THE EFFICACY OF COMBINED THERAPY IN PATIENTS WITH NEUTROPHILIC BRONCHIAL ASTHMA

THE EFFICACY OF COMBINED THERAPY IN PATIENTS WITH NEUTROPHILIC BRONCHIAL ASTHMA Yu. I. Feshchenko, L. A. Iashyna, G. L. Gumeniuk, V. I. Ignatieva, M. A. Polianska, S. G. Opimakh, I. V. Zvol, S. M. Moskalenko, N. A. Vlasova, L. A. Halai State organization «F. G. Yanovsky National institute of phthisiology and pulmonology National Academy of medical sciences of Ukraine» , Kyiv, Ukraine Abstract. Background: Issues of neutrophilic bronchial asthma remain unresolved and the investigations of the pathogenesis and treatment of this disease endotype are currently continuing. The aim of the study: This study aimed to develop the technology of the treatment of the neutrophilic asthma with the use of available drugs in Ukraine. Methods. The study involved 30 patients with neutrophilic asthma. The first (control) group consisted of 15 patients who received standard therapy with a combination of budesonide and formoterol. The second (main) group consisted of 15 patients who received the treatment according the technology (ultrafine beclomethasone dipropionate, formoterol, tiotropium bromide and additionally for the first 10 days — inhalation of 10.0 % acetylcysteine solution through a nebulizer). All patients were surveyed with the Asthma Control Test (ACT), the Asthma Control Questionnaire (ACQ). The quality of life of patients was assessed by a St. George’s Respiratory Questionnaire. All patients underwent spirometry and a 6-minute walking test (6MWT). Results: In the prescription of complex therapy to patients with neutrophilic asthma clinical and functional efficacy was achieved in 93.3 % of patients. There were observed statistically significant increase in the ACT from (14.3 ± 1.3) to (20.3 ± 0.8) points (p < 0.05), a decrease in the ACQ from (2.3 ± 0.2) ) to (1.1 ± 0.1) points (p < 0.05), clinically significant reduction in the number of symptoms from (71.4 ± 5.6) points to (51.3  5.0) points, p < 0.05 according to the results of the St. George’s Respiratory Questionnaire, and a statistically significant increase in MEF50 from (28.9 ± 4.5) % to (41.6 ± 4.2) %, p < 0.05, MEF25 — from (19.1 ± 2.9) % to (27.6 ± 2.6) %, p < 0.05 and FEV1 /FVC from (67.2 ± 3.5) % to (76.1 ± 2.3) %, p < 0.05 after 3 months of complex treatment, as well as a statistically significant increase in the number of meters passed in the 6MWT from (266.3 ± 16.2) m to (312.0 ± 14.4) m, p < 0.05, reduction of shortness of breath on the Borg scale before test from (2.5  0.3) points to (1.5 ± 0.1) points, p < 0.05 and after the test — from (4.1 ± 0.3) points to (3.1 ± 0.3) points, p < 0.05. Conclusions: The technology of treatment of patients with neutrophilic asthma allows to improve the control of the asthma symptoms and quality of life of the patients, bronchial patency at the small airways and reduce fixed bronchial obstruction, as well as increase exercise tolerance. Key words: bronchial asthma, neutrophilic inflammation, combined therapy.

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Seasonal Indicators of Blood Pressure, Data of Asthma Control Questionnaires and Quality of Life in Hypertensive Patients with Bronchial Asthma

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2019-15-6-831-839 ◽

2020 ◽

Vol 15 (6) ◽

pp. 831-839

Author(s):

