Two long-acting ß 2 -adrenergic agonists (LABAs), salmeterol and formoterol, have been demonstrated to be safe and effective agents in children, both in terms of bronchodilation and prevention of exercise-induced bronchospasm. Their onsets of action differ, with formoterol having an onset similar to albuterol (3 minutes), while salmeterol has a slower onset of action (10–20 minutes). Following a single-dose administration, both agents demonstrate durations of action up to 12 hours. Following regular twice-daily administration, bronchodilation remains effective; however, a level of tolerance (or tachyphylaxis) (more…)
For most patients, asthma is not controlled as defined by guidelines; whether this is achievable has not been prospectively stu ...
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and s ...
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require relie ...
Regular use of ß-agonists has been known to lead to tolerance to their bronchodilator effects. It is not known how quickly toleranc ...
Current internationally recognized guidelines indicate that symptomatic asthmatics using a low to medium inhaled corticosteroid ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbations. Dose–response studies using inhaled corticosteroids have generally been unable to demonstrate any significant difference between individual doses of inhaled corticosteroids. For example, a metaanalysis evaluated eight studies (2324 asthmatics) where the effects of at least two doses of inhaled fluticasone were measured. (more…)
Current internationally recognized guidelines indicate that symptomatic asthmatics using a low to medium inhaled corticosteroid ...
Leukotrienes can be found in the airway and urine following both spontaneous exacerbations of asthma and acute exposure to bron ...
Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
The new corticosteroid ciclesonide has been evaluated in various studies to assess its efficacy and adverse effect profile in asthma. However, there are no data comparing the effects of high-dose ciclesonide with those of fluticasone propionate on airway and systemic outcomes in patients with moderate persistent asthma.
The relative effects of 4 weeks of treatment with ciclesonide and fluticasone propionate on airway hyper-reactivity, exhaled nitric oxide levels, lung function, symptoms, and quality of life were compared in 14 patients with moderately persistent asthma. Both drugs significantly improved airway outcomes in terms of methacholine bronchial hyper-responsiveness and exhaled nitric oxide levels. Fluticasone propionate 2000 µg daily but not ciclesonide 1600 µg daily significantly suppressed hypothalamic pituitary adrenal (HPA) axis outcomes, overnight 10 h urinary cortisol levels being lower after fluticasone propionate administration than after ciclesonide administration.
The efficacy of a new medication depends upon comparison with an existing medication that is used in the community for the treatment of a particular condition. Inhaled corticosteroid, namely beclomethasone, budesonide and fluticasone, have been used in the treatment of asthma. The introduction of newer inhaled corticosteroid would depend on the efficacy of the medication in comparison with existing medication. Ciclesonide has been evaluated in various studies essentially looking at the adverse effect profile and its effectiveness in asthma. There are no reports of head-to-head comparisons with the standard inhaled corticosteroid asthma. This study compared the effects of ciclesonide with those of fluticasone propionate, albeit in a small population of moderately persistent asthmatics. The absence of significant differences between the group receiving fluticasone propionate and the group receiving ciclesonide in airway parameters, including spirometry, PEF, symptoms and Mini-AQLQ (Asthma Quality of Life Questionnaire) score, suggest that ciclesonide could prove to be a useful option in the management of asthma. With regard to safety, the treatment period of 4 weeks may not be adequate to cause significant suppression of the hypothalamic–pituitary–adrenal axis and long-term trials are required to evaluate the effects of ciclesonide on the HPA axis.
The findings of these studies, coupled with the results of earlier studies on the pharmacology, pharmacokinetics and efficacy of ciclesonide, indicate great promise for this new inhaled steroid in the treatment of asthma. The higher bioavailability and improved plasma binding of this steroid provide it with greater efficacy and minimal side effects. Furthermore, ciclesonide nasal spray with its minimal effect on the hypothalamic–pituitary–adrenal axis, could be useful in the treatment of children with asthma. However, data on the long-term effects on the HPA axis with ciclesonide are necessary if they are to be considered to be safe medications with no effect on the HPA axis.
Maintenance of asthma control by once-daily inhaled ciclesonide nasal spray in adults with persistent asthma. Ciclesonide is an ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
The role of oral and inhaled corticosteroids in the management of acute asthma is well known. This study compared the effects of in ...
For most patients, asthma is not controlled as defined by guidelines; whether this is achievable has not been prospectively stu ...
Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid during an asthma exacerbation. This study investigated whether doubling the dose of budesonide inhalation in patients on regular inhaled budesonide would be beneficial during an asthma exacerbation. (more…)
The management of asthma in the community involves patient education to avoid the triggers, doubling the dose of inhaled steroi ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require relie ...
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and s ...
The role of oral and inhaled corticosteroids in the management of acute asthma is well known. This study compared the effects of in ...
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and symptom relief (Symbicort Single Inhaler Therapy) – compared with a higher maintenance dose of budesonide in patients with moderate to severe asthma. (more…)
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require relie ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
Regular use of ß-agonists has been known to lead to tolerance to their bronchodilator effects. It is not known how quickly toleranc ...
Two long-acting ß 2 -adrenergic agonists (LABAs), salmeterol and formoterol, have been demonstrated to be safe and effective ag ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
Anti-IgE therapy could be particularly beneficial for patients with concomitant asthma and rhinitis as it targets a common factor in the two diseases. Omalizumab is significantly more efficacious than placebo in preventing asthma exacerbations and in improving disease-related quality of life scores when added to standard asthma and rhinitis therapies. (more…)
Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 ther ...
Treatment with omalizumab has been shown to reduce serum free IgE concentrations and to have beneficial effects on allergic airway ...
IgE plays an important role in allergic asthma. Reducing IgE in the airway mucosa should reduce airway inflammation. Omalizumab has ...
Allergic rhinitis is a very common problem associated with poor quality of life, reductions in social and work activities and p ...
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and s ...
Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying inflammatory process.
Fexofenadine and montelukast exhibited additive effects to moderately high doses of inhaled corticosteroids when used as add-on therapy in the treatment of patients with persistent atopic asthma. (more…)
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
The role of oral and inhaled corticosteroids in the management of acute asthma is well known. This study compared the effects of in ...
Montelukast has proven efficacy in the treatment of chronic asthma and seasonal allergic rhinitis, but it has not been evaluate ...
Roflumilast is an oral, once-daily PDE4 inhibitor with antiinflammatory activity in development for the treatment of asthma. Ro ...
Current internationally recognized guidelines indicate that symptomatic asthmatics using a low to medium inhaled corticosteroid ...
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require reliever medication for breakthrough symptoms. Periodic fluctuations in symptoms and airway inflammation are characteristics of asthma, which means that treatment requirements, especially reliever use, can vary over time. (more…)
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and s ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
Two long-acting ß 2 -adrenergic agonists (LABAs), salmeterol and formoterol, have been demonstrated to be safe and effective ag ...
Regular use of ß-agonists has been known to lead to tolerance to their bronchodilator effects. It is not known how quickly toleranc ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, but in clinical practice it has been observed that patients often do not feel the need to use their inhaled corticosteroid regularly, which may lead to poor compliance. One possible reason is that because there are no symptoms the patients are not reminded to use their medications. Hence, the use of intermittent inhaled corticosteroid during worsening of asthma may be an option that could be considered in these subgroups of asthmatics. (more…)
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 ther ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
The management of asthma in the community involves patient education to avoid the triggers, doubling the dose of inhaled steroi ...
Maintenance of asthma control by once-daily inhaled ciclesonide nasal spray in adults with persistent asthma. Ciclesonide is an ...