibiotic for acute asthma

Study shows no benefit of an antibiotic for acute asthma Signal - Study shows no benefit of an antibiotic for acute asthma Dissemination Centre Discover Portal NIHR DC Discover Study shows no benefit of an antibiotic for acute asthma Published on 21 December 2016 The antibiotic azithromycin did not reduce symptoms or change other outcomes in adults seeking emergency care for an acute asthma attack. However people not already taking antibiotics were hard to find and the trial failed to enrol (...) enough people to answer the research question. In this UK-based trial, people with asthma who received azithromycin on top of standard treatment with corticosteroids had no better symptoms ten days later than people who received corticosteroids alone. Almost half of almost 4,600 potential participants had already been given antibiotics. This study shows that many people are being prescribed antibiotics to treat an asthma attack despite British guidance stating that antibiotics should not be routinely

2019 NIHR Dissemination Centre

10. The nitric oxide breath test offers little benefit when monitoring asthma

The nitric oxide breath test offers little benefit when monitoring asthma Signal - The nitric oxide breath test offers little benefit when monitoring asthma Dissemination Centre Discover Portal NIHR DC Discover The nitric oxide breath test offers little benefit when monitoring asthma Published on 10 January 2017 Using exhaled nitric oxide levels to guide the dose of asthma medication at regular clinic visits may reduce flare-ups but does not improve overall symptoms or quality (...) of life. In this review hospitalisations and the total inhaled steroid doses were unaffected by the intervention. Measuring the amount of fractional exhaled nitric oxide (FeNO) in the breath of people with asthma detects lung inflammation. If inflammation increases, this may indicate that a flare-up is likely and preventative action can be taken. The aim is to ensure medication corresponds to symptom severity, the ideal being the minimum dose needed to control symptoms. The usual monitoring strategy consists

2019 NIHR Dissemination Centre

11. GP letter to improve medication adherence did not reduce unplanned care for children with asthma

GP letter to improve medication adherence did not reduce unplanned care for children with asthma Signal - GP letter to improve medication adherence did not reduce unplanned care for children with asthma Dissemination Centre Discover Portal NIHR DC Discover GP letter to improve medication adherence did not reduce unplanned care for children with asthma Published on 14 March 2017 A one-off GP letter reminding parents of children with asthma to use their medications over the August summer holiday (...) did not prevent a characteristic annual peak in unplanned care on returning to school in September, but did lead to more prescriptions. Unplanned care represents visits to the GP or accident and emergency that is not part of the child’s asthma care plan. They do not include scheduled medical review or visits for repeat prescriptions. The letter prompted about a third more parents to collect inhaler prescriptions in August than parents receiving no letter. But this failed to reduce the high

2019 NIHR Dissemination Centre

12. Asthma self-management programmes can reduce unscheduled care

Asthma self-management programmes can reduce unscheduled care Signal - Asthma self-management programmes can reduce unscheduled care Dissemination Centre Discover Portal NIHR DC Discover Asthma self-management programmes can reduce unscheduled care Published on 20 June 2017 People with asthma who receive supported self-management are less likely to attend A&E or be admitted to hospital. The interventions are unlikely to increase overall costs for healthcare services. Those who self-manage (...) are also likely to have more controlled asthma and a better quality of life. This extensive overview of systematic reviews included evidence from 270 randomised controlled trials exploring the effects of asthma self-management on healthcare utilisation and costs. Self-management programmes were slightly more expensive, but this cost was likely to be offset by reducing unplanned medical visits and improving patient quality of life. Trials covered different self-care education programmes delivered

2019 NIHR Dissemination Centre

13. Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks

Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks Signal - Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks Dissemination Centre Discover Portal NIHR DC Discover Combination inhaler treatment in emergency departments may reduce admissions for asthma attacks Published on 30 May 2017 Using a combination of two inhaled drugs to open the airways may modestly reduce the need to admit an adult with asthma (...) attack to hospital, though the underlying evidence is weak. The first-line treatment for an asthma attack is an inhaled β2 agonist, like salbutamol. This Cochrane review compared emergency department treatment with this drug alone, or combined with an inhaled short-acting anticholinergic, like ipratropium bromide. Pooled results from 16 trials included found that combination therapy would mean about 65 fewer patients per 1000 are admitted to hospital. As most underlying trials were conducted outside

2019 NIHR Dissemination Centre

14. Breathing exercises improve asthma and can be learned by DVD

Breathing exercises improve asthma and can be learned by DVD Signal - Breathing exercises improve asthma and can be learned by DVD Dissemination Centre Discover Portal NIHR DC Discover Breathing exercises improve asthma and can be learned by DVD Published on 7 November 2017 Breathing exercises taught by a physiotherapist in person or on DVD both improved the quality of life of adults with poorly controlled asthma to a small but similar extent. The DVD was the cheapest option, and it could lead (...) to inexpensive internet delivery in the future. This NIHR-funded trial recruited 655 UK adults with poorly controlled asthma. It showed about 63% of those receiving the breathing exercises had clinically important improvements in their asthma-related quality of life over a year, compared to 56% who improved receiving usual care. Exercises did not improve formally measured lung function, suggesting the underlying biology of the asthma was unchanged. The findings imply that breathing exercise programmes