G. F. Andreeva ◽

M. I. Smirnova ◽

V. M. Gorbunov ◽

A. S. Kurekhyan ◽

Ya. N. Koshelyaevskaya

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Bronchial Asthma ◽

Main Group ◽

Control Group ◽

Seasonal Fluctuations ◽

Hypertensive Patients ◽

Quality Of Life Indicators ◽

Different Seasons

Aim. To study the seasonal indicators of quality of life and control of bronchial asthma in hypertensive patients with bronchial asthma, observed by a cardiologist of the state outpatient institution.Material and methods. Data from a prospective cohort study of hypertensive patients, some of which had bronchial asthma without exacerbation, were analyzed. Patients who were observed by a cardiologist at a state outpatient clinic took part in the study. There were other concomitant diseases that occurred in the participants, in addition to hypertension and bronchial asthma. Two groups of patients were formed: the control group (n=85) included patients with hypertension only, the main group (n=40) included hypertension and bronchial asthma. Patients had 3 visits: initial one, and after 6 and 12 months and then data on outcomes (30.1Ѓ}7.6 months of follow-up) were collected. The first and third visits included clinical measurements of blood pressure (BP), 24-hour BP monitoring, spirometry, clinical and biochemical blood tests, a standard survey, survey with questionnaires evaluating the control of bronchial asthma (Asthma Control Questionnaire; ACQ) and the patients quality of life (General Well-Being Questionnaire; GWBQ). The second visit included clinical BP and ACQ and GWBQ questionnaires. A comparison of the average indicators from the total number of observations carried out in winter, spring, summer and autumn periods has been performed.Results. Hypertensive patients with/without bronchial asthma (n=125; 28 men, 97 women, average age 62.6Ѓ}8.8 years, duration of hypertension – 11.6Ѓ}8.6, duration of bronchial asthma – 9.3Ѓ}11.9 years) took part in the study. Outpatient BP levels throughout the study period were maintained at target values in both groups. It was shown that seasonal BP levels do not differ in the compared groups, except for winter indicators: winter daytime systolic BP levels were higher in the main group (p=0.03). Seasonal fluctuations in BP were not detected in the control group, however, they were present in the patients of the main group: winter daytime levels of diastolic BP and average daily levels of diastolic BP and systolic BP were higher than summer ones, and winter daytime systolic BP values (p<0.05) and clinical diastolic BP (p=0.004) – higher than autumn levels. Seasonal quality of life indicators in the main group were worse than in the control group in all seasons. Significant seasonal dynamics of quality of life indicators in patients in two groups was not detected. The ACQ questionnaire showed that asthma control changed in different seasons in accordance with the ACQ total score: in winter and spring – uncontrolled bronchial asthma (total score >1.5), in summer and autumn – partially controlled (total score ≤1.5). During the analysis of various factors associated with the combined primary endpoint (death, transient ischemic attack, angina pectoris, cardiac arrhythmias, arterial revascularization), relationships with quality of life indicators were revealed: negative connections – with indicators characterizing positive psychological health, mood at visit, positive correlations – with psychological abilities.Conclusion: Seasonal fluctuations in ambulatory BP levels were not found in the control group and were found in the main group. The quality of life indicators for patients of the main group were significantly worse than in the control group for all components in all seasons. The control of asthma changed in different seasons in accordance with the ACQ total score: uncontrolled bronchial asthma occurred in winter and spring, partially controlled – in summer and autumn. Correlations of the combined primary endpoint with quality of life indicators were found after analyzing various factors.

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Asthma in Adolescents: A Randomized, Controlled Trial of an Asthma Program for Adolescents and Young Adults with Severe Asthma

Canadian Respiratory Journal ◽

10.1155/2002/106262 ◽

2002 ◽

Vol 9 (4) ◽

pp. 253-259 ◽

Cited By ~ 21

Author(s):

Robert L Cowie ◽

Margot F Underwood ◽

Cinde B Little ◽

Ian Mitchell ◽

Sheldon Spier ◽

...

Keyword(s):

Quality Of Life ◽

Emergency Department ◽

Randomized Controlled Trial ◽

Asthma Control ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Randomized Controlled ◽

Disease Specific

BACKGROUND: Asthma is common and is often poorly controlled in adolescent subjects.OBJECTIVE: To determine the impact of an age-specific asthma program on asthma control, particularly on exacerbations of asthma requiring emergency department treatment, and on the quality of life of adolescents with asthma.METHODS: The present randomized, controlled trial included patients who were 15 to 20 years of age and had visited emergency departments for management of their asthma. The interventional group attended an age-specific asthma program that included assessment, education and management by a team of asthma educators, respiratory therapists and respiratory physicians. In the control group, spirometry was performed, and the patients continued to receive usual care from their regular physicians. The outcomes were assessed by a questionnaire six months after entry into the study.RESULTS: Ninety-three subjects entered the study and were randomly assigned to the intervention or control group. Of these, only 62 patients were available for review after six months. Subjects in both the control and the intervention groups showed a marked improvement in their level of asthma control, reflected primarily by a 73% reduction in the rate of emergency department attendance for asthma. Other indexes of disease control, including disease-specific quality of life, as assessed by questionnaires, were improved. There was, however, no discernible difference between the subjects in the two groups, with the exception of an improvement in favour of the intervention group in the symptom (actual difference 0.7, P=0.048) and emotional (actual difference 0.8, P=0.028) domains of the asthma quality of life questionnaire. The overall quality of life score favoured the intervention group by a clinically relevant difference of 0.6, but this difference did not reach statistical significance (P=0.06).CONCLUSIONS: Although all subjects demonstrated a significant improvement in asthma control and quality of life, the improvement attributable to this intervention was limited to two domains in disease-specific quality of life.

