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The Risks and Benefits of Indacaterol — The FDA's Review
In July 2011, the Food and Drug Administration (FDA) approved Arcapta Neohaler (indacaterol maleate powder), a long-acting beta-agonist (LABA), at a dose of 75 μg once daily as a bronchodilator for patients with chronic obstructive pulmonary disease (COPD). Since the European Medicines Agency (EMA)…
- December 15, 2011
- Chowdhury B.A., Seymour S.M., Michele T.M., et al.
- N Engl J Med 2011; 365:2247 - 2249
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In July, the FDA approved Arcapta Neohaler (indacaterol maleate powder), a long-acting beta-agonist, at a daily dose of 75 μg for chronic obstructive pulmonary disease. Why was this dose selected, after the European Medicines Agency approved 150-μg and 300-μg doses?
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Original Article
Daily or Intermittent Budesonide in Preschool Children with Recurrent Wheezing
Recurrent wheezing episodes in preschool-age children are usually triggered by respiratory tract infections,, which often progress to severe exacerbations requiring systemic glucocorticoids and frequent use of health care services. In children under the age of 5 years who had at least four wheezing…
- November 24, 2011
- Zeiger R.S., Mauger D., Bacharier L.B., et al.
- N Engl J Med 2011; 365:1990 - 2001
Guidelines suggest daily inhaled glucocorticoids in young children at high risk for asthma exacerbation. These investigators found that such treatment was not superior to the intermittent use of budesonide initiated when signs and symptoms indicated an impending asthma exacerbation.
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Review Article
Mechanisms of Disease: Filaggrin Mutations Associated with Skin and Allergic Diseases
Mutations in the filaggrin gene (FLG) are among the most common and profound single-gene defects identified to date in the causation and modification of disease. FLG encodes an important epidermal protein abundantly expressed in the outer layers of the epidermis. Approximately 10% of persons of…
- October 6, 2011
- Irvine A.D., McLean W.H.I., Leung D.Y.M.
- N Engl J Med 2011; 365:1315 - 1327
Mutations in the filaggrin gene are associated with a broad range of skin and allergic diseases. The biology of this molecule and the role of mutations in its altered function offer new insights into a range of conditions not previously thought to be related to one another.
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Original Article
Genomewide Association between GLCCI1 and Response to Glucocorticoid Therapy in Asthma
Asthma is a complex genetic syndrome that affects 300 million persons worldwide. The response to treatment is also genetically complex and is characterized by high intraindividual repeatability and high interindividual variability, with up to 40% of patients with asthma having no response to…
- September 29, 2011
- Tantisira K.G., Lasky-Su J., Harada M., et al.
- N Engl J Med 2011; 365:1173 - 1183
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Patients with asthma vary markedly in their clinical response to inhaled glucocorticoids. These investigators used a novel approach to identify a common variant in the glucocorticoid-induced transcript 1 gene associated with a decreased response to glucocorticoids.
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Editorial
A Step toward Personalized Asthma Treatment
Inhaled glucocorticoids are used every day by millions of patients with asthma. As with all asthma-controller treatments, there is marked patient-to-patient variability in the therapeutic response; about one in three patients with asthma who use inhaled glucocorticoids may not benefit from this…
- September 29, 2011
- Drazen J.M.
- N Engl J Med 2011; 365:1245 - 1246
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Inhaled glucocorticoids are used every day by millions of patients with asthma. As with all asthma-controller treatments, there is marked patient-to-patient variability in the therapeutic response¹; about one in three patients with asthma who use inhaled ...
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Editorial
Asthma Phenotypes and Interleukin-13 — Moving Closer to Personalized Medicine
Asthma is a chronic inflammatory disease of the airways manifested by reversible airflow obstruction and airway hyperresponsiveness. One of the challenges of treating patients with asthma is the known heterogeneity of the disease and differential responses to standard treatments.– For example, in…
- September 22, 2011
- Kraft M.
- N Engl J Med 2011; 365:1141 - 1144
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Asthma is a chronic inflammatory disease of the airways manifested by reversible airflow obstruction and airway hyperresponsiveness.¹ One of the challenges of treating patients with asthma is the known heterogeneity of the disease and differential ...
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Original Article
Lebrikizumab Treatment in Adults with Asthma
Asthma is a complex disease with marked heterogeneity in the clinical course and in the response to treatment.– Variability in the type of airway inflammation may underlie this heterogeneity.– Despite treatment with inhaled glucocorticoids, many patients continue to have uncontrolled asthma…
- September 22, 2011
- Corren J., Lemanske R.F., Hanania N.A., et al.
- N Engl J Med 2011; 365:1088 - 1098
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In this trial, patients with poorly controlled asthma despite inhaled glucocorticoid therapy were treated with lebrikizumab, an anti–IL-13 monoclonal antibody. Lebrikizumab was associated with improvement in FEV₁ overall, with greater improvements in patients with a positive IL-13 signature.
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Original Article
Active Albuterol or Placebo, Sham Acupuncture, or No Intervention in Asthma
Placebo effects (i.e. benefits resulting from simulated treatment or the experience of receiving care) are reported to improve signs and symptoms of many diseases in clinical trials and in clinical practice. On this basis, the accepted standards for clinical-trial design specify that the effects of…
- July 14, 2011
- Wechsler M.E., Kelley J.M., Boyd I.O.E., et al.
- N Engl J Med 2011; 365:119 - 126
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In patients with asthma, an active bronchodilator improved lung function; two inactive treatments and no intervention had no effect. The same patients reported subjective improvements after both inactive and active interventions but not after no intervention at all.
