Efficacy of Esomeprazole for Treatment of Poorly Controlled Asthma

Mastronarde, John G.; Anthonisen, Nicholas R.; Castro, Mario; Holbrook, Janet T.; Leone, Frank T.; Teague, W. Gerald; Wise, Robert A.

doi:10.1056/nejmoa0806290

Cited by 328 publications

(90 citation statements)

References 45 publications

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“…All participants in two American Lung Association Asthma Clinical Research Center (ALA-ACRC) studies, The Leukotriene Modifier or Corticosteroid or Corticosteroid-Salmeterol Trial (LOCCS) 21 and Study of Acid Reflux and Asthma (SARA) trial 22 , were included for analysis if they met the following criteria: age ≥18 years, a body mass index (BMI) ≥ 20 kg/m 2 , acceptable spirometry, available asthma control scores by the Juniper Asthma Control Questionnaire (ACQ) 23 , and a methacholine challenge test at study entry.…”

Section: Methodsmentioning

confidence: 99%

“…Inclusion and exclusion criteria for LOCCS 21 and SARA 22 have been previously reported. Briefly, LOCCS included subjects with physician-diagnosed asthma, pre-bronchodilator FEV 1 ≥ 60% predicted, beta-agonist reversibility (defined as 12% or greater reversibility using up to 4 puffs of albuterol) or airway hyperreactivity by methacholine challenge (defined as the provocative concentration of methacholine producing a 20% fall in FEV 1 ), and ACQ score of 1.5 or greater if not on daily controller medication.…”

Section: Methodsmentioning

confidence: 99%

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Effect of Obesity on Asthma Phenotype is Dependent upon Asthma Severity

et al. 2010

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Background We recently reported that obese and non-obese patients with asthma have similar airflow limitation and bronchodilator responsiveness, but obese patients have more symptoms overall. There is limited information on the effect of obesity on asthmatics of varying severity measured by objective physiological parameters. Understanding how obesity affects asthmatics of differing severity can provide insights into the pathogenesis of asthma in the obese and a rationale for the therapeutic approach to such patients. Methods Participants with asthma from two American Lung Association-Asthma Clinical Research Center studies were grouped by tertiles of airflow obstruction (FEV1% predicted, FEV1/FVC) and methacholine reactivity (PC20FEV1). Within each tertile we examined the independent effect of body mass index (BMI), divided into normal weight, overweight and obese categories, on lung function, airway reactivity and symptoms. Results Overall, both FEV1 and FVC decreased and symptoms worsened with increasing BMI; airway reactivity was unchanged. When stratified by the degree of airflow obstruction, higher BMI was not associated with greater airway reactivity to methacholine. Higher BMI was associated with more asthma symptoms only in the least obstructed FEV1/FVC tertile. When stratified by degree of airway reactivity, BMI was inversely associated with FVC in all PC20FEV1 tertiles. BMI was directly associated with asthma symptoms only in those with the least airway reactivity. Conclusions Obesity does not influence airway reactivity in patients with asthma and it is associated with more symptoms only in those with less severe disease.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effect of Obesity on Asthma Phenotype is Dependent upon Asthma Severity

et al. 2010

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“…In addition, several other randomized controlled trials 19, 21–23, 38 have used the ASUI. In all of these trials, the ASUI was used as a secondary outcome, together with other measures such as QOL and symptom-free days.…”

Section: Review Of Specific Asthma Symptom Questionnairesmentioning

confidence: 99%

Asthma outcomes: Symptoms

Krishnan

Lemanske

Canino

et al. 2012

Journal of Allergy and Clinical Immunology

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Background Respiratory symptoms are commonly used to assess the impact of patient-centered interventions. Objective At the request of National Institutes of Health (NIH) institutes and other federal agencies, an expert group was convened to propose which measurements of asthma symptoms should be used as a standardized measure in future clinical research studies. Methods Asthma symptom instruments were classified as daily diaries (prospectively recording symptoms between research visits) or retrospective questionnaires (completed at research visits). We conducted a systematic search in PubMed and a search for articles that cited key studies describing development of instruments. We classified outcome instruments as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results Four instruments (3 daily diaries, 1 for adults and 2 for children; and 1 retrospective questionnaire for adults) were identified. Minimal clinically important differences have not been established for these instruments, and validation studies were only conducted in a limited number of patient populations. Validity of existing instruments may not be generalizable across racial-ethnic or other subgroups. Conclusions An evaluation of symptoms should be a core asthma outcome measure in clinical research. However, available instruments have limitations that preclude selection of a core instrument. The working group participants propose validation studies in diverse populations, comparisons of diaries versus retrospective questionnaires, and evaluations of symptom assessment alone versus composite scores of asthma control.

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“…To characterize the spirometric findings of a well-defined cohort of asthmatic adults, we included enrollment demographic and spirometric data from four published ALA-ACRC trials (8-11). These trials examined participants with both well-controlled disease (the Leukotriene or Corticosteroid or Corticosteroid-Salmeterol [LOCCS] trial (8)) and poorly-controlled disease (Effectiveness of Low Dose Theophylline as Add-On Therapy in Treatment of Asthma [LODO] (9), Study of Acid Reflux and Asthma [SARA] (10), and the Trial of Asthma Patient Education [TAPE] (11)). All patients had a physician diagnosis of asthma and were prescribed appropriate medications.…”

Section: Methodsmentioning

confidence: 99%