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FEATURES OF BRONCHIAL ASTHMA CONTROL AND COURSE IN CHILDREN WITH AN ALTERNATIVE ONSET OF THE DISEASE

Eastern Ukrainian Medical Journal ◽

10.21272/eumj.2020;8(4):383-392 ◽

2020 ◽

Vol 8 (4) ◽

pp. 383-392

Author(s):

О.К. Koloskova ◽

Т.М. Bilous ◽

N.O. Shevchenko ◽

V.V. Bilous

Keyword(s):

Quality Of Life ◽

Respiratory Tract ◽

Medical Care ◽

Asthma Control ◽

Bronchial Asthma ◽

Diagnostic Procedures ◽

Individualized Treatment ◽

Economic Losses ◽

Non Invasive

Despite the large number of studies on the diagnosis and treatment of asthma and the constant updating of recommendations for the provision of medical care to patients with asthma, this disease still has a significant impact on the quality of life of patients and their families and significant economic losses. However, the peculiarities of bronchial asthma and the diagnosis of certain phenotypes of the disease in children, depending on biomarkers of inflammatory activity in the airways, require greater use of non-invasive diagnostic procedures and optimization of individualized treatment depending on the nature and intensity of inflammation in the respiratory tract.

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Effect of vitamin D supplementation on asthma control in patients with vitamin D deficiency: the ACVID randomised clinical trial

Thorax ◽

10.1136/thoraxjnl-2019-213936 ◽

2020 ◽

pp. thoraxjnl-2019-213936

Author(s):

Rubén Andújar-Espinosa ◽

Lourdes Salinero-González ◽

Fátima Illán-Gómez ◽

Manuel Castilla-Martínez ◽

Chunshao Hu-Yang ◽

...

Keyword(s):

Quality Of Life ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Asthma Control ◽

Intervention Group ◽

Vitamin D Supplementation ◽

Control Group ◽

Asthmatic Patients ◽

Secondary Endpoints

BackgroundThe relationship between asthma and vitamin D deficiency has been known for some time. However, interventional studies conducted in this regard have shown conflicting results.ObjectiveTo evaluate the efficacy of vitamin D supplementation in asthmatic patients in improving the degree of control of asthma.MethodsRandomised, triple-blind, placebo-controlled, parallel-group study in adult asthmatic patients with serum 25-hydroxyvitamin-D3 <30 ng/mL. The intervention group received oral supplementation with 16 000 IU of calcifediol per week, and the control group had placebo added to their usual asthma treatment. The study period was 6 months. The primary endpoint was the degree of asthma control as determined by the asthma control test (ACT). Secondary endpoints included quality of life measured using the mini Asthma Quality of Life Questionnaire, the number of asthma attacks, oral corticosteroid cycles, the dose of inhaled corticosteroids, number of emergency visits, unscheduled consultations with the primary care physician and hospitalisations for asthma.ResultsOne hundred and twelve patients were randomised (mean age 55 years, with 87 (78%) being women). Of the 112 patients, 106 (95%) completed the trial. Half the patients (56) were assigned to the intervention group and the other half to the control group. A statistically significant clinical improvement was observed in the intervention group (+3.09) compared with the control group (−0.57) (difference 3.66 (95% CI 0.89 to 5.43); p<0.001) as measured using ACT scores. Among the secondary endpoints, a significant improvement in the quality of life was found in the intervention group (5.34), compared with the control group (4.64) (difference 0.7 (95% CI 0.15 to 1.25); p=0.01).ConclusionAmong adults with asthma and vitamin D deficiency, supplementation with weekly oral calcifediol compared with placebo improved asthma control over 6 months. Further research is needed to assess long-term efficacy and safety.Trial registration numberNCT02805907.

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Efficacy of air purifier therapy for patients with allergic asthma

10.21203/rs.2.11196/v1 ◽

2019 ◽

Author(s):

Jiaying LUO ◽

Zhao Chen ◽

Li-li Ou ◽

Xin-yuan Lin ◽

Hai-cheng Liu ◽

...

