Journal ArticleDOI
Daily versus As-Needed Corticosteroids for Mild Persistent Asthma
Homer A. Boushey,Christine A. Sorkness,Tonya S. King,Sean D. Sullivan,John V. Fahy,Stephen C. Lazarus,Vernon M. Chinchilli,Timothy J. Craig,Emily A. Dimango,Aaron Deykin,Joanne K. Fagan,James E. Fish,Jean G. Ford,Monica Kraft,Robert F. Lemanske,Frank T. Leone,Richard J. Martin,Elizabeth A. Mauger,Gene R. Pesola,Stephen P. Peters,Nancy J. Rollings,Stanley J. Szefler,Michael E. Wechsler,Elliot Israel +23 more
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TLDR
It may be possible to treat mild persistent asthma with short, intermittent courses of inhaled or oral corticosteroids taken when symptoms worsen, and further studies are required to determine whether this novel approach to treatment should be recommended.Abstract:
Background Although guidelines recommend daily therapy for patients with mild persistent asthma, prescription patterns suggest that most such patients use these so-called controller therapies intermittently. In patients with mild persistent asthma, we evaluated the efficacy of intermittent short-course corticosteroid treatment guided by a symptom-based action plan alone or in addition to daily treatment with either inhaled budesonide or oral zafirlukast over a one-year period. Methods In a double-blind trial, 225 adults underwent randomization. The primary outcome was morning peak expiratory flow (PEF). Other outcomes included the forced expiratory volume in one second (FEV1) before and after bronchodilator treatment, the frequency of exacerbations, the degree of asthma control, the number of symptom-free days, and the quality of life. Results The three treatments produced similar increases in morning PEF (7.1 to 8.3 percent; approximately 32 liters per minute; P=0.90) and similar rates of asthma exacerbations (P=0.24), even though the intermittent-treatment group took budesonide, on average, for only 0.5 week of the year. As compared with intermittent therapy or daily zafirlukast therapy, daily budesonide therapy produced greater improvements in pre-bronchodilator FEV1 (P=0.005), bronchial reactivity (P Conclusions It may be possible to treat mild persistent asthma with short, intermittent courses of inhaled or oral corticosteroids taken when symptoms worsen. Further studies are required to determine whether this novel approach to treatment should be recommended.read more
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Journal ArticleDOI
An official American Thoracic Society/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice.
Helen K. Reddel,D. Robin Taylor,Eric D. Bateman,Louis-Philippe Boulet,Homer A. Boushey,William W. Busse,Thomas B. Casale,Pascal Chanez,Paul L. Enright,Peter G. Gibson,Johan C. de Jongste,Huib A. M. Kerstjens,Stephen C. Lazarus,Mark L Levy,Paul M. O'Byrne,Martyn R Partridge,Ian D. Pavord,Malcolm R. Sears,Peter J. Sterk,Stuart W. Stoloff,Sean D. Sullivan,Stanley J. Szefler,Mike Thomas,Sally E. Wenzel +23 more
TL;DR: New definitions for asthma control, severity, and exacerbations are developed, based on current treatment principles and clinical and research relevance, to provide a basis for a multicomponent assessment of asthma by clinicians, researchers, and other relevant groups in the design, conduct, and evaluation of clinical trials, and in clinical practice.
Journal ArticleDOI
Periostin is a systemic biomarker of eosinophilic airway inflammation in asthmatic patients.
Guiquan Jia,Richard W. Erickson,David F. Choy,Sofia Mosesova,Lawren C. Wu,Owen D. Solberg,Aarti Shikotra,Richard Carter,Severine Audusseau,Qutayba Hamid,Peter Bradding,Peter Bradding,John V. Fahy,Prescott G. Woodruff,Jeffrey M. Harris,Joseph R. Arron +15 more
TL;DR: Periostin is a systemic biomarker of airway eosinophilia in asthmatic patients and has potential utility in patient selection for emerging asthma therapeutics targeting T(H)2 inflammation.
Journal ArticleDOI
Intermittent Inhaled Corticosteroids in Infants with Episodic Wheezing
Hans Bisgaard,Mette N. Hermansen,Lotte Loland,Liselotte Brydensholt Halkjaer,Frederik Buchvald +4 more
TL;DR: Intermittent inhaled corticosteroid therapy had no effect on the progression from episodic to persistent wheezing and no short-term benefit during episodes of wheazing in the first three years of life.
Journal ArticleDOI
A Large Subgroup of Mild-to-Moderate Asthma Is Persistently Noneosinophilic
Kelly Wong McGrath,Nikolina Icitovic,Homer A. Boushey,Stephen C. Lazarus,E. Rand Sutherland,Vernon M. Chinchilli,John V. Fahy +6 more
TL;DR: Almost half of patients with mild-to-moderate asthma have persistently noneosinophilic disease, a disease phenotype that responds poorly to currently available antiinflammatory therapy.
References
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Journal ArticleDOI
Development and validation of a questionnaire to measure asthma control
TL;DR: The Asthma Control Questionnaire has strong evaluative and discriminative properties and can be used with confidence to measure asthma control.
Journal ArticleDOI
Long-term effects of budesonide or nedocromil in children with asthma.
Stanley J. Szefler,Scott T. Weiss,James Tonascia,N. Franklin Adkinson,Bruce G. Bender,Reuben M. Cherniack,Michele Donithan,H William Kelly,J. Reisman,Gail G. Shapiro,Alice L. Sternberg,R.C. Strunk,Virginia S. Taggart,Mark L. Van Natta,Robert A. Wise,Margaret Wu,Robert S. Zeiger +16 more
TL;DR: In children with mild-to-moderate asthma, neither budesonide nor nedocromil is better than placebo in terms of lung function, but inhaled budesonides improves airway responsiveness and provides better control of asthma than placebo or nedOCromil.
Journal ArticleDOI
How Often Is Medication Taken as Prescribed?: A Novel Assessment Technique
TL;DR: Using a new method with epilepsy as a model, compliance with long-term medications among newly treated and long- term patients is assessed using standard pill bottles with micro-processors in the cap to record every bottle opening as a presumptive dose.
Journal ArticleDOI
Low-dose inhaled corticosteroids and the prevention of death from asthma.
TL;DR: The regular use of low-dose inhaled corticosteroids is associated with a decreased risk of death from asthma and was higher than the rate among patients who continued to use the drugs.
Journal ArticleDOI
Comparison of a beta 2-agonist, terbutaline, with an inhaled corticosteroid, budesonide, in newly detected asthma.
Tari Haahtela,Markku Järvinen,Tuomo Kava,Kirsti Kiviranta,Sirkka Koskinen,Kaarina Lehtonen,Kurt Nikander,Tore Persson,Kaija Reinikainen,Olof Selroos,Anssi Sovijärvi,Brita Stenius-Aarniala,Thore Svahn,Ritva Tammivaara,Lauri A. Laitinen +14 more
TL;DR: Antiinflammatory therapy with inhaled budesonide is an effective first-line treatment for patients with newly detected, mild asthma, and it is superior to the use of terbutaline in such patients.
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