Asthma symptoms, SABA use, and lung function before and after a moderate or severe exacerbation

2017 ◽  
Author(s):  
Ida Smith ◽  
Victoria Cardona ◽  
Hanne Villesen ◽  
Christian Ljørring ◽  
Dorte Rehm ◽  
...  
Keyword(s):  
Lung Function ◽  
Severe Exacerbation ◽  
Asthma Symptoms ◽  
Before And After

scholarly journals Improvement in Asthma Symptoms and Pulmonary Function in Children After SARS-CoV-2 Outbreak

2021 ◽  
Vol 9 ◽  
Author(s):  
Jessica Taytard ◽  
Florence Coquelin ◽  
Nicole Beydon
Keyword(s):  
Lung Function ◽  
Asthma Symptom ◽  
Symptom Control ◽  
Persistent Asthma ◽  
Z Score ◽  
Asthmatic Children ◽  
Asthma Symptoms ◽  
Asthma Exacerbations ◽  
Before And After ◽  
Function Testing

Introduction: Little is known on the effect of SARS-CoV-2 circulation on asthma daily symptoms in children. We compared asthma exacerbations, asthma symptom control and lung function before and after SARS-CoV-2 outbreak in children.Methods: Retrospective study of children with persistent asthma referred for lung function testing. The second quarter of 2020 being a period with nearly no activity, we compared the activity between the first, third and fourth quarters of 2019 and 2020 (Q1-2019 vs. Q1-2020, Q3-2019 vs. Q3-2020 and Q4-2019 vs. Q4-2020).Results: We retrieved 1,871 files in 2019 and 1,548 in 2020. The whole population [2,165 (63.3%) boys] had a median [IQR] age of 9.7 [6.8;13.1] years. There was no difference in age, sex, and ethnicity between 2019 and 2020 populations. Asthma was better controlled during Q4-2020 compared to Q4-2019 (P = 0.042), and there was a lower proportion of children with at least one exacerbation in the previous 3 months after the reopening, compared to the same period in 2019 (P < 0.0001). Baseline FEV1 (Z-score) recorded after the reopening was significantly higher (with less reversibility) compared to the same period before the epidemic (P < 0.0001). Baseline FEV1/FVC (Z-score) was significantly higher during Q3-2020 compared to Q3-2019 (P = 0.026), with fewer children having a significant reversibility (P = 0.035).Discussion: We demonstrated a trend toward increased exacerbations just before the recognition of the epidemic, and fewer exacerbations, better asthma symptom control and improvement in the lung function of asthmatic children after the reopening.

Asthma Medication Regimens in Pregnancy: Longitudinal Changes in Asthma Status

2021 ◽  
Author(s):  
Matthew C.H. Rohn ◽  
Danielle R. Stevens ◽  
Jenna Kanner ◽  
Carrie Nobles ◽  
Zhen Chen ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Propensity Scores ◽  
First Trimester ◽  
Forced Expiratory Volume ◽  
Asthma Medication ◽  
Severe Exacerbation ◽  
Medication Regimen ◽  
Asthma Symptoms ◽  
The Impact

Objective This study aimed to assess the impact of common asthma medication regimens on asthma symptoms, exacerbations, lung function, and inflammation during pregnancy. Study Design A total of 311 women with asthma were enrolled in a prospective pregnancy cohort. Asthma medication regimen was categorized into short-acting β agonist (SABA) alone, SABA + inhaled corticosteroid (ICS), SABA + ICS + long-acting β agonist (LABA), and no asthma medications (reference). We evaluated asthma control at enrollment (< 15 weeks' gestation) and its change into trimesters 2 and 3, including per cent predicted forced expiratory volume in 1 second (%FEV1) and peak expiratory flow (%PEF), pulse oximetry, fractional exhaled nitric oxide (FeNO), asthma symptoms (asthma attacks/month, night symptoms/week), and severe exacerbations. Linear mixed models adjusted for site, age, race, annual income, gestational age, body mass index, and smoking, and propensity scores accounted for asthma control status at baseline. Results Women taking SABA + ICS and SABA + ICS + LABA had better first trimester %PEF (83.5% [75.7–91.3] and 84.6% [76.9–92.3], respectively) compared with women taking no asthma medications (72.7% [66.0–79.3]). Women taking SABA + ICS + LABA also experienced improvements in %FEV1 (+11.1%, p < 0.01) in the third trimester and FeNO in the second (−12.3 parts per billion [ppb], p < 0.01) and third (−11.0 ppb, p < 0.01) trimesters as compared with the trajectory of women taking no medications. SABA + ICS use was associated with increased odds of severe exacerbations in the first (odds ratio [OR]: 2.22 [1.10–4.46]) and second (OR: 3.15 [1.11–8.96]) trimesters, and SABA + ICS + LABA use in the second trimester (OR: 7.89 [2.75–21.47]). Women taking SABA alone were similar to those taking no medication. Conclusion Pregnant women taking SABA + ICS and SABA + ICS + LABA had better lung function in the first trimester. SABA + ICS + LABA was associated with improvements in lung function and inflammation across gestation. However, both the SABA + ICS and SABA + ICS + LABA groups had a higher risk of severe exacerbation during early to mid-pregnancy. Key Points