Keyword(s):

Quality Of Life ◽

Treatment Group ◽

Allergic Asthma ◽

Asthma Control ◽

Control Group ◽

Control Test ◽

Asthma Control Test ◽

Air Purifier ◽

Der P1

Abstract Background and Objectives: The prevalence of allergic disease, which has a severely negative effect on patients' quality of life, has been increasing in recent years. Environmental intervention is internationally regarded as a feasible method for controlling asthma. Thus, this study aimed to evaluate the efficacy of air purifier therapy for patients with allergic asthma. Methods: In total, 38 subjects were divided into a treatment group and a control group. All subjects were under the age of eighteen years and had been clinically diagnosed with allergic asthma. The treatment group used High Efficiency Particulate Air (HEPA) air purifiers for six consecutive months, and the control group did not use the air filters. Particulate matter (PM) data and dust samples (bedding and a static point) were collected from the subjects' bedrooms before they started to use the air purifiers and each month thereafter. Simultaneously, the subjects were asked to complete a questionnaire for the Asthma Control Test (ACT) or Childhood Asthma Control Test (C-ACT). Fractional exhaled nitric oxide (FENO) tests were performed at the start and end of the study. The concentrations of Der p1 and Der f1 were measured in the dust samples. Results: 1. After utilizing an air purifier, the concentrations of house dust mite (HDM) allergens (Der p1+ Der f1) in the bedding and static samples decreased by 68.3% and 71.0%, respectively. In addition, the PMindoor/outdoor levels significantly decreased. 2. The ACT and C-ACT scores in the treatment group maintained a steady significant upward trend. 3. At the end of the study, the FENO levels in both groups were lower, although the differences were not significant. Conclusions: HEPA air purifiers are able to decrease indoor HDM allergen and PM levels and improve quality of life in allergic asthma patients.

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PENGARUH PEMBERIAN INHALASI KOMBINASI SALMETEROL/FLUTIKASON PROPIONAT TERHADAP KUALITAS HIDUP PENDERITA PENYAKIT PARU OBSTRUKTIF KNONIK STABIL

Jurnal Penelitian Kesmasy ◽

10.36656/jpksy.v1i2.155 ◽

2019 ◽

Vol 1 (2) ◽

pp. 28-33

Author(s):

Refi Sulistiasari

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Treatment Group ◽

Control Group ◽

Copd Assessment Test ◽

Copd Patients ◽

Significant Difference ◽

Inhaled Therapy ◽

St George's Respiratory Questionnaire

It is known that inflammation is the underlying cause of COPD, and this affects to quality of life of the patient. Provision of inhaled therapy combination of LABA and corticosteroids is one of therapy in pharmacology of stable PPOK patients. The aim of this study was to know the benefits of inhalation of 50 g / fluticasone propionate 500 g inhibition in stable COPD patients. The research design is clinical trial. The study was conducted for 3 months and was performed on 26 stable COPD patients divided into two groups: 15 patients for the treatment group and 15 patients for the control group. After the measurements were obtained, there was a significant difference in the quality of life as measured by St. George's Respiratory Questionnaire (SGRQ) (p = 0.001) and COPD Assessment Test (CAT) (0.001) measurements were made twice on the first and thirtieth days.

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Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

10.21203/rs.3.rs-403514/v1 ◽

2021 ◽

Author(s):

Soraia Nogueira Felix ◽

Rosana Camara Agondi ◽

Marcelo Vivolo Aun ◽

Clarice Rosa Olivo ◽

Francine Maria de Almeida ◽

...

Keyword(s):

Quality Of Life ◽

Asthma Control ◽

Educational Intervention ◽

Intervention Group ◽

Educational Activity ◽

Control Group ◽

Life Questionnaire ◽

Asthmatic Patients ◽

Quality Life

Abstract This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 minutes applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 after bronchodilatation and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in the IG compared to the CG. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.

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Functional state of the small airways in patients with bronchial asthma associated with obesity

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.01.000031 ◽

2019 ◽

Vol 91 (1) ◽

pp. 61-63 ◽

Cited By ~ 1

Author(s):

E E Mineeva ◽

M V Antonyuk ◽

A V Yurenko ◽

T A Gvozdenko

Keyword(s):

