High-dose inhaled corticosteroids versus add-on long-acting β-agonists in asthma: An observational study

Thomas, Mike; Ziegenweidt, Julie von; Lee, Dean A.; Price, David

doi:10.1016/j.jaci.2008.09.035

Cited by 51 publications

(26 citation statements)

References 32 publications

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“…4,21-24 Moreover, it has been shown that chronic use of ICS does not improve long-term outcomes in children with asthma. 25 Unfortunately, the usual strategies proposed to achieve ICS reduction consider different pharmacologic agents, either in addition to or as a substitute for corticosteroids, [26][27][28][29][30][31][32] but the use of these agents is very often restricted in children-for example, long-acting b-agonists. 33,34 Thus, introducing SIT in children with mite allergic asthma may be critical for reducing potential adverse effects of steroid therapy during a period of rapid growth and development.…”

Section: Discussionmentioning

confidence: 99%

Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: A randomized controlled trial

Zielen

Kardos²,

Madonini

2010

Journal of Allergy and Clinical Immunology

142

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Section: Discussionmentioning

confidence: 99%

Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: A randomized controlled trial

Zielen

Kardos²,

Madonini

2010

Journal of Allergy and Clinical Immunology

142

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“…The composite for asthma control included measures that are recommended to define asthma exacerbations (hospitalisations, unscheduled use of secondary care, and oral corticosteroid courses), 20,22,23 as well as prescriptions for antibiotics for LRTI, since the symptoms of an asthma exacerbation may be confused for those of respiratory infection. In addition, to maximise the power of the composite measure, we assessed the use of short-acting β 2-agonist, captured via prescribing records, as use of reliever therapy reflects the presence of asthma symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, to maximise the power of the composite measure, we assessed the use of short-acting β 2-agonist, captured via prescribing records, as use of reliever therapy reflects the presence of asthma symptoms. 22,23 The criteria to define rhinitis control included no change in rhinitis treatment, which served as an indicator that no additional or different treatment was needed, and two consultations or fewer for rhinitis during the outcome year. We allowed for up to two scheduled visits on the basis that good practice would dictate at least one routine follow-up consultation after initiation of rhinitis treatment in addition to one longer-term review.…”

Section: Discussionmentioning

confidence: 99%

Observational study comparing intranasal mometasone furoate with oral antihistamines for rhinitis and asthma

Price

Kemp

Sims

et al. 2010

Primary Care Respiratory Journal

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Aims: Retrospective database study comparing upper and lower airway-related outcomes for patients with rhinitis and co-morbid asthma receiving mometasone furoate -an intranasal corticosteroid with low systemic bioavailability -or an oral antihistamine.Methods: 395 patients prescribed intranasal mometasone were matched on 10 demographic and respiratory-related criteria in a 1:2 ratio to 790 patients prescribed oral antihistamine. Asthma and rhinitis control were assessed over one year using predefined composite proxy measures.Results: Asthma control was achieved by 309/395 (78.2%) versus 580/790 (73.4%; p=0.071) patients in the mometasone and antihistamine cohorts, respectively. Rhinitis control was achieved by 293 (74.2%) versus 539 (68.2%; p=0.035), respectively. The adjusted odds ratios for antihistamines, relative to mometasone, were 0.71 (95% CI, 0.52-0.98) for achieving asthma control and 0.74 (95% CI, 0.56-0.97) for achieving rhinitis control. Conclusions:Patients with rhinitis and co-morbid asthma initiating rhinitis therapy achieved significantly better upper as well as lower airway outcomes with intranasal mometasone than with oral antihistamine.

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“…Patients with persistent asthma need a combination of these medications. NHLBI guidelines recommend that adult asthma patients step up 1 step for not well-controlled asthma [10]. Patients not well controlled on step 3 preferred treatment (lowdose ICS +LABA OR medium-dose ICS) need to step up to step 4 therapy (medium-dose ICS +LABA or alternatively low-dose ICS +either Leukotriene Receptor Antagonist [LTRA],Theophylline, or Zileuton).…”

Section: Introductionmentioning

confidence: 99%

Asthma control and disease burden in patients with asthma and allergic comorbidities

Lee

Engels²,

Paknis

et al. 2017

Journal of Asthma

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Objective: To assess asthma control and associations with health-related quality of life (HRQoL) and economic outcomes among patients with asthma and allergic comorbidities treated with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) combination therapy. Methods: Data from the 2011-2013 US National Health and Wellness Survey were used to identify patients with asthma currently treated with ICS and LABA combination therapy (N = 1923). Patients were included if they selfreported a physician diagnosis of asthma and at least one allergic/asthma-related comorbid condition (e.g., nasal allergies, atopic dermatitis). Asthma Control Test scores categorized patients as very poorly (scores ࣘ 15; 29.3%), not well (16-19; 25.1%), or well controlled (20-25; 45.7%). Outcomes included HRQoL (SF-36v2; SF-12v2), work productivity and activity impairment, healthcare utilization (HRU), and annual indirect and direct costs. Generalized linear models, controlling for covariates, examined whether outcomes differed by asthma control. Results: Over half of the patients had very poorly or not well-controlled asthma (54.4%). Patients with very poorly controlled versus well-controlled asthma reported significantly greater decreases in HRQoL, greater overall work impairment, and higher HRU (all, p < 0.05). Very poorly controlled patients incurred over double the indirect costs and nearly one and a half times the direct and total costs of well-controlled patients. Conclusions: Increasing level of asthma control was related to improved HRQoL and lower costs. The considerably high prevalence of uncontrolled asthma among patients on ICS and LABA suggests poor treatment adherence or unmet needs in current treatment and may require step-up therapy in appropriate patients according to clinical guidelines.

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High-dose inhaled corticosteroids versus add-on long-acting β-agonists in asthma: An observational study

Cited by 51 publications

References 32 publications

Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: A randomized controlled trial

Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: A randomized controlled trial

Observational study comparing intranasal mometasone furoate with oral antihistamines for rhinitis and asthma

Asthma control and disease burden in patients with asthma and allergic comorbidities

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