Inhaled steroids with and without regular salmeterol for asthma: serious adverse events

Cates, Christopher J; Schmidt, Stefanie; Ferrer, Montse; Sayer, Ben; Waterson, Samuel

doi:10.1002/14651858.cd006922.pub4

Cited by 19 publications

(12 citation statements)

References 173 publications

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“…Combined low-dose ICS with LABA was found to improve asthma control for patient whose asthma is not controlled at step 2 and reduce asthma attacks (Evidence A). [ 134 135 ] The patient is recommended to continue on reliever treatment on “as-needed basis” (Evidence A). ICS with LABA are available (refer Medication Appendix) as follows:…”

Section: Section 6: Pharmacological Management In Adults and Adolescementioning

confidence: 99%

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

et al. 2021

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The Saudi Initiative for Asthma 2021 (SINA-2021) is the fifth version of asthma guidelines for the diagnosis and management of asthma for adults and children, which is developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5–12 years, and children aged less than 5 years. SINA guidelines have focused more on personalized approaches reflecting better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. Medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.

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Section: Section 6: Pharmacological Management In Adults and Adolescementioning

confidence: 99%

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

et al. 2021

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“… 10 Some studies reported that for every 1000 children treated with ICS for 23 weeks, 15 children experienced severe adverse effects. 26 …”

Section: Discussionmentioning

confidence: 99%

Neuropsychiatric side reactions of leukotriene receptor antagonist, antihistamine, and inhaled corticosteroid: A real-world analysis of the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS)

Bian

Wang

et al. 2021

World Allergy Organization Journal

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Background There are limited real-world studies on the differences in leukotriene receptor antagonists (LTRA), H1-antihistamines (H1-AH), and inhaled corticosteroids (ICS) associated neuropsychiatric events. In this study, we aimed to analyze the characteristics of drug associated neuropsychiatric events, and compare the differences among different drug categories. Methods Disproportionality analysis and Bayesian analysis were used in data mining to identify suspected neuropsychiatric events associated with LTRA, H1-AH, and ICS based on the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) from January 2004 to September 2020. Demographic information, time interval to onset, and death rates of LTRA, H1-AH, and ICS-associated neuropsychiatric events were also analyzed. Results A total of 9475 neuropsychiatric events were identified. The number of neuropsychiatric events related to LTRA, H1-AH, and ICS were 5201 (54.89%), 3226 (34.05%), and 1048 (11.06%), respectively. LTRA related neuropsychiatric events were more common in patients aged 4–6 years (18.66%). H1-AH and ICS related neuropsychiatric events were more common in patients aged 18–44 years (29.92%) and older than 65 years (30.60%), respectively. Montelukast was highly associated with neuropsychiatric events, with a high reporting odds ratio (ROR). Most neuropsychiatric symptoms occurred within the first 10 days after drug initiation (78.63% for LTRA, 91.39% for H1-AH, and 84.07% for ICS). The death rate due to neuropsychiatric events of first generation H1-AH was significantly higher than that of LTRA and ICS (p < 0.001). Conclusions LTRA associated neuropsychiatric events reported in FAERS were most frequent in 4 to 6-year-old children. Most reported cases occurred within the first 10 days after drug initiation. The second generation H1-AH was relatively safe for neuropsychiatric events compared with the first generation. The fatality rate due to first generation H1-AH associated neuropsychiatric events was higher than that of LTRA and ICS. More attention should be paid to specific patients treated with LTRA and H1-AH.

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“…For patients receiving maintenance ICS treatment with as-needed SABA, adding LABA in a combination inhaler provides additional improvements in symptoms and lung function with a reduced risk of exacerbations compared with the same dose of ICS, 214,215 (Evidence A) but there is only a small reduction in reliever use. 216,217 Currently approved…”

Section: Preferred Step 3 Controller Options For Adults and Adolescentsmentioning

confidence: 99%

Eficacia y seguridad de la inmunoterapia subcutánea para alérgenos inhalables en pacientes con alergia respiratoria a un año de tratamiento

Sánchez-Villalobos

Caballero-López

López-García

et al. 2021

RAM

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Antecedentes: La inmunoterapia específica con alérgenos es una importante modalidad terapéutica para el manejo de la rinitis y asma alérgica. Objetivo: Evaluar la eficacia y seguridad de la inmunoterapia subcutánea con alérgenos en pacientes con alergia respiratoria del Hospital Universitario de Puebla posterior a 12 meses de tratamiento. Métodos: Estudio longitudinal, secuencial, analítico, cuasiexperimental, prolectivo. Durante 12 meses se incluyeron pacientes con asma o rinitis, sensibilizados a aeroalérgenos, de cuatro a 65 años y de ambos sexos; bimensualmente se recolectaron los cuestionarios CARAT y Portnoy para evaluar la eficacia y seguridad, respectivamente. Resultados: Se incluyeron 47 pacientes, 37 (78.7 %) mujeres. La edad promedio fue de 29.8 años. El 76.6 % tuvo diagnóstico de rinitis alérgica y 23.4 % de asma y rinitis alérgica. Al comparar el promedio del CARAT inicial contra el promedio final mediante prueba de t de Student se obtuvo un valor de –8.86 y p < 0.05. Se reportó una frecuencia total de reacciones adversas locales de 19 % y de reacciones adversas sistémicas de 2.1 % a los seis y 12 meses del tratamiento. Conclusiones: El esquema de inmunoterapia evaluado, derivado de la Guía Mexicana de Práctica Clínica de Inmunoterapia 2011, es eficaz con un conveniente perfil de seguridad.

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Inhaled steroids with and without regular salmeterol for asthma: serious adverse events

Abstract: Editorial group: Cochrane Airways Group. Publication status and date: New search for studies and content updated (conclusions changed), published in Issue 12, 2018.

Cited by 19 publications

References 173 publications

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

The Saudi Initiative for Asthma - 2021 Update: Guidelines for the diagnosis and management of asthma in adults and children

Neuropsychiatric side reactions of leukotriene receptor antagonist, antihistamine, and inhaled corticosteroid: A real-world analysis of the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS)

Eficacia y seguridad de la inmunoterapia subcutánea para alérgenos inhalables en pacientes con alergia respiratoria a un año de tratamiento

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