2019 NIHR Dissemination Centre

15. Bronchial thermoplasty for severe asthma

Bronchial thermoplasty for severe asthma Bronchial thermoplasty for se Bronchial thermoplasty for sev vere asthma ere asthma Interventional procedures guidance Published: 19 December 2018 nice.org.uk/guidance/ipg635 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However (...) should be interpreted in a way that would be inconsistent with compliance with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. This guidance replaces IPG419. 1 1 Recommendations Recommendations 1.1 Current evidence on the safety and efficacy of bronchial thermoplasty for severe asthma is adequate to support

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

16. Tiotropium (Spiriva Respimat) - as add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma who experienced one or more severe asthma exacerbations in the preceding year

Tiotropium (Spiriva Respimat) - as add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma who experienced one or more severe asthma exacerbations in the preceding year Published 14 January 2019 www.scottishmedicines.org.uk Product update SMC2118 tiotropium 2.5 microgram solution for inhalation (Spiriva® Respimat®) Boehringer Ingelheim Limited 7 December 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product (...) and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarised as follows: ADVICE: following an abbreviated submission tiotropium (Spiriva® Respimat®) is accepted for use within NHSScotland. Indication under review: as add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma who experienced one or more severe asthma exacerbations in the preceding year. Tiotropium has previously been accepted for use

2019 Scottish Medicines Consortium

17. Inhaled steroids with and without regular salmeterol for asthma: serious adverse events. (PubMed)

Inhaled steroids with and without regular salmeterol for asthma: serious adverse events. BACKGROUND: Epidemiological evidence has suggested a link between use of beta₂-agonists and increased asthma mortality. Much debate has surrounded possible causal links for this association, and whether regular (daily) long-acting beta₂-agonists (LABAs) are safe, particularly when used in combination with inhaled corticosteroids (ICSs). This is an update of a Cochrane Review that now includes data from two (...) large trials including 11,679 adults and 6208 children; both were mandated by the US Food and Drug Administration (FDA). OBJECTIVES: To assess risks of mortality and non-fatal serious adverse events (SAEs) in trials that randomised participants with chronic asthma to regular salmeterol and ICS versus the same dose of ICS. SEARCH METHODS: We identified randomised trials using the Cochrane Airways Group Specialised Register of trials. We checked websites of clinical trials registers for unpublished

2018 Cochrane

18. Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature

Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature 30190274 2018 10 26 1399-3003 52 4 2018 Oct The European respiratory journal Eur. Respir. J. Consequences of long-term oral corticosteroid therapy and its side-effects in severe asthma in adults: a focused review of the impact data in the literature. 1800703 10.1183/13993003.00703-2018 This review provides an overview of the role of long (...) -term treatment of severe asthma with oral corticosteroids (OCS) and its associated side-effects in adults. It is based on a systematic literature search conducted in MEDLINE, Embase and the Cochrane Library to identify relevant studies. After a short overview of severe asthma and its treatment we present studies showing a dose-response relationship in asthmatic patients treated with OCS and then consider by organ systems the undesired effects demonstrated in clinical and epidemiological studies

2018 EvidenceUpdates

19. Temporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST

Temporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST Temporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata (...) .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} An asthma self-management plan that advised patients to temporarily quadruple their dose of inhaled corticosteroid reduced asthma exacerbations, with fewer serious adverse events and at lower cost. {{author}} {{($index , , , , , , , , , , , , , , , & . Tricia McKeever 1 , Kevin Mortimer 2 , Lucy Bradshaw 3 , Rebecca Haydock 3 , Ian Pavord 4 , Bernard Higgins 5 , Samantha Walker 6 , Andrew Wilson 7 , David Price 8, 9 , Mike

2018 NIHR HTA programme

20. Tiotropium (Spiriva Respimat) add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma

Tiotropium (Spiriva Respimat) add-on maintenance bronchodilator treatment in patients aged 6 years and older with severe asthma Tiotropium (Spiriva ® Respimat ® ). Reference number 1882. Page 1 of 3 AWMSG Secretariat Assessment Report – Limited submission Tiotropium (Spiriva ® Respimat ® ) 2.5 microgram, inhalation solution Company: Boehringer Ingelheim Ltd Licensed indication under consideration: add-on maintenance bronchodilator treatment in patients aged 6 years to < 18 years with severe (...) asthma who experienced one or more severe asthma exacerbations in the preceding year Date of licence extension: 12 April 2018 Comparator(s) The company stated that there is no comparator and that tiotropium (Spiriva ® Respimat ® ) is an add-on treatment. Limited submission details ? The limited submission criteria were met based on a minor licence extension. Clinical effectiveness ? Tiotropium (Spiriva ® Respimat ® ) was recommended by the All Wales Medicines Strategy Group in 2017 as an add

2018 All Wales Medicines Strategy Group