Asthma

Mar 152011
 

Busse et al randomized 419 inner-city kids (age 6-20) with uncontrolled, skin-test-positive, mostly severe allergic asthma and IgE < 1,300 IU/mL to 60 weeks of omalizumab or placebo. The treated group had modest improvements: ~1 fewer day of symptoms per month and a 5% absolute reduction in hospitalizations (1.5% vs 6.3%); 18% fewer of them [… read more]

Feb 192011
 

People (n=21) with inadequately controlled asthma in a supervised exercise program for 12 weeks followed by self-motivated exercise for 12 weeks had “clinically significant” 0.5-point lower scores on the Asthma Control Questionnaire, as well as improved aerobic fitness, compared to 16 nonrandomized matched controls. Astonishingly, no serious trial testing exercise in asthma control has ever [… read more]

Feb 172011
 

Daily inhaled corticosteroids (ICS) may retard growth in children, who would rather play than take daily inhalers. Martinez et al randomized children with mild persistent asthma to four groups, one of which was beclomethasone + albuterol as rescue therapy only (i.e., no daily ICS), for 44 months. They did slightly worse than children taking daily [… read more]

Feb 162011
 

Ciclesonide, a new inhaled corticosteroid that seems to cause thrush less often than others, reached for equivalency with salmeterol/fluticasone in mild persistent asthma. Ciclesonide was better than placebo in controlling asthma but Advair users had a longer time to first asthma exacerbation. CHEST 2011;139: online supplement. A Cochrane review on ciclesonide could not establish its [… read more]

Feb 092011
 

The hygiene hypothesis got a boost from Ege et al, who analyzed dust from 16,000 European children’s bedrooms and mattresses (stored with clinical/demographic data in two huge repositories, GABRIELA and PARSIFAL), for bacterial DNA or growth on bacterial/fungal culture media. Children living on farms had odds ratios for asthma of 0.49 to 0.76, compared to [… read more]