Lung-Function Profile Before and After the First Moderate to Severe Exacerbation During the WISDOM Study

Pneumologie ◽  
2017 ◽  
Vol 71 (S 01) ◽  
pp. S1-S125
Author(s):  
EFM Wouters ◽  
H Magnussen ◽  
R Rodríguez-Roisin ◽  
K Tetzlaff ◽  
S Bell ◽  
...  
Keyword(s):  
Lung Function ◽  
Severe Exacerbation ◽  
Before And After ◽  
Function Profile

scholarly journals P297 Lung-function profile before and after the first moderate to severe exacerbation during the wisdom study

Thorax ◽  
2016 ◽  
Vol 71 (Suppl 3) ◽  
pp. A254-A255
Author(s):  
E Wouters ◽  
H Magnussen ◽  
R Rodriguez-Roisin ◽  
K Tetzlaff ◽  
S Bell ◽  
...  
Keyword(s):  
Lung Function ◽  
Severe Exacerbation ◽  
Before And After ◽  
Function Profile

scholarly journals P157 Potential benefit of intravenous immunoglobulin in connective tissue disease associated interstitial lung diseases

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Vasilis Kouranos ◽  
Lauren V Host ◽  
Corrado Campochiaro ◽  
Athol Wells ◽  
Christopher P Denton ◽  
...  
Keyword(s):  
Lung Function ◽  
Connective Tissue ◽  
Lung Diseases ◽  
Immunosuppressive Treatment ◽  
Interstitial Lung Diseases ◽  
Ivig Treatment ◽  
Before And After ◽  
Predicted Values ◽  
Relative Change ◽  
Median Change

Abstract Background/Aims  Intravenous immunoglobulin (IVIg) confers significant benefit in range of connective tissue diseases (CTD) including inflammatory myopathy (IM) of which interstitial lung diseases (ILD) are a major complication. This study aimed to assess the efficacy of IVIg on pulmonary involvement in refractory active CTD including systemic sclerosis (SSc). Methods  All patients with CTD-ILD confirmed on HRCT either with IM or SSc overlap myositis who did not achieve satisfactory clinical response to standard immunosuppressive agents and subsequently received regular IVIg infusions for IM were retrospectively identified. Serial lung function tests and immunosuppressive treatment regimen 9-12 months prior and 9-12 months after repeat courses of IVIg were recorded. Progressive ILD was considered when, despite immunosuppressive treatment, a relative FVC decline≥10% and/or relative DLco decline ≥15% were identified during the 9-12 months preceding IVIg treatment. The significance of median DLco and FVC percentage relative change to IVIg treatment was assessed by Wilcoxon signed-rank test. Results  22 patients (mean age 50.5±13.1 years old) with IM-ILD treated with IVIg were identified. ILD occurred in association with IM in 10 patients, overlap SSc myositis in another 11 patients, while one had mixed connective tissue disease with myositis. Lung function results were available for 19/22 (86%). Eight patients (42.1%) were found to have progressive ILD(four with IM and four with overlap SSc-myositis). The median change in FVC% predicted and DLco% predicted in the 9-12 months before and after IVIg treatment is presented in Table 1. There was a significant difference in the DLco% predicted rate of relative change before and after IVIg treatment (p = 0.035) for the overall cohort. However, no differences in lung function were observed in the rate of relative change between patients with IM and patients with SSc myositis overlap. Significant improvement in DLco% predicted values was identified in the subgroup analysis of patients with progressive ILD(p = 0.012). P157 Table 1:The median change in FVC and DLco% predicted values prior and after the IVIg treatmentPatients with myositis related ILD9-12 months before IVIg treatment (relative change)9-12 months after IVIg treatment (relative change)p-valueAll (n = 19)FVC % predicted-3.8 (-54.4 - 14.6)2.1 (-33 - 33.7)0.145DLco % predicted-9.2 (-60.7 - 9.2)-2.3 (-26 - 41.9)0.035PM/DM (n = 10)FVC % predicted-1.8 (-20.2 - 14.6)0.8 (-33 - 30.9)0.401DLco % predicted-9.6 (-60.7 - 9.2)-2.4 (-26 - 41.9)0.093SSc-PM/DM overlap (n = 11)FVC % predicted-6 (-54.4 - 10.6)3.4 (-19.9 - 33.7)0.139DLco % predicted-10.8 (-47.1 - 2.5)4.2 (-22.7 - 16.8)0.173Progressive ILD (n = 8)FVC % predicted-14.5 (-54.4 - 14.6)5.7 (-11.9 - 33.7)0.123DLco % predicted-25.3 (-60.6 - -14.1)12 (-2.3 - 41.9)0.012 Conclusion  IVIg may be an effective rescue therapy in the prevention of further lung function decline in refractory myositis and SSc overlap in particular in subgroups with progressive ILD. Future studies to determine its role in CTD-ILD are warranted. Disclosure  V. Kouranos: None. L.V. Host: None. C. Campochiaro: None. A. Wells: None. C.P. Denton: None. V.H. Ong: None. E. Renzoni: None.

