Low Variability in Peak Expiratory Flow Predicts Successful Inhaled Corticosteroid Step-Down in Adults with Asthma

Tsurikisawa, Naomi; Oshikata, Chiyako; Sato, Toshio; Kimura, Goro; Mizuki, Masami; Tsuburai, Takahiro; Shoji, Shunsuke; Saitô, Hiroshi; Shimoda, Terufumi

doi:10.1016/j.jaip.2017.10.036

Cited by 11 publications

(8 citation statements)

References 32 publications

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“…1,6,15,136 Risk modeling to identify other markers of success (or failure) remains a goal. Potential predictors, including clinical and demographic characteristics (eg, disease duration, 61,137 age, 60 bronchial hyperresponsiveness, 61,138 lung function, 61 and biomarkers (eg, FeNO, 57,61,139 serum eosinophils, 56,58,59,82,129 sputum eosinophils, 56,60,137,139,140 serum eotaxin 141 ) have been proposed, but the data are inconclusive.…”

Section: Discussionmentioning

confidence: 99%

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The Asthma Controller Step-down Yardstick

Chipps

Bacharier

Murphy

et al. 2019

Annals of Allergy, Asthma & Immunology

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Asthma guidelines recommend a control-based approach to disease management in which the assessment of impairment and risk is linked to step-based therapy. Using this model, controller treatment is adjusteddupward or downwarddaccording to a patient's level of asthma control over time. Strategies for stepping up controller therapy are well described, and the adult and pediatric Asthma Yardsticks provide operational recommendations based on patient profiles. Strategies for stepping down controller treatment are less clear, although stepping down to the minimum effective therapy is important and should be considered when a patient's asthma has been well controlled for an adequate period as defined by risk and impairment. This Yardstick presents recommendations for when and how to step down asthma controller therapy according to guideline-defined control levels. The objective is to provide clinicians who treat patients with asthma with a practical and clinically relevant framework for implementing a step-down in controller therapy.

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Section: Discussionmentioning

confidence: 99%

“…Discontinuing the ICS is not recommended because evidence shows an association with an increased risk for exacerbation. 15,19,54,55 Markers of inflammation may aid in proper patient selection, [56][57][58][59][60][61] but further studies are needed.…”

Section: Patients Using Ics and Leukotriene Modifier (Lm)mentioning

confidence: 99%

The Asthma Controller Step-down Yardstick

Chipps

Bacharier

Murphy

et al. 2019

Annals of Allergy, Asthma & Immunology

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“…33 Atopy was defined as the presence of at least one positive antigen with a radioallergosorbent test score of 1 (ie 0.35 IU/mL). 34 Active CEP was defined as the fulfillment of at least two of the following three criteria: respiratory symptoms of more than 2 weeks' duration, alveolar or blood eosinophilia (alveolar eosinophilia >25% on bronchoalveolar lavage fluid differential cell count; blood eosinophilia >1000/mm 3 ), and pulmonary infiltrates with the usual peripheral predominance on chest imaging. 35 Patients with CEP who also had allergic bronchopulmonary mycosis were excluded from the study.…”

Section: Introductionmentioning

confidence: 99%

Innate immune response reflects disease activity in eosinophilic granulomatosis with polyangiitis

Tsurikisawa

Oshikata

Watanabe

et al. 2018

Clin Experimental Allergy

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“…The PEFR is a valuable tool for assessing asthma status, even in patients with low perception of respiratory symptoms, and for evaluating the influence of environmental triggers. A recent study has demonstrated that low PEFR variability could be a useful indicator of good asthma control [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Seasonal and monthly variation in peak expiratory flow rate in children with asthma

Kim

Lee

et al. 2021

Asia Pacific Allergy

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Background Although understanding the seasonal patterns of asthma deterioration is important to prevent asthma exacerbation, previous approaches have limitations in evaluating the actual trend of asthma exacerbation. Objective This study aimed to evaluate the seasonal and monthly variations in the peak expiratory flow rate (PEFR) among children with asthma. Methods A total of 89 patients with asthma were enrolled between December 2012 and March 2015. The PEFR in the morning and evening was recorded daily, and the percentage change in PEFR from baseline was calculated. Generalized estimating equation models were constructed after adjusting for age, sex, body mass index, and sensitization to house dust mites or pollen. Results The PEFR records of 11,222 person-days showed a significant decrease in the morning and evening in autumn than in winter by −1.9% (95% confidence interval [CI], −3.73 to −0.15) and −2.1% (95% CI, −3.80 to −0.37), respectively. The morning PEFR was significantly lower in April, August, October, and December than in January with changes of −4.2% (95% CI, −7.08 to −1.23) in April, −3.1% (95% CI, −5.79 to −0.47) in August, −3.7% (95% CI, −6.09 to −1.21) in October, and −1.9% (95% CI, −3.62 to −0.12) in December. The percentage change of evening PEFR significantly decreased by −3.3% (95% CI, −6.38 to −0.25) in April and by −3.3% (95% CI, −5.56 to −1.07) in October. Conclusion The PEFR in children with asthma was lower in autumn than in winter. In terms of monthly patterns, the PEFR was significantly reduced in April and October than in January. These results can serve as a basis for preventing asthma exacerbations by developing seasonal or monthly management strategies for children with asthma.

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Low Variability in Peak Expiratory Flow Predicts Successful Inhaled Corticosteroid Step-Down in Adults with Asthma

Cited by 11 publications

References 32 publications

The Asthma Controller Step-down Yardstick

The Asthma Controller Step-down Yardstick

Innate immune response reflects disease activity in eosinophilic granulomatosis with polyangiitis

Seasonal and monthly variation in peak expiratory flow rate in children with asthma

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