Clinically Important Improvements in Asthma-Specific Quality of Life, But No Difference in Conventional Clinical Indexes in Patients Changed From Conventional Beclomethasone Dipropionate to Approximately Half the Dose of Extrafine Beclomethasone Dipropionate

Juniper, Elizabeth F.; Price, David; Stampone, Patti; Creemers, Jacques; Mol, Stijn J.M.; Fireman, Philip

doi:10.1378/chest.121.6.1824

Cited by 106 publications

(93 citation statements)

References 14 publications

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“…However, a number of studies [6][7][8] have demonstrated poor correlation between conventional clinical indices and the outcomes of the Asthma Quality of Life Questionnaire (AQLQ). Conversely, studies that have used more comprehensive measures of overall asthma control have found that achieving asthma control translates into significant improvements in AQLQ score [9,10].…”

mentioning

confidence: 99%

The correlation between asthma control and health status: the GOAL study

Bateman

Bousquet²,

Keech³

et al. 2006

European Respiratory Journal

146

103

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The present study examined the association between guideline-derived asthma control and health-related quality of life, assessed using the Asthma Quality of Life Questionnaire (AQLQ), in patients with uncontrolled asthma whose treatment was directed towards achieving the highest possible level of control.The present randomised, double-blind, parallel-group study compared the efficacy of fluticasone propionate (FP) and salmeterol/fluticasone propionate combination (SFC) in achieving two composite, guideline-derived measures of control: total control (TC) and wellcontrolled (WC) asthma. Not achieving these levels was classed as not well-controlled (NWC). Doses were augmented until patients achieved TC or reached the maximum dose. This dose was maintained for the remainder of the study. AQLQ was assessed at baseline and at each clinic visit.AQLQ scores improved throughout the study, reaching near-maximal levels in patients achieving TC and WC, and 52-week mean scores in the three control groups were statistically significantly different. Clinically meaningful improvements (mean change from baseline) were: TC group (SFC 1.9, FP 1.8), WC (SFC 1.5, FP 1.5) and NWC (SFC 1.0, FP 0.9).In conclusion, the treatment aimed at controlling asthma improves the health-related quality of life to levels approaching normal. The difference in Asthma Quality of Life Questionnaire scores between total control and well-controlled confirms that patients distinguish even between these high levels of control.

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mentioning

confidence: 99%

The correlation between asthma control and health status: the GOAL study

Bateman

Bousquet²,

Keech³

et al. 2006

European Respiratory Journal

146

103

View full text Add to dashboard Cite

show abstract

“…Asthma-specific quality of life questionnaires have been developed and validated so that this aspect of patient management can be accurately measured and treatment effectiveness assessed. These questionnaires are now used in both clinical trials and clinical practice alongside the more traditional clinical measures of airway status, such as airway caliber, symptoms and markers of inflammation (Juniper et al, 2002). In another study that evaluated the effectiveness of the herbal medicine called AKLI, which contains the phytochemical component of Picrorrhiza kurroa, and extracts of Zingiber officinale and Ginkgo biloba, similar results as in the present study were also obtained; the efficacy was satisfactory in accordance with the AQLQ, but no statistically significant changes were found in lung function by spirometry data (Thomas et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of cumaru syrup as complementary therapy in mild persistent asthma: a double-blind, randomized, placebo-controlled study

Carvalho

Cunha

Fechine

et al. 2012

Braz. J. Pharm. Sci.

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Amburana cearensis is a medicinal plant known as "cumaru". It is used in Northeast Brazil in the treatment of respiratory diseases. This was a randomized, double-blind, placebo-controlled study, with the aim of evaluating the efficacy and safety of cumaru syrup as complementary therapy in mild persistent asthma. The study consisted of 3 phases, pre-treatment, treatment and post-treatment. The primary efficacy outcome was comparison of the changes reported by patients of the cumaru and placebo groups after treatment, using the "Asthma Quality of Life Questionnaire" (AQLQ). The secondary outcome was the effect of cumaru syrup on lung function based on spirometry. The results showed that in the cumaru group, the proportion of patients who had global improvement in asthma symptoms was significantly greater (61.90%, P=0.0009) than in the placebo group (9.52%). Only the spirometric parameters Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1) showed significant intergroup differences in post-treatment (P<0.05). The hematological and serum chemistry tests performed in the pre-treatment and post-treatment showed no statistically significant differences (P>0.05). Adverse events were reported by 3 patients (14.29%) in the cumaru group and 3 patients (14.29%) in the placebo group. All adverse events were considered non-serious and mild.

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“…Indeed, it was calculated that 2.6-fold non-extrafine beclometasone (BDP) is required to achieve the same improvement in FEV 1 as extra-fine HFAeBDP [72]. Moreover, in an open-label, 12-month randomised controlled trial, Juniper et al showed that in asthmatic patients previously treated with non-extrafine CFCeBDP and switching to equipotent doses of extra-fine HFAeBDP (half of the dose of non-extra-fine CFCeBDP), there was a significant improvement in asthma quality of life compared with those patients who continued to receive nonextrafine CFCeBDP [73].…”

Section: Accessing the Peripheral Airways: Current Evidence And Futurmentioning

confidence: 99%

Assessing and accessing the small airways; implications for asthma management

Scichilone

Contoli

Paleari

et al. 2013

Pulmonary Pharmacology & Therapeutics

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a b s t r a c tDespite the wealth of experience in the management of asthma, the disease remains inadequately controlled in some patients, who face long-term respiratory impairment and disability. The disease has been characterised as an inflammatory condition affecting first the larger airways and eventually the smaller airways, but there is evidence that peripheral airway involvement defines a particular and more severe phenotype of asthma. For this reason, assessing functional and biological parameters reflective of small airways involvement is important prognostically. No assessment method is universally and directly representative of peripheral airway function, but the traditional spirometric tests, including vital capacity, residual volume and forced vital capacity, are somewhat correlated with this function; useful methods for further assessment include the single-breath nitrogen wash-out test, impulse oscillometry, nitrous oxide and exhaled breath concentrate measurements, as well as computed tomography to reflect air trapping and response to treatment. Formulation advancements have made for easier treatment access to the smaller airways, with the new extrafine formulations resulting in better asthma control compared with non-extrafine formulations.

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Clinically Important Improvements in Asthma-Specific Quality of Life, But No Difference in Conventional Clinical Indexes in Patients Changed From Conventional Beclomethasone Dipropionate to Approximately Half the Dose of Extrafine Beclomethasone Dipropionate

Cited by 106 publications

References 14 publications

The correlation between asthma control and health status: the GOAL study

The correlation between asthma control and health status: the GOAL study

Efficacy and safety of cumaru syrup as complementary therapy in mild persistent asthma: a double-blind, randomized, placebo-controlled study

Assessing and accessing the small airways; implications for asthma management

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