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Genotype-Guided Asthma Treatment Reduces Exacerbations in Children: Meta-Analysis of Two RCTs.
Allergy
December 2024
Department of Pulmonary Medicine, AmsterdamUMC, University of Amsterdam, Amsterdam, The Netherlands.
Background: Long-acting beta2-agonists (LABA) in combination with inhaled corticosteroids (ICS) are commonly used to treat asthma, however, some children lack response to the addition of LABA. This might be partially due to the presence of the Arg16Gly polymorphism, encoded by rs1042713 G>A in the ADRB2 gene. Carrying the A allele (Arg16) at this variant has been associated with an increased risk of exacerbations despite LABA treatment.
View Article and Find Full Text PDFBackground: Whether inhaled corticosteroids (ICSs) reduce major adverse cardiovascular events (MACEs) in people with chronic obstructive pulmonary disease (COPD) is debated.
Objectives: To establish, within people with COPD, (1) whether ICS reduced MACE rates (acute coronary syndrome (ACS), heart failure (HF), ischaemic strokes or cardiovascular-specific death) compared with long-acting bronchodilators; and (2) whether drug class, incident usership or patient cardiovascular history influenced the ICS-MACE relationship.
Methods: We conducted a cohort study including patients with COPD in England, using Clinical Practice Research Datalink Aurum data, linked with Hospital Episode Statistics and Office of National Statistics death data, between 1 January 2010 and 31 December 2019.
Efficacy of Continuous Positive Airway Pressure Therapy in a Patient With Saber-Sheath Trachea on Dilated Central and Peripheral Airways: A Case Report.
Cureus
November 2024
Department of Multidisciplinary Internal Medicine, Division of Respiratory Medicine and Rheumatology, School of Medicine, Faculty of Medicine, Tottori University, Tottori, JPN.
A saber-sheath trachea is a type of tracheal deformity characterized by coronal narrowing and sagittal widening of the intrathoracic trachea. In this case report, we describe a 76-year-old man with a history of chronic obstructive pulmonary disease (COPD) and repeated episodes of type 2 respiratory failure that responded poorly to inhaled long-acting β2 agonists, long-acting muscarinic antagonists, and corticosteroids. The patient was admitted to our hospital due to a COPD exacerbation.
View Article and Find Full Text PDFEvaluating the Role of Maximal Expiratory Flow at 25% (MEF-25) in Detecting and Managing Patients With Small Airway Disease in the United Arab Emirates.
Cureus
November 2024
Department of Pulmonary Medicine, King's College Hospital, Dubai, ARE.
Middle Eastern countries, such as the United Arab Emirates and Oman, are affected by frequent dust storms and extreme hot climatic conditions, which can exacerbate respiratory conditions. These environmental factors are particularly injurious to asthmatic patients, as they can aggravate small airway disease (SAD), leading to increased morbidity and healthcare challenges. The evaluation of maximal mid-expiratory flow (MEF-25) as a diagnostic and therapeutic tool for early-stage small airway dysfunction is of significant clinical importance, particularly in hot and arid metropolitan environments where dusty conditions exacerbate pulmonary issues.
View Article and Find Full Text PDFMedicare Advantage Population in the United States: Outcomes of Patients with Asthma Treated with ICS/LABA Before and After Initiation with Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI).
Adv Ther
December 2024
US Value Evidence and Outcomes, GSK, Collegeville, PA, USA.
Introduction: The clinical benefits of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) have been demonstrated in clinical trials. There is limited evidence regarding the effectiveness and economic outcomes associated with FF/UMEC/VI use in US clinical practice. This real-world study assessed asthma-related exacerbations, healthcare resource utilization (HRU), and healthcare costs among a Medicare Advantage-insured population before and after initiation of FF/UMEC/VI in patients with asthma previously treated with an inhaled corticosteroid/long-acting β-agonist (ICS/LABA).
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