1.Clinical efficacy observation of omalizumab on patients with moderate to severe allergic asthma for one year.
Yu XU ; De Xun ZHOU ; Ping HU ; Pei Hua GONG
Chinese Journal of Preventive Medicine 2023;57(3):427-432
To observe the symptom control, pulmonary function changes and safety of use of omalizumab in patients with moderate to severe allergic asthma for 1 year. A small sample self-controlled study before and after treatment was conducted to retrospective analysis involved 17 patients with moderate to severe asthma who received omalizumab therapy for 12 months in Peking University People's Hospital and Beijing Jishuitan Hospital from January 2020 to December 2021. The clinical symptoms and pulmonary function changes were compared before treatment, after 6 months and 12 months of treatment, and the clinical data such as the use of other drugs and adverse reactions were observed. Statistical data are collected using the median method, and non-parametric paired Wilcoxon analysis was used for pairwise comparison. Before treatment with omalizumab, the patients' FeNO value was 79(58, 121) ppb, and the total serum IgE was 228(150.5, 345.5) IU/ml. After 6 months of omalizumab therapy, the percent predicted value of the forced expiratory volume in 1 second (FEV1%) before inhaled bronchodilator increased from 86.70(82.65, 91.35)% to 90.90(87.70, 95.85)% (Z=-3.626, P<0.001). The FEV1%pred after inhaled bronchodilator increased from 92.60(85.75, 96.90)% to 94.30(89.95, 98.15)% (Z=-2.178, P=0.029). The absolute value of improvement in FEV1 decreased from 150(95, 210)ml to 50(20, 125) ml (Z=-2.796, P=0.005), and the improvement rate decreased from 6.60(3.80, 7.85)% to 1.90(0.75, 4.85)% (Z=-2.922, P=0.003). After 12 months of treatment, the FEV1%pred before inhaled bronchodilator further increased to 92.90 (91.60, 98.15)% (Z=-3.575, -2.818, and P<0.001, 0.005 compared with before treatment and 6 months after treatment, respectively). The FEV1%pred after inhaled bronchodilator increased to 96.80 (91.90, 101.25)% (Z=-3.622, -1.638, and P<0.001, 0.008 compared with before treatment and after 6 months of treatment, respectively). The absolute value of improvement in FEV1 was 70 (35, 120) ml (P=0.004, 0.842 before treatment and 6 months after treatment, respectively), and the improvement rate was 3.0(1.0, 5.0)% (Z=-2.960, -0.166, and P=0.003, 0.868, compared with before treatment and after 6 months of treatment, respectively). After 12 months of treatment, ACT increased from 13 (10.5, 18) before treatment to 24 (23, 25) (Z=-3.626,P<0.001). Only 1 patient experienced an injection site skin reaction during treatment. Therefore, after 6 months and 12 months of treatment with omalizumab, the patient's lung function improved and symptoms were relieved, which could effectively prevent the acute exacerbation of asthma. Omalizumab treatment is safe and well tolerated, and no effect on blood pressure and blood glucose was observed.
Humans
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Omalizumab/therapeutic use*
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Anti-Asthmatic Agents/therapeutic use*
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Retrospective Studies
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Bronchodilator Agents/therapeutic use*
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Asthma/diagnosis*
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Treatment Outcome
2.Therapeutic effect and safety of montelukast sodium combined with budesonide in children with cough variant asthma: a Meta analysis.
Yan WEI ; Dong-Sheng LI ; Jian-Jun LIU ; Jing ZHANG ; Hai-En ZHAO
Chinese Journal of Contemporary Pediatrics 2016;18(11):1100-1105
OBJECTIVETo evaluate the therapeutic effect and safety of montelukast sodium combined with budesonide in children with cough variant asthma.
METHODSThe databases CNKI, Wanfang Data, VIP, PubMed, EMbase, and BioMed Central were searched for randomized controlled trials (RCTs) of montelukast sodium combined with budesonide in the treatment of children with cough variant asthma. Data extraction and quality assessment were performed for RCTs which met the inclusion criteria, and RevMan 5.3 software was used to perform quality assessment of the articles included and Meta analysis.
RESULTSA total of 11 RCTs involving 1 097 patients were included. The results of the Meta analysis showed that compared with the control group (inhalation of budesonide alone), the observation group (inhalation of montelukast sodium combined with budesonide) had significantly higher overall response rate and more improved pulmonary function parameters including forced expiratory volume in the first second, percentage of forced expiratory volume in the first second, and peak expiratory flow, as well as significantly lower recurrence rate (P<0.01). The incidence of adverse events showed no significant difference between the two groups.
