Inhaled corticosteroids compared to placebo for prevention of exercise induced bronchoconstriction

Abstract

Inhaled corticosteroids compared to placebo for prevention of exercise induced bronchoconstriction (Review)

Pharmacological Advances in Managing Exercise‐Induced Bronchospasm: An Umbrella Review Following PRIOR Guideline

“…Koh et al. [20] conducted a systematic review and meta‐analysis of three studies with at least 4 weeks of ICS treatment, finding that ICS significantly reduced the percentage fall in FEV 1 (weighted MD [WMD] 11.74%, 95% CI, 10.06–13.42). A crossover study also confirmed these effects, reporting that ICS attenuated the percentage fall in FEV 1 (WMD 11.70%, 95% CI, 7.51–15.90) and in the percentage fall in PEF (WMD 11.50%, 95% CI, 6.31–16.69) post‐exercise.…”

“…Muscarinic antagonists have also emerged as effective therapeutic agents, acting on the parasympathetic nervous system to regulate bronchial tone and may serve as suitable relievers, particularly in pediatric populations with increased vagal tone [23,24]. Furthermore, ICS [20,22], LTRA [22,24] and MCS [15,16,18,19] attenuate EIB by inhibiting airway inflammation and mast cell degranulation. Combinations such as LTRA+ICS and ICS/LABA have demonstrated efficacy in preventing post-exercise decreases in FEV 1 and may reduce the rate of asthma exacerbations [22,24].…”

“…Regarding specific age‐related populations, ICS administered for at least 4 weeks remains the first‐line therapy for preventing EIB in children [20], with the potential addition of SABA, LABA, or LTRA; notably, the latter being particularly effective in subjects aged less than 18 years even in monotherapies [24]. Prophylactic inhalation of MCS prior to exercise appears more effective in subjects with more severe EIB.…”

Pharmacological Advances in Managing Exercise‐Induced Bronchospasm: An Umbrella Review Following PRIOR Guideline

“…Koh et al. [20] conducted a systematic review and meta‐analysis of three studies with at least 4 weeks of ICS treatment, finding that ICS significantly reduced the percentage fall in FEV 1 (weighted MD [WMD] 11.74%, 95% CI, 10.06–13.42). A crossover study also confirmed these effects, reporting that ICS attenuated the percentage fall in FEV 1 (WMD 11.70%, 95% CI, 7.51–15.90) and in the percentage fall in PEF (WMD 11.50%, 95% CI, 6.31–16.69) post‐exercise.…”

“…Muscarinic antagonists have also emerged as effective therapeutic agents, acting on the parasympathetic nervous system to regulate bronchial tone and may serve as suitable relievers, particularly in pediatric populations with increased vagal tone [23,24]. Furthermore, ICS [20,22], LTRA [22,24] and MCS [15,16,18,19] attenuate EIB by inhibiting airway inflammation and mast cell degranulation. Combinations such as LTRA+ICS and ICS/LABA have demonstrated efficacy in preventing post-exercise decreases in FEV 1 and may reduce the rate of asthma exacerbations [22,24].…”

“…Regarding specific age‐related populations, ICS administered for at least 4 weeks remains the first‐line therapy for preventing EIB in children [20], with the potential addition of SABA, LABA, or LTRA; notably, the latter being particularly effective in subjects aged less than 18 years even in monotherapies [24]. Prophylactic inhalation of MCS prior to exercise appears more effective in subjects with more severe EIB.…”

Encasing bedding in covers made of microfine fibers reduces exposure to house mite allergens and improves disease management in adult atopic asthmatics

“…Levels of Der 1 allergen exposure were decreased in adult patients by encasing pillows and mattresses or futons and giving counseling on avoiding exposure to indoor allergens; asthma control was also increased. Factors that exacerbate asthma in adult patients include not only exposure to indoor allergens derived from HDMs, cockroaches, cats, dog, and fungi, but also respiratory infections [ 32 ], development of allergic rhinitis [ 33 ], high levels of airborne pollutants [ 34 , 35 ], changes in the weather [ 36 ], and exercise [ 37 ]. No clear evidence of a dose–response relationship between HDM levels and asthma severity has yet been found [ 2 ].…”

Bronchial Challenge Testing

“…EIB also improves after use of ICS (Koh 2007). The degree of AHR to indirect stimuli correlates with the degree of airways inflammation.…”

Pharmacological Advances in Managing Exercise‐Induced Bronchospasm: An Umbrella Review Following PRIOR Guideline

