Dupilumab Suppresses Fractional Exhaled Nitric Oxide (FeNO) and Biomarkers of Type 2 Inflammation in Adult Patients with Persistent Uncontrolled Asthma Despite Use of Medium-to-High Dose Inhaled Corticosteroids Plus Long-Acting Beta-Agonists (ICS/LABAs)

2016 ◽  
Vol 137 (2) ◽  
pp. AB190 ◽  
Author(s):  
Brian N. Swanson ◽  
Ariel Teper ◽  
Jennifer D. Hamilton ◽  
Bingzhi Zhang ◽  
Heribert Staudinger ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Inhaled Corticosteroids ◽  
Adult Patients ◽  
High Dose ◽  
Uncontrolled Asthma ◽  
Fractional Exhaled Nitric Oxide ◽  
Beta Agonists ◽  
Long Acting ◽  
Type 2 Inflammation

scholarly journals Algorithm of biophenotyping and choice of medication for targeted therapy of severe uncontrolled asthma with eosinophilic type of airways inflammation

2017 ◽  
Vol 14 (3) ◽  
pp. 5-18
Author(s):  
N I Ilina ◽  
N M Nenasheva ◽  
S N Avdeev ◽  
Z R Aisanov ◽  
V V Arkhipov ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Clinical Studies ◽  
Inhaled Corticosteroids ◽  
Uncontrolled Asthma ◽  
Treatment Regimens ◽  
Expert Opinions ◽  
Beta Agonists ◽  
Biomarker Testing ◽  
High Doses ◽  
Long Acting

The article is based on the resolution of the Expert Council, including experts from Russian Association of Allergists and Clinical Immunologists (RAACI) and Russian Respiratory Society (RRS) dated November 20, 2016, and the review of clinical studies results and publications on the biomarker-based diagnosis and biological treatment of severe uncontrolled asthma. The aim of this work is to develop a phenotype-oriented algorithm of diagnostics and treatment of severe asthma, supported by the biomarker testing for subsequent selection of appropriate immunobiological treatment. The article constitutes the summary of results of clinical studies and expert opinions on the treatment of asthma in patients who do not achieve disease control with standard treatment regimens including high doses of inhaled corticosteroids in the combination with long-acting beta-agonists, tiotropium, and medications from other pharmacological groups according to Russian Respiratory Society (2016) and GINA (2016-2017) guidelines. The article summarizes the results of international randomized clinical studies performed to assess safety and efficacy of new class of biological treatments, monoclonal antibodies acting against major cytokines that are responsible for inflammation, in patients with severe asthma, including a new anti-IL-5 antibody, reslizumab (Cinqaero).

Triple therapy in uncontrolled asthma: a network meta-analysis of Phase III studies

2021 ◽  
pp. 2004233
Author(s):  
Paola Rogliani ◽  
Beatrice Ludovica Ritondo ◽  
Luigino Calzetta
Keyword(s):  
Meta Analysis ◽  
Phase Iii ◽  
Fixed Dose ◽  
High Dose ◽  
Severe Exacerbation ◽  
Triple Combination ◽  
Combination Therapies ◽  
Uncontrolled Asthma ◽  
Long Acting ◽  
The Impact

Conflicting evidence is currently available concerning the impact on asthma exacerbation of triple inhaled corticosteroid (ICS), long-acting β2-adrenoceptor agonist (LABA), and long-acting muscarinic receptor antagonist (LAMA) fixed-dose combination (FDC). Since meta-analyses allow settling controversies of apparently inconsistent results, we performed a network meta-analysis of Phase III randomised controlled trials including 9535 patients to assess the effect of ICS/LABA/LAMA combinations in uncontrolled asthma. Triple combination therapies with an ICS administered at high dose (HD) were more effective (p<0.05) than medium dose (MD) ICS/LABA/LAMA FDC and both MD and HD ICS/LABA FDCs against moderate to severe exacerbation (relative risk [RR] from 0.61 to 0.80) and increasing trough forced expiratory volume in the 1st second (mL from +33 to +114). Triple combination therapies including HD ICS were superior (p<0.05) than MD ICS/LABA/LAMA FDC in preventing severe exacerbation (RR from 0.46 to 0.65), but not with respect to moderate exacerbation (p>0.05). Triple combination therapies were equally effective on asthma control, with no safety concerns. This quantitative synthesis suggests that ICS/LABA/LAMA FDCs are effective and safe in uncontrolled asthma, and that the dose of ICS in the combination represents the discriminating factor to treat patients with a history of moderate or severe exacerbation.

Phenotypes favoring fractional exhaled nitric oxide discordance vs guideline-based uncontrolled asthma

2019 ◽  
Vol 123 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Tricia Morphew ◽  
Hye-Won Shin ◽  
Sara Marchese ◽  
Naomi Pires-Barracosa ◽  
Stanley P. Galant
Keyword(s):  
Nitric Oxide ◽  
Exhaled Nitric Oxide ◽  
Uncontrolled Asthma ◽  
Fractional Exhaled Nitric Oxide
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