The efficacy and safety of fluticasone/salmeterol compared to fluticasone in children younger than four years of age

Yoshihara, Shigemi; Tsubaki, Toshikazu; Ikeda, Masanori; Lenney, Warren; Tomiak, R. H. H.; Hattori, Takako; Hashimoto, Kazuhito; Soutome, Toru; Kato, Shihona

doi:10.1111/pai.13010

Cited by 19 publications

(19 citation statements)

References 23 publications

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“…The annual exacerbation rate of our patients was rather constant during the past 10 years although there was a significant treatment switch of our hospital policy from ICS to an ICS + LABA combination, which was successfully implemented as set up treatment in uncontrolled asthma of school children (30) (Figure 2). Although the number of patients with adherence to treatment was small, our data are in accordance with two recent reports which showed that the ICS + LABA combination was not superior to ICS alone in pre-school asthma (23,24).…”

Section: Discussionsupporting

confidence: 91%

“…ICS dose did not reduce the rate of severe asthma exacerbations and may be associated with diminished linear growth (21,22). In addition, in children with persistent asthma, the combination of ICS and additional long acting beta agonists (LABA) was not associated with a significant reduction of exacerbations requiring systemic steroids (23,24).…”

Section: Introductionmentioning

confidence: 99%

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Hospitalization, Asthma Phenotypes, and Readmission Rates in Pre-school Asthma

et al. 2020

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Objective: Children with pre-school asthma suffer disproportionally more often from severe asthma exacerbations with emergency visits and hospital admissions compared to school children. Despite this high disease burden, there are only a few reports looking at this particular severe asthma cohort. Similarly, there is little real-life research on the distribution of asthma phenotypes and personalized treatment at discharge in this age group.Patients and Methods: Retrospective analysis of the electronic charts of all children aged 1–5 years with asthma hospitalizations (ICD J45) at the Frankfurt University between 2008 and 2017. An acute severe asthma exacerbation was defined as dyspnea, oxygen demand, and/or systemic steroid therapy. Age, gender, duration of hospitalization, asthma phenotype, treatment, and readmission rate were analyzed.Results: Of 572 patients, 205 met the definition of acute severe asthma. The phenotypic characterization showed 56.1% had allergic asthma, 15.2% eosinophilic asthma and 28.7% non-allergic asthma. Of these patients, 71.7% were discharged with inhaled corticosteroids (ICS) or ICS + long-acting-beta-agonists (LABA), 15.1% with leukotriene antagonists (LTRA) and 7.3% salbutamol on demand. The rate of emergency presentations (emergency department and readmission) within 12 months after discharge was high (n = 42; 20.5%). No phenotype tailored treatment was detectable. Neither the number of eosinophils (>300/μl) nor the treatment at discharge had an effect on emergency visits and readmission rate.Conclusion: Despite protective therapy with ICS, ICS + LABA, or LTRA, the readmission rate was high. Thus, current care and treatment strategies should be reevaluated continuously, in order to better control asthma in pre-school children and prevent hospitalization.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Hospitalization, Asthma Phenotypes, and Readmission Rates in Pre-school Asthma

et al. 2020

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“…We emphasize that there have been very few studies evaluating the efficacy and safety of the use of this combination in this age group. (47,70,71) In this situation, referring the patient to a specialist should be considered.…”

Section: Maintenance Therapymentioning

confidence: 99%

2020 Brazilian Thoracic Association recommendations for the management of asthma

et al. 2020

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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.

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“…A short-term (8 week) placebo-controlled study did not show any significant difference in symptoms between combination fluticasone propionate-salmeterol vs fluticasone propionate alone; no additional safety signals were noted in the group receiving LABA. 674…”

Section: Not Recommendedmentioning

confidence: 99%

Epidemiología del asma en adultos. Una visión introspectiva

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Zunino

Heras

et al. 2021

RAM

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Antecedentes: El asma es una enfermedad crónica de gran impacto en la salud pública y en la calidad de vida de los pacientes. En Latinoamérica existen escasos estudios epidemiológicosObjetivo: Describir la prevalencia del asma y las características clínico-demográficas en una población adulta de un sistema de salud privado de la ciudad de Buenos Aires.Métodos: Estudio de corte transversal de adultos afiliados al programa médico de un sistema de salud privado de Buenos Aires, entre el 1 de enero de 2017 y 1 de enero de 2018, con diagnóstico médico de asma. Resultados: La prevalencia de asma en pacientes adultos de un sistema de salud prepago en la ciudad de Buenos Aires fue de 6 % (n = 66, IC 95 % = 5-7) y de asma grave de 5 % (n = 3 IC 95 % = 1-13) La mayoría de los pacientes presentaron asma intermitente y leve. Conclusión: El estudio aporta nuevos datos sobre la epidemiología del asma en la región.

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The efficacy and safety of fluticasone/salmeterol compared to fluticasone in children younger than four years of age

Cited by 19 publications

References 23 publications

Hospitalization, Asthma Phenotypes, and Readmission Rates in Pre-school Asthma

Hospitalization, Asthma Phenotypes, and Readmission Rates in Pre-school Asthma

2020 Brazilian Thoracic Association recommendations for the management of asthma

Epidemiología del asma en adultos. Una visión introspectiva

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