In Europe, patients with asthma have long been advised to take more puffs of their combination inhaled corticosteroid-long-acting beta-agonist (ICS-LABA) inhaler during periods of increased asthma symptoms. In the U.S., patients are instead advised to use albuterol as their rescue inhaler, and stick firmly to the usual maintenance dose of ICS-LABA regardless of symptom severity. [… read more]
When patients with asthma feel their symptoms worsening and fear a full-blown exacerbation is imminent, what should they do? Doctors and researchers have never found a good answer to this question for most patients. The options are, generally: 1) continue current controller inhalers and observing; 2) increase the dose of inhaled steroid inhalers; or 3) [… read more]
By Salynn Boyles, Contributing Writer, MedPageToday Self-taught breath retraining proved to be an effective, readily available and cost efficient strategy for improving quality of life among patients with asthma in a randomized trial. The training involved video instruction designed to teach patients breathing exercises such as diaphragmatic breathing, nasal breathing, slow breathing, controlled breath holds, and relaxation [… read more]
by Salynn Boyles Contributing Writer, MedPage Today The FDA has approved AstraZeneca’s biologic drug benralizumab (Fasenra) for the add-on maintenance treatment of patients age 12 years and over with severe asthma with an eosinophilic phenotype, the drugmaker announced. Approval was based on pivotal trials showing up to a 51% reduction in the annual asthma exacerbation [… read more]
Multiple randomized trials have suggested that vitamin D supplementation might improve asthma control and reduce severity of asthma attacks. A new meta-analysis bolsters that hypothesis, and may encourage more physicians and people with asthma to consider vitamin D supplements for low vitamin D levels. In a study in Lancet Respiratory Medicine, authors analyzed the experience [… read more]
by Salynn Boyles, Contributing Writer, MedPage Today Asthma costs the U.S. economy more than $80 billion a year in medical expenditures, missed school and work days, and deaths, according to CDC researchers. The condition is responsible for 8.7 million lost workdays and 5.2 million lost school-days annually, at an estimated cost of around $3 billion, reported Tursynbek [… read more]
Combination inhalers for asthma and COPD containing long-acting beta agonists (LABA) drugs along with inhaled corticosteroids can lose their black-box warnings about their previously-theorized risk of asthma-related death, the FDA announced. The original boxed warning came in 2011 in the wake of a small number of asthma-related deaths among patients taking LABA monotherapy (without inhaled [… read more]
The FDA has expanded the indication for tiotropium (Spiriva Respimat) to include children age 6 and older, based on efficacy data similar to that in adults. Tiotropium (Spiriva Respimat) was approved by FDA in 2015 for adults with asthma after clinical trials showed benefit of Spiriva as an add-on therapy to patients with persistent asthma [… read more]
GlaxoSmithKline is voluntarily recalling more than 590,000 albuterol inhalers (brand name Ventolin), citing a defect that may cause the inhalers to deliver fewer doses of the medicine than prescribed, the British drugmaker announced. Patients complained about a bulging of the outside wrapper of Ventolin’s packaging; a leak of the medicine’s propellant is suspected to be [… read more]
Can fish oil supplements taken during pregnancy prevent asthma in children? According to a randomized trial in the New England Journal of Medicine, yes. Children of 736 pregnant women who took supplements containing given n-3 long-chain polyunsaturated fatty acid during their third trimester had a 31% relative reduction in risk of developing asthma or persistent [… read more]
Anyone caring for patients in a clinic setting knows that asthma can easily be overdiagnosed. Asthma lacks a gold standard test for diagnosis, can produce vague symptoms, and inexpensive, low risk treatments are available (inhaled corticosteroids and albuterol). The result is many dyspneic or coughing patients are given an asthma diagnosis that is provisional or tentative — whether [… read more]
After the Serevent Nationwide Surveillance (SNS) and SMART trials both appeared to link the use of long-acting beta agonists (LABAs) to an increased risk of asthma-related death, routine asthma care got scary. The FDA slapped a black box warning on LABAs like Serevent (salmeterol) and Foradil (formoterol) and also the combination treatments containing them (Advair, [… read more]
Reslizumab (CINQAIR) is a humanized, anti-IL-5 biologic agent approved by FDA in March 2016 as add-on treatment for asthma with peripheral blood eosinophilia, uncontrolled by usual treatments. In two randomized trials, reslizumab improved lung function and asthma symptoms in patients meeting these criteria. Patients without high eosinophil count in peripheral blood did not experience clinically [… read more]
Adding azithromycin to usual treatment for asthma exacerbations in adults did not improve asthma symptoms or speed their resolution, investigators reported in the AZALEA randomized clinical trial. Patients getting azithromycin also had no improvement in lung function. Azithromycin is known to have some activity against viruses that infect bronchial cells; viruses are causative or contributory [… read more]
The US Food and Drug Administration (FDA) is advising the public not to use over the counter homeopathic asthma products. Thanks to protection from friendly legislators, the multibillion dollar homeopathic and supplement industry is allowed to mislead the public by labeling homeopathic products as “promoting lung health,” or even advertising them specifically as “providing relief [… read more]
Or, How to Treat Asthma in Pregnancy Do long-acting beta agonists cause birth defects when taken by pregnant women? A new study can’t settle the question, but might give women and their doctors more peace of mind when LABAs are necessary to control asthma during pregnancy. Current guidelines for treating asthma during pregnancy advise that for [… read more]
Once upon a time in 1964, it was noted that propranolol, a nonselective beta-blocker, could precipitate severe bronchospasm in patients with asthma, especially at high doses. Additional small studies showed propranolol and other nonselective beta blockers could increase airway resistance. British guidelines advise avoiding beta blockers in asthma generally. As a result, beta blockers are [… read more]
Olodaterol Olodaterol, a new once-daily inhaled long-acting beta agonist, improved lung function and exercise capacity in chronic obstructive pulmonary disease (COPD) in two randomized trials (n=199) presented by Gregory Feldman et al at the Chest 2013 meeting in Chicago. The new once-daily LABA olodaterol will reportedly be marketed by Boehringer Ingelheim under the trade name Striverdi [… read more]
Breo Ellipta (GlaxoSmithKline) is the first FDA-approved combination product with a once-daily long acting beta agonist (vilanterol) and inhaled corticosteroid (fluticasone). Additional once daily combination ICS/LABA and LABA/antimuscarinics are expected to launch over the next decade, increasing the options for treatment of asthma and COPD. GSK got good news in the October Chest, with the publication [… read more]
Once-daily long-acting beta agonist indacaterol (Arcapta Neohaler) went head to head against tiotropium (Spiriva) in a randomized trial among 3,444 patients with severe COPD, funded by indacaterol makers Novartis. Indacaterol, approved in 2011 as a treatment for COPD, was deemed noninferior to tiotropium according to the prespecified criteria of the trial, bronchodilating almost identically (a [… read more]
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