“…Koh et al. [20] conducted a systematic review and meta‐analysis of three studies with at least 4 weeks of ICS treatment, finding that ICS significantly reduced the percentage fall in FEV 1 (weighted MD [WMD] 11.74%, 95% CI, 10.06–13.42). A crossover study also confirmed these effects, reporting that ICS attenuated the percentage fall in FEV 1 (WMD 11.70%, 95% CI, 7.51–15.90) and in the percentage fall in PEF (WMD 11.50%, 95% CI, 6.31–16.69) post‐exercise.…”

“…Muscarinic antagonists have also emerged as effective therapeutic agents, acting on the parasympathetic nervous system to regulate bronchial tone and may serve as suitable relievers, particularly in pediatric populations with increased vagal tone [23,24]. Furthermore, ICS [20,22], LTRA [22,24] and MCS [15,16,18,19] attenuate EIB by inhibiting airway inflammation and mast cell degranulation. Combinations such as LTRA+ICS and ICS/LABA have demonstrated efficacy in preventing post-exercise decreases in FEV 1 and may reduce the rate of asthma exacerbations [22,24].…”

“…Regarding specific age‐related populations, ICS administered for at least 4 weeks remains the first‐line therapy for preventing EIB in children [20], with the potential addition of SABA, LABA, or LTRA; notably, the latter being particularly effective in subjects aged less than 18 years even in monotherapies [24]. Prophylactic inhalation of MCS prior to exercise appears more effective in subjects with more severe EIB.…”

Encasing bedding in covers made of microfine fibers reduces exposure to house mite allergens and improves disease management in adult atopic asthmatics

“…Levels of Der 1 allergen exposure were decreased in adult patients by encasing pillows and mattresses or futons and giving counseling on avoiding exposure to indoor allergens; asthma control was also increased. Factors that exacerbate asthma in adult patients include not only exposure to indoor allergens derived from HDMs, cockroaches, cats, dog, and fungi, but also respiratory infections [ 32 ], development of allergic rhinitis [ 33 ], high levels of airborne pollutants [ 34 , 35 ], changes in the weather [ 36 ], and exercise [ 37 ]. No clear evidence of a dose–response relationship between HDM levels and asthma severity has yet been found [ 2 ].…”

Bronchial Challenge Testing

“…EIB also improves after use of ICS (Koh 2007). The degree of AHR to indirect stimuli correlates with the degree of airways inflammation.…”

Pharmacological Advances in Managing Exercise‐Induced Bronchospasm: An Umbrella Review Following PRIOR Guideline

“…Koh et al. [20] conducted a systematic review and meta‐analysis of three studies with at least 4 weeks of ICS treatment, finding that ICS significantly reduced the percentage fall in FEV 1 (weighted MD [WMD] 11.74%, 95% CI, 10.06–13.42). A crossover study also confirmed these effects, reporting that ICS attenuated the percentage fall in FEV 1 (WMD 11.70%, 95% CI, 7.51–15.90) and in the percentage fall in PEF (WMD 11.50%, 95% CI, 6.31–16.69) post‐exercise.…”

“…Muscarinic antagonists have also emerged as effective therapeutic agents, acting on the parasympathetic nervous system to regulate bronchial tone and may serve as suitable relievers, particularly in pediatric populations with increased vagal tone [23,24]. Furthermore, ICS [20,22], LTRA [22,24] and MCS [15,16,18,19] attenuate EIB by inhibiting airway inflammation and mast cell degranulation. Combinations such as LTRA+ICS and ICS/LABA have demonstrated efficacy in preventing post-exercise decreases in FEV 1 and may reduce the rate of asthma exacerbations [22,24].…”

“…Regarding specific age‐related populations, ICS administered for at least 4 weeks remains the first‐line therapy for preventing EIB in children [20], with the potential addition of SABA, LABA, or LTRA; notably, the latter being particularly effective in subjects aged less than 18 years even in monotherapies [24]. Prophylactic inhalation of MCS prior to exercise appears more effective in subjects with more severe EIB.…”

Encasing bedding in covers made of microfine fibers reduces exposure to house mite allergens and improves disease management in adult atopic asthmatics

“…Levels of Der 1 allergen exposure were decreased in adult patients by encasing pillows and mattresses or futons and giving counseling on avoiding exposure to indoor allergens; asthma control was also increased. Factors that exacerbate asthma in adult patients include not only exposure to indoor allergens derived from HDMs, cockroaches, cats, dog, and fungi, but also respiratory infections [ 32 ], development of allergic rhinitis [ 33 ], high levels of airborne pollutants [ 34 , 35 ], changes in the weather [ 36 ], and exercise [ 37 ]. No clear evidence of a dose–response relationship between HDM levels and asthma severity has yet been found [ 2 ].…”

Bronchial Challenge Testing

“…EIB also improves after use of ICS (Koh 2007). The degree of AHR to indirect stimuli correlates with the degree of airways inflammation.…”