Formoterol prolongs time to first severe asthma exacerbation

Abstract Background The French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients. Results The guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research was conducted based on publications indexed in PubMed™ and Cochrane™ databases. Of the 21 formalized guidelines, 4 had a high level of evidence (GRADE 1+/−) and 7 a low level of evidence (GRADE 2+/−). The GRADE method was inapplicable to 10 guidelines, which resulted in expert opinions. A strong agreement was reached for all guidelines. Conclusion The conjunct work of 36 experts from 3 scientific societies resulted in 21 formalized recommendations to help improving the emergency and intensive care management of adult and pediatric patients with SAE.

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Emergency Management of Acute Severe Asthma Exacerbation in the Adult Population

Journal of Asthma & Allergy Educators ◽

10.1177/2150129710374232 ◽

2010 ◽

Vol 1 (5) ◽

pp. 174-179

Author(s):

Sandra E. Marotta ◽

Yuly Belchikov ◽

Katherine Banker ◽

Peter S. Marshall

Keyword(s):

Emergency Management ◽

Severe Asthma ◽

Asthma Exacerbation ◽

Adult Population ◽

Acute Severe Asthma ◽

Severe Asthma Exacerbation

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Association of Moulds and Metrological Parameters in Relation to Severe Asthma Exacerbation

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2017.12.095 ◽

2018 ◽

Vol 141 (2) ◽

pp. AB30

Author(s):

Mona Sulaiman Al-Ahmad ◽

Nermina Arifhodzic

Keyword(s):

Severe Asthma ◽

Asthma Exacerbation ◽

Severe Asthma Exacerbation ◽

Metrological Parameters

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Duration of the efficacy of omalizumab after treatment discontinuation in ‘real life’ severe asthma

Thorax ◽

10.1136/thoraxjnl-2017-210017 ◽

2017 ◽

Vol 73 (8) ◽

pp. 782-784 ◽

Cited By ~ 12

Author(s):

Maria del Carmen Vennera ◽

Carlos Sabadell ◽

Cesar Picado

Keyword(s):

Prospective Study ◽

Asthma Control ◽

Severe Asthma ◽

Asthma Exacerbation ◽

Real Life ◽

First Year ◽

Severe Asthma Exacerbation ◽

Optimal Duration ◽

Open Prospective Study

Efficacy of omalizumab in severe asthma is well documented; however, the optimal duration of the treatment remains unclear. In an open prospective study, we sought to assess the persistence of response in subjects withdrawing from omalizumab treatment. We evaluated 49 patients who voluntarily accepted to discontinue omalizumab treatment after 6 years of therapy. Asthma relapse was defined as any severe asthma exacerbation associated with loss of asthma control. Twelve patients relapsed in the first year of follow-up, and 7 within 13 and 48 months. These results suggest that the effects of 6 years of omalizumab may persist after discontinuation of therapy in 60% of patients for at least 4 years.

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Ketamine for Adults with Severe Asthma Exacerbation: A Systematic Review and Meta-analysis

The Journal of Medicine, Law & Public Health ◽

10.52609/jmlph.v2i1.37 ◽

2022 ◽

Vol 2 (1) ◽

pp. 91-97

Author(s):

Fatimah AlShehri ◽

Heetaf Aloqaily ◽

Joud Enabi ◽

Sharafaldeen Bin Nafisah

Keyword(s):

Systematic Review ◽

Severe Asthma ◽

Asthma Exacerbation ◽

Meta Analysis ◽

World Health ◽

Severe Asthma Exacerbation ◽

Number Of Patients ◽

Acute Asthma Exacerbation ◽

Health Organization ◽

Meta Analyses

BACKGROUND: Severe asthma mandates careful attention and timely management, and the benefit of ketamine in severe asthma exacerbations in adult patients require further exploration. METHODS: We conducted a systematic review and meta-analysis of the use of ketamine in cases of acute asthma exacerbation in adults. We searched PubMed, Google Scholar, Cochrane databases, and gray literature (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform); we also searched the reference lists of included articles and any systematic reviews and meta-analyses identified therein. Our search covered the period from 1963 to August 20, 2021. Search terms were “ketamine” AND “asthma”. RESULTS: Of 25 540 articles, two studies were included in the analysis. The total number of patients included in the studies was 136 (68 in the ketamine groups and 68 in the placebo group). The pooled effect size was 0.30 (95% CI: -0.04, 0.63) favouring ketamine over placebo, p=0.08, (I2=0%, p=0.39). A paired t-test revealed that ketamine improved the mean peak expiratory flow rate (PEFR) from 242.4 (SD=146.23) to 286.95 (SD=182.22), p=0.33, representing an 18.38% improvement. CONCLUSION: Ketamine can induce a 30% improvement in PEFR, representing a small positive effect in the treatment of acute severe asthma exacerbation in the emergency department (ED). The improvement was not statistically significant; nonetheless, since the improvement could be as great as 63% versus only a 4% possibility of no benefit/harm, the benefit appears to considerably outweigh any harm.

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Combination of ipratropium bromide and salbutamol in children and adolescents with asthma: a meta-analysis

10.1101/2020.07.31.230318 ◽

2020 ◽

Author(s):

Hongzhen Xu ◽

Lin Tong ◽

Peng Gao ◽

Yan Hu ◽

Huijuan Wang ◽

...

Keyword(s):

Adverse Events ◽

Hospital Admission ◽

Children And Adolescents ◽

Severe Asthma ◽

Subgroup Analysis ◽

Asthma Exacerbation ◽

Ipratropium Bromide ◽

Cochrane Library ◽

Severe Asthma Exacerbation ◽

Asthma In Children

AbstractBackgroundA combination of ipratropium bromide (IB) and salbutamol is commonly used to treat asthma in children and adolescents; however, there has been a lack of consistency in its usage in clinical practice.ObjectiveTo evaluate the efficacy and safety of IB + salbutamol in the treatment of asthma in children and adolescents.MethodsThe MEDLINE, Embase, and Cochrane Library as well as other Chinese biomedical databases (including China Biological Medicine Database, Chinese National Knowledge Infrastructure, Chongqing VIP, and Wanfang Chinese language bibliographic database) were systematically searched from the date of database inception to 02/09/2019 for randomized controlled trials in children and adolescents (≤18 years) with asthma who received IB + salbutamol or salbutamol alone. The primary outcomes included hospital admission and adverse events. A random effects model with a 95% confidence interval (CI) was used. Subgroup analysis was performed according to age, severity of asthma, and co-interventions with other asthma controllers. This study was registered with PROSPERO.ResultsOf the 637 studies that were identified, 55 met the inclusion criteria and involved 6396 participants. IB + salbutamol significantly reduced the risk of hospital admission compared with salbutamol alone (risk ratio [RR] 0.79; 95% CI 0.66–0.95; p = 0.01; I2 = 40%). Subgroup analysis only showed significant difference in the risk of hospital admission in participants with severe asthma exacerbation (RR 0.71; 95% CI 0.60–0.85; p = 0.0001; I2 = 0%) and moderate-to-severe exacerbation (RR 0.69; 95% CI 0.50–0.96; p = 0.03; I2 = 3%). There were no significant differences in the risk of adverse events between IB + salbutamol group and salbutamol alone group (RR 1.77; 95% CI 0.63–4.98).ConclusionIB + salbutamol may be more effective than salbutamol alone for the treatment of asthma in children and adolescents, especially in those with severe and moderate to severe asthma exacerbation. Future prospective research on these subgroup population are needed.

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