Effects of Early Intervention With Inhaled Budesonide on Lung Function in Newly Diagnosed Asthma

O’Byrne, Paul M.; Pedersen, Søren; Busse, William W.; Tan, Wan C.; Chen, Yuzhi; Ohlsson, Stefan V.; Ullman, Anders; Lamm, Carl Johan; Pauwels, Romain

doi:10.1378/chest.129.6.1478

Cited by 103 publications

(62 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our bivariate results that found older age, African American race, and higher BMI are associated with lower vitamin D levels have been seen in previous studies (14,15). Multiple previous studies have found that inhaled corticosteroids improve lung function (16). Our finding that children who are vitamin D deficient are more likely to have lower lung function is consistent with a previous study that demonstrated that in children with exerciseinduced bronchoconstriction, lower vitamin D levels were associated with reduced lung function (17).…”

Section: Discussionsupporting

confidence: 90%

Effect of Vitamin D and Inhaled Corticosteroid Treatment on Lung Function in Children

Tantisira

Fuhlbrigge

et al. 2012

Am J Respir Crit Care Med

120

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 90%

Effect of Vitamin D and Inhaled Corticosteroid Treatment on Lung Function in Children

Tantisira

Fuhlbrigge

et al. 2012

Am J Respir Crit Care Med

120

View full text Add to dashboard Cite

“…Our study suggests that discrepant findings may, at least partially, be due to a modulating effect of both ICSs and CDH1 SNPs on airway remodelling and lung function. As previous studies have shown, treatment with ICSs may reduce or control the intensity of airway remodelling, improve FEV1 and reduce loss of lung function [30][31][32].…”

Section: Discussionmentioning

confidence: 86%

E-cadherin gene polymorphisms in asthma patients using inhaled corticosteroids

et al. 2011

View full text Add to dashboard Cite

E-cadherins form intercellular junctions that maintain epithelial integrity. Epithelial integrity is impaired in asthma and can be restored by inhaled corticosteroids (ICSs). Our aim was to investigate the association of CDH1 gene polymorphisms (single-nucleotide polymorphisms (SNPs)) with airway remodelling, inflammation and forced expiratory volume in 1 s (FEV1) decline in asthma patients and assess whether ICSs modulate these effects.Bronchial biopsies of 138 asthmatics were available (population 1). Associations of 17 haplotype-tagging SNPs with epithelial E-cadherin expression, biopsy parameters and FEV1/vital capacity (VC) ratio were tested. FEV1 and VC data were collected in 281 asthmatics with 30-yr follow-up (population 2). Linear mixed-effect models were used to assess associations of SNPs with FEV1 decline.Seven out of the 17 SNPs were associated with airway remodelling, three with CD8+ T-cell counts, two with eosinophil counts and seven with FEV1 decline. All associations occurred only in patients using ICS. In general, alleles associated with less remodelling correlated with less FEV1 decline and higher FEV1/VC. Decreased epithelial E-cadherin expression was associated with five SNPs in non-ICS users.In conclusion, our data show that CDH1 polymorphisms are associated with epithelial Ecadherin expression and suggest that epithelial adhesion is an important contributor to airway remodelling and lung function in asthma. These effects are modified by the use of inhaled corticosteroids.

show abstract

“…Treatment with budesonide significantly improved prebronchodilator and postbronchodilator FEV 1 % predicted, and reduced the mean decline from baseline for postbronchodilator FEV 1 at both one year and three years (0.62% and 1.79% for budesonide, and 2.11% and 2.68% for placebo, respectively). These declines were greater in male patients, active smokers and patients older than 18 years of age; the smallest treatment effects were noted in adolescents (31).…”

Section: Impact Of Asthma Worsenings Impact On Lung Functionmentioning

confidence: 85%

“…The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study (31) examined the impact of low-dose inhaled budesonide on lung function in over 7000 patients (aged five to 66 years) with persistent asthma of less than two years' duration. Treatment with budesonide significantly improved prebronchodilator and postbronchodilator FEV 1 % predicted, and reduced the mean decline from baseline for postbronchodilator FEV 1 at both one year and three years (0.62% and 1.79% for budesonide, and 2.11% and 2.68% for placebo, respectively).…”

Section: Impact Of Asthma Worsenings Impact On Lung Functionmentioning

confidence: 99%

Asthma Worsenings: Approaches to Prevention and Management from the Asthma Worsenings Working Group

Balter

Ernst

Watson

et al. 2008

Canadian Respiratory Journal

View full text Add to dashboard Cite

A sthma is a variable disease characterized by periods of generally well-controlled asthma interspersed with worsenings and, if allowed to progress, more severe exacerbations. The current management of asthma focuses on achieving optimal asthma control through the use of recommended maintenance therapies such as inhaled corticosteroids (ICSs), leukotriene receptor antagonists (LTRAs), or ICS/ long-acting beta-2 agonist (LABA) combinations (1,2). Despite these treatments, asthma control remains suboptimal (3). Surveys of asthma patients have shown that the majority of those prescribed a combination ICS/LABA treatment or ICS therapy alone still experience periods of asthma worsenings requiring daily short-acting beta-2 agonist (SABA) therapy at least once per day, with high proportions reporting daytime symptoms, night-time awakenings and hospital admissions due to asthma (4-7). Furthermore, even those with well-controlled disease experience periods of asthma worsenings (4). A recent randomized trial of over 2000 asthma patients who had experienced an exacerbation in the previous year found that despite using moderate to high doses of combination ICS/LABA therapy, episodes of high reliever use on a single day were common and were often associated with a high subsequent risk of an exacerbation (8). AsthmA WorseninGs WorkinG Group©2008 Pulsus Group Inc. All rights reserved Most asthma patients prescribed maintenance asthma therapies still experience periods of asthma worsenings characterized by daytime or nighttime symptoms, or an increased need for rescue medication. In fact, these episodes are highly prevalent even in patients with well-controlled disease. Published literature suggests that asthma worsenings likely represent a window of opportunity during which patients could intervene early to prevent exacerbations or further deterioration of asthma symptoms. However, current evidence suggests that most patients fail to respond or to self-manage appropriately during these periods. To address the issue of asthma worsenings, an interdisciplinary committee of respirologists, allergists, family physicians, pharmacists and certified asthma educators from across Canada developed a practical definition of asthma worsenings and provided approaches to the prevention and management of these episodes based on current literature. To date, combination inhaled corticosteroid/long-acting beta-agonist therapy, particularly single inhaler maintenance and reliever therapy, appears to be an effective strategy for preventing asthma worsenings and exacerbations. Addressing the potential barriers to appropriate patient self-management of asthma worsenings, such as failure to adequately identify and respond to worsenings, low expectations for controlling asthma, low health literacy and poor patient-health care professional communication, are also critical to the successful prevention and management of these episodes. Finally, an interdisciplinary team approach involving patients and their families, certified asthma educators, primary c...

show abstract

Effects of Early Intervention With Inhaled Budesonide on Lung Function in Newly Diagnosed Asthma

Cited by 103 publications

References 22 publications

Effect of Vitamin D and Inhaled Corticosteroid Treatment on Lung Function in Children

Effect of Vitamin D and Inhaled Corticosteroid Treatment on Lung Function in Children

E-cadherin gene polymorphisms in asthma patients using inhaled corticosteroids

Asthma Worsenings: Approaches to Prevention and Management from the Asthma Worsenings Working Group

Contact Info

Product

Resources

About