Respiratory Tract ◽

Bronchial Asthma ◽

Forced Expiratory Volume ◽

Control Group ◽

Bronchial Obstruction ◽

Small Airways ◽

Average Flow Velocity ◽

Residual Capacity ◽

Normal Body Weight ◽

Bronchial Resistance

Aim. To assess the functional status of the small Airways in patients with bronchial asthma associated with obesity, by body plethysmography. Materials and methods. 65 patients with bronchial asthma of mild severity, partially controlled course, including 30 patients with normal body weight and 35 patients with obesity of I degree were examined. Control group-30 healthy volunteers. Examined forced vital capacity (FVC), forced expiratory volume in first second (FEV1) ratio of FEV1 to FVC (FEV1/FVC), maximum volumetric exhalation rate after 25.50 and 75% FVC (MEF75, MEF50, MEF25), average flow velocity in the exhalation interval 25-75% of FVC (MMEF25-75). Method bodyplethysmography was evaluated in bronchial resistance, functional residual capacity (FRC), residual volume of the lungs (RV), total lung capacity (TLC), the percentage of RV/TLC. Results. Patients with bronchial asthma with obesity showed a reduction of indicators of bronchial obstruction: FEV1 of 14% (p=0.02), FEV1/FVC by 14% (p=0.001), MEF75 30% (p=0.001), MEF50 by 35% (p=0.001), MEF25 by 44% (p=0.003), MMEF25-75 by 38% (p=0.001). The increase of bronchial resistance on inhalation in 2 times (p=0.001), on exhalation in 3.3 times (p=0.003) was found, which is typical for generalized bronchial obstruction at the proximal level. An increase in RV by 24% (p=0.03), TLC - by 9% (p=0.03), RV/TLC - by 18% (p=0.03), indicating the presence of "air traps" and dysfunction of the small respiratory tract. Conclusion. In patients with asthma of mild severity associated with obesity, both the central bronchis and the distal lung are affected, which are manifested by generalized bronchial obstruction, the formation of "air traps" and dysfunction of the small respiratory tract.

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Bronchial asthma control, quality of life, and psychiatric disorders vicious cycle: Asyut society point of view

Egyptian Journal of Bronchology ◽

10.1186/s43168-021-00107-5 ◽

2022 ◽

Vol 16 (1) ◽

Author(s):

Samiaa Hamdy Sadek ◽

Maha Mohamed El-kholy ◽

Fareda Ahmed Mohammed ◽

Reham Mohammed El-Morshedy

Keyword(s):

Quality Of Life ◽

Psychiatric Disorders ◽

Asthma Control ◽

Bronchial Asthma ◽

Hospital Admissions ◽

Symptom Control ◽

Anxiety And Depression ◽

Asthma Patients ◽

Healthy Control

Abstract Background Poorly controlled bronchial asthma limits patients’ quality of life (QOL), the condition which may potentiate the development of psychiatric disorders. The aim of this study was the assessment of anxiety and depression in bronchial asthma patients, and their interrelation with both level of asthma control and quality of life in our society. Results This study included 102 bronchial asthma patients, and 50 healthy control individuals. Patients had poorer QOL, and higher anxiety and depression scores compared to healthy control, moreover these scores were higher in uncontrolled asthma patients compared to controlled group. Poor QOL, frequent hospital admissions, and poor asthma control were the predictors for psychiatric disorders. Conclusion Depression and anxiety are frequently encountered in patients with bronchial asthma in our society; poor symptom control, poor QOL, and frequent hospital admissions are the main predictors for these psychiatric disorders.

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PENGARUH PEMBERIAN INHALASI KOMBINASI SALMETEROL/FLUTIKASON PROPIONAT TERHADAP KUALITAS HIDUP PENDERITA PENYAKIT PARU OBSTRUKTIF KNONIK STABIL

Jurnal Penelitian Kesmasy ◽

10.36656/jpksy.v1i2.88 ◽

2019 ◽

Vol 1 (2) ◽

pp. 28-33

Author(s):

Refi Sulistiasari

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Treatment Group ◽

Control Group ◽

Copd Assessment Test ◽

Copd Patients ◽

Significant Difference ◽

Inhaled Therapy ◽

St George's Respiratory Questionnaire

It is known that inflammation is the underlying cause of COPD, and this affects to quality of life of the patient. Provision of inhaled therapy combination of LABA and corticosteroids is one of therapy in pharmacology of stable PPOK patients. The aim of this study was to know the benefits of inhalation of 50 mg / fluticasone propionate 500 mg inhibition in stable COPD patients. The research design is clinical trial. The study was conducted for 3 months and was performed on 26 stable COPD patients divided into two groups: 15 patients for the treatment group and 15 patients for the control group. After the measurements were obtained, there was a significant difference in the quality of life as measured by St. George's Respiratory Questionnaire (SGRQ) (p = 0.001) and COPD Assessment Test (CAT) (0.001) measurements were made twice on the first and thirtieth days.

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