CONCLUSIONSInhalation of montelukast sodium combined with budesonide has a significant effect in children with cough variant asthma and does not increase the incidence of adverse events.
Acetates ; administration & dosage ; adverse effects ; Anti-Asthmatic Agents ; administration & dosage ; adverse effects ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; adverse effects ; Budesonide ; administration & dosage ; adverse effects ; Child ; Cough ; drug therapy ; Drug Therapy, Combination ; Humans ; Quinolines ; administration & dosage ; adverse effects
3.Phenotype of asthma-chronic obstructive pulmonary disease overlap syndrome.
The Korean Journal of Internal Medicine 2015;30(4):443-449
Many patients with asthma or chronic obstructive pulmonary disease (COPD) have overlapping characteristics of both diseases. By spirometric definition, patients with both fixed airflow obstruction (AO) and bronchodilator reversibility or fixed AO and bronchial hyperresponsiveness can be considered to have asthma-COPD overlap syndrome (ACOS). However, patients regarded to have ACOS by spirometric criteria alone are heterogeneous and can be classified by phenotype. Eosinophilic inflammation, a history of allergic disease, and smoke exposure are important components in the classification of ACOS. Each phenotype has a different underlying pathophysiology, set of characteristics, and prognosis. Medical treatment for ACOS should be tailored according to phenotype. A narrower definition of ACOS that includes both spirometric and clinical criteria is needed.
Anti-Asthmatic Agents/therapeutic use
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Asthma/*complications/diagnosis/drug therapy/physiopathology
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Bronchodilator Agents/therapeutic use
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Humans
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Lung/drug effects/*physiopathology
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Phenotype
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Predictive Value of Tests
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Pulmonary Disease, Chronic Obstructive/*complications/diagnosis/drug therapy/physiopathology
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Risk Factors
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Spirometry
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Syndrome
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Terminology as Topic
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Treatment Outcome
4.Pharmacogenetics of asthma in children.
Naomi KONDO ; Eiko MATSUI ; Akane NISHIMURA ; Hideo KANEKO
Allergy, Asthma & Immunology Research 2010;2(1):14-19
Allergic diseases such as bronchial asthma and atopic dermatitis develop by a combination of genetic and environmental factors. Several candidate causative genes of asthma and atopy have been reported as the genetic factors. The clinical features of patients and causes of diseases vary. Therefore, personalized medicine (tailor-made medicine) is necessary for the improvement of quality of life (QOL) and for asthma cure. Pharmacogenetics is very important for personalized medicine. Here, we present the genetics and pharmacogenetics of asthma in children. Finally, we show the guideline for personalized medicine for asthma, particularly in childhood, including the pharmacogenetics of anti-asthmatic drugs, preliminarily produced by the authors.
Anti-Asthmatic Agents
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Asthma
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Child
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Dermatitis, Atopic
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Humans
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Precision Medicine
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Pharmacogenetics
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Quality of Life
5.Addition of Montelukast to Low-Dose Inhaled Corticosteroid Leads to Fewer Exacerbations in Older Patients Than Medium-Dose Inhaled Corticosteroid Monotherapy.
Young Min YE ; Sang Ha KIM ; Gyu Young HUR ; Joo Hee KIM ; Jung Won PARK ; Jae Jeong SHIM ; Ki Suck JUNG ; Hyun Young LEE ; Hae Sim PARK
Allergy, Asthma & Immunology Research 2015;7(5):440-448
PURPOSE: There have been few reports regarding the efficacy of antiasthmatics in older patients. To compare the efficacy of the addition of montelukast to low-dose inhaled budesonide (MON-400BUD) versus increasing the dose of inhaled steroid (800BUD) on asthma control in older asthmatics. METHODS: A randomized, open-label, parallel-designed trial was conducted for 12 weeks. The primary endpoint was the rate of patients who reached "well-controlled asthma status" after the 12-week treatment period. Additionally, asthma exacerbations, sputum inflammatory cells, asthma control test (ACT) and physical functioning scale (PFS), and adverse reactions were monitored. RESULTS: Twenty-four (36.9%) and 22 (34.9%) subjects in the MON-400BUD (n=65) and 800BUD (n=63) groups had well-controlled asthma at the end of the study, respectively. The numbers of asthma exacerbations requiring oral corticosteroid treatment (20 vs 9, respectively, P=0.036) and the development of sore throat (22 vs 11, respectively, P=0.045) were significantly higher in the 800BUD group than in the MON-400BUD group. Body mass index and changes in ACT, FEV1%, 6-min walk distance and PFS from baseline were all significant determinants for distinguishing subjects with well-controlled and partly controlled asthma from those with uncontrolled asthma (P<0.05) at the end of the study. CONCLUSIONS: The efficacy of 12-week treatment with MON-400BUD in older asthmatics was comparable to that of 800BUD on asthma control but associated with reduced frequency of asthma exacerbations requiring oral steroids and sore throat events. Changes in ACT and PFS can be useful predictors of asthma control status in older patients.