scholarly journals Omalizumab reduces bronchial mucosal IgE and improves lung function in non-atopic asthma

2016 ◽  
Vol 48 (6) ◽  
pp. 1593-1601 ◽  
Author(s):  
Prathap Pillai ◽  
Yih-Chih Chan ◽  
Shih-Ying Wu ◽  
Line Ohm-Laursen ◽  
Clare Thomas ◽  
...  
Keyword(s):  
Mast Cells ◽  
Lung Function ◽  
Plasma Cells ◽  
Placebo Treatment ◽  
Forced Expiratory Volume ◽  
Atopic Asthma ◽  
Before And After ◽  
Bronchial Biopsies ◽  
Withdrawal Of Therapy ◽  
Therapy Reduction

Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE and inflammation and preserves/improves lung function when disease is destabilised by staged withdrawal of therapy.18 symptomatic, non-atopic asthmatics were randomised (1:1) to receive omalizumab or identical placebo treatment in addition to existing therapy for 20 weeks. Bronchial biopsies were collected before and after 12–14 weeks of treatment, then the patients destabilised by substantial, supervised reduction of their regular therapy. Primary outcome measures were changes in bronchial mucosal IgE+ cells at 12–14 weeks, prior to regular therapy reduction, and changes in lung function (forced expiratory volume in 1 s) after destabilisation at 20 weeks. Quality of life was also monitored.Omalizumab but not placebo therapy significantly reduced median total bronchial mucosal IgE+ cells (p<0.01) but did not significantly alter median total mast cells, plasma cells, B lymphocytes, eosinophils and plasmablasts, although the latter were difficult to enumerate, being distributed as disperse clusters. By 20 weeks, lung function declined in the placebo-treated patients but improved in the omalizumab treated patients, with significant differences in absolute (p=0.04) and % predicted forced expiratory volume in 1 s (p=0.015).Omalizumab therapy of non-atopic asthmatics reduces bronchial mucosal IgE+ mast cells and improves lung function despite withdrawal of conventional therapy.

Impact of Lung Biopsy on Lung Function in Idiopathic Pulmonary Fibrosis

Respiration ◽  
2020 ◽  
pp. 1-8
Author(s):  
Pierre-Henri Aussedat ◽  
Nader Chebib ◽  
Kais Ahmad ◽  
Jean-Charles Glerant ◽  
Gabrielle Drevet ◽  
...  
Keyword(s):  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Forced Vital Capacity ◽  
Lung Biopsy ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Surgical Lung Biopsy ◽  
Before And After ◽  
The Impact

<b><i>Background:</i></b> Video-assisted surgical lung biopsy (SLB) is performed in 10–30% of cases to establish the diagnosis of idiopathic pulmonary fibrosis (IPF). <b><i>Objectives:</i></b> The aim of the study was to analyze the impact of SLB on lung function in patients eventually diagnosed with IPF. <b><i>Methods:</i></b> This is an observational, retrospective, monocentric study of all consecutive patients eventually diagnosed with IPF in multidisciplinary discussion who underwent SLB over 10 years in a specialized center. The primary end point was the variation in forced vital capacity (FVC) before and after the SLB. The secondary end points were the variations in forced expiratory volume in one second (FEV1), total lung capacity (TLC), carbon monoxide diffusion capacity (DLCO), and morbidity and mortality associated with the SLB. <b><i>Results:</i></b> In 118 patients who underwent SLB and were diagnosed with IPF, a relative decrease in FVC of 4.8% (<i>p</i> &#x3c; 0.001) was found between measurements performed before and after the procedure. The mean FVC decrease was 156 ± 386 mL in an average period of 185 days, representing an annualized decline of 363 ± 764 mL/year. A significant decrease was also observed after SLB in FEV1, TLC, and DLCO. Complications within 30 days of SLB occurred in 14.4% of patients. Two patients (1.7%) died within 30 days, where one of them had poor lung function. Survival at 1 year was significantly poorer in patients with FVC &#x3c;50% at baseline. <b><i>Conclusion:</i></b> In this uncontrolled study in patients ultimately diagnosed with IPF, SLB was followed by a significant decline in FVC, which appears to be numerically greater than the average decline in the absence of treatment in the literature. <b><i>Summary at a Glance:</i></b> This study evaluated the change in lung function in 118 consecutive patients diagnosed with idiopathic pulmonary fibrosis by surgical lung biopsy. Forced vital capacity decreased by 156 ± 386 mL in a mean of 185 days between the last measurement before and first measurement after biopsy, representing an annualized decline of 363 ± 764 mL/year.

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