Anti-Asthmatic Agents
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Asthma
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Body Mass Index
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Budesonide
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Humans
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Motor Activity
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Pharyngitis
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Sputum
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Steroids
6.Some medicinal plants with antiasthmatic potential: a current status.
Dnyaneshwar J TAUR ; Ravindra Y PATIL
Asian Pacific Journal of Tropical Biomedicine 2011;1(5):413-418
Asthma is a common disease that is rising in prevalence worldwide with the highest prevalence in industrialized countries. Asthma affects about 300 million people worldwide and it has been estimated that a further 100 million will be affected by 2025. Since the ancient times, plants have been exemplary sources of medicine. Current asthma therapy lack satisfactory success due to adverse effect, hence patients are seeking complementary and alternative medicine to treat their asthma. Ayurveda and other Indian literature mention the use of plants in various human ailments. India has about 45,000 plant species and among them several thousand are claimed to possess medicinal properties. Researches conducted in the last few decades on the plants mentioned in ancient literature or used traditionally for asthma have shown antiasthmatic, antihistaminic and antiallergic activity. This review reveals that some plants and their extract have antiasthmatic, antihistaminic, anticholinergic and antiallergic activity.
Anti-Asthmatic Agents
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Asthma
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drug therapy
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Humans
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Medicine, Ayurvedic
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Plant Extracts
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Plants, Medicinal
7.Effects of different segments of acupuncture serum on eosinophil counts in the rat with eosinophilia.
Hui-ming XU ; Shu-lan MA ; Yong-qing YANG ; Ying-ying ZHANG
Chinese Acupuncture & Moxibustion 2005;25(4):272-274
OBJECTIVETo further analyze and identify effective components of anti-asthma in acupuncture serum.
METHODSChanges of eosinophils in the peripheral blood of rats with eosinophilia were observed for 10 days after intravenous injection of the different segments of serum (serum: normal saline = 1:20, 2.5 mL/kg, from the first day of the model establishment, for 3 consecutive days).
RESULTSAfter intravenous injection of different segments of serum, the eosinophil counts in the peripheral blood decreased significantly from the 3rd day as compared with those of the model group (P<0.05).
CONCLUSIONThe effective components of acupuncture serum from asthmatic rats treated by acupuncture for eosinophils are not a single component, and acupuncture stimulation may produce many kinds of components of anti-asthma.
Animals ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; drug therapy ; Eosinophilia ; Eosinophils ; Leukocyte Count ; Rats
8.Effects and mechanisms of actions of Chinese herbal medicines for asthma.
Min-Li HONG ; Ying SONG ; Xiu-Min LI
Chinese journal of integrative medicine 2011;17(7):483-491
Asthma is a chronic inflammatory disorder of airways that affects approximately 300 million adults and children worldwide. Most therapy currently uses bronchodilators and corticosteroids. Systemic side effects from chronic use of these drugs are concern. Chinese medicine (CM) has a long history of human use in China and other Asian countries and well received by the patients. But as one component of Western integrative medicine (WIM), it is required that CM use is supported by scientific evidence. On the other hand, there are also suggestions that Western standardized medicine should consider personalized practice. In recent years there have been an increasing studies to narrow the gap between CM, the personalized medicine and Western medicine, evidence based medicine. This communication reviews several CM studies published in the English language in details by reviewing the effects and mechanisms of actions on asthma from clinic and experimental studies.Chinese herbal medicines exhibit broad actions on multiple asthma pathologic mechanisms. These mechanisms may involve antiinflammatory and immunomodulatory effects, inhibiting airway remodeling and normalization of hypothalamus, pituitary and adrenal (HPA)-axis disturbances. However, the mechanisms of actions of Chinese herbal medicines for asthma are not fully understood. More controlled clinical studies are warranted and some anti-asthma CM may be proved to be effective when used as monotherapy or complementary asthma therapies.
Animals
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Anti-Asthmatic Agents
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therapeutic use
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Asthma
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drug therapy
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Drugs, Chinese Herbal
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therapeutic use
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Humans
10.Biologic Targeting: New and Effective Therapeutic Approaches against Severe Asthma.
Xin YANG ; Han-Rong FENG ; Zhi-Min CHEN ; Song-Min YING ;
Chinese Medical Journal 2018;131(9):1009-1012