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Editorial
Meaningful Placebos — Controlling the Uncontrollable
In this issue of the Journal, Wechsler et al. report data from a study that compared four interventions involving patients with asthma (ClinicalTrials.gov number, NCT01143688). They found that three of the interventions — active albuterol, sham albuterol, and sham acupuncture — were all equally…
- July 14, 2011
- Moerman D.E.
- N Engl J Med 2011; 365:171 - 172
In this issue of the Journal, Wechsler et al.¹ report data from a study that compared four interventions involving patients with asthma (ClinicalTrials.gov number, NCT01143688). They found that three of the interventions — active albuterol, sham albuterol,...
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Perspective
Assessing the Safety of Adding LABAs to Inhaled Corticosteroids for Treating Asthma
Long-acting beta-agonists (LABAs) — drugs that provide bronchodilation for 12 hours or longer by stimulating the β2-adrenergic receptor — have been associated with serious adverse asthma outcomes such as asthma-related hospitalization, need for intubation, and even death in some patients. In…
- June 30, 2011
- Chowdhury B.A., Seymour S.M., Levenson M.S.
- N Engl J Med 2011; 364:2473 - 2475
The FDA has issued a requirement for manufacturers of long-acting beta-agonists (LABAs) marketed for asthma to conduct controlled clinical trials to assess the safety of a regimen of LABAs plus inhaled corticosteroids as compared with inhaled corticosteroids alone.
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Original Article
Effect of Bronchoconstriction on Airway Remodeling in Asthma
Asthma is a common chronic respiratory condition characterized clinically by an excessive tendency toward reversible airway narrowing. This may arise in response to everyday environmental exposure and is worsened both by intercurrent infection and, in sensitized persons, by allergen exposure. In…
- May 26, 2011
- Grainge C.L., Lau L.C.K., Ward J.A., et al.
- N Engl J Med 2011; 364:2006 - 2015
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Airway remodeling in asthma has been classically considered to be the result of inflammatory changes. In this study, the investigators show that bronchoconstriction alone can result in changes consistent with airway remodeling.
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Editorial
Physical Forces and Airway Remodeling in Asthma
Asthma is a disease of the airways characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Asthma is also accompanied by changes to the structure and composition of the airway walls, collectively termed airway remodeling. Cardinal features of airway…
- May 26, 2011
- Tschumperlin D.J.
- N Engl J Med 2011; 364:2058 - 2059
Asthma is a disease of the airways characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Asthma is also accompanied by changes to the structure and composition of the airway walls, collectively termed ...
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Perspective
Statistics in Medicine: Pragmatic Trials — Guides to Better Patient Care?
Although randomized clinical trials provide essential, high-quality evidence about the benefits and harms of medical interventions, many such trials have limited relevance to clinical practice. The investigations are often framed in ways that fail to address patients' and clinicians' actual…
- May 5, 2011
- Ware J.H. and Hamel M.B.
- N Engl J Med 2011; 364:1685 - 1687
Because of concerns about the real-world applicability of clinical trials and about improving the quality and value of health care, “pragmatic” trials are attracting increasing attention. These trials have both important strengths and inherent limitations.
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Original Article
Leukotriene Antagonists as First-Line or Add-on Asthma-Controller Therapy
Results of double-blind, randomized, controlled trials provide, appropriately, the bedrock of evidence in determining the efficacy of therapeutic interventions. Proof of efficacy in the trial setting of optimized adherence and follow-up for selective patient populations does not, however, guarantee…
- May 5, 2011
- Price D., Musgrave S.D., Shepstone L., et al.
- N Engl J Med 2011; 364:1695 - 1707
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In this pragmatic trial, patients with asthma who required first-line controller therapy or were already using an inhaled glucocorticoid and needed additional therapy received a leukotriene-receptor antagonist (LTRA) or an inhaled glucocorticoid as first-line treatment or an LTRA or a long-acting beta₂-agonist as an add-on.
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Editorial
Asthma Treatment Guidelines Meet the Real World
Asthma is a common reason for seeking medical care; it is the most frequent medical handicap among children. Because it is so common, most patients with asthma are treated by generalists and family physicians. Guidelines for treating asthma are built on results from randomized, tightly controlled…
- May 5, 2011
- Dahlén S.-E., Dahlén B., Drazen J.M.
- N Engl J Med 2011; 364:1769 - 1770
Asthma is a common reason for seeking medical care; it is the most frequent medical handicap among children. Because it is so common, most patients with asthma are treated by generalists and family physicians. Guidelines for treating asthma are built on ...
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Original Article
Randomized Trial of Omalizumab (Anti-IgE) for Asthma in Inner-City Children
Studies of inner-city children, adolescents, and young adults with asthma show that symptom control is improved and exacerbations are decreased when there is either a reduction in household exposure to allergens or aggressive implementation of guidelines-based therapy. Nonetheless, achieving…
- March 17, 2011
- Busse W.W., Morgan W.J., Gergen P.J., et al.
- N Engl J Med 2011; 364:1005 - 1015
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In this study, the introduction of guidelines-based therapy in all children decreased the number of days per fortnight that children had asthma symptoms. Treatment with omalizumab resulted in fewer days with asthma symptoms than placebo.
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Perspective
Collaborative Clinical Trials
Ongoing improvement in health care requires, among other things, the introduction of new therapies that have been evaluated in clinical trials. Unfortunately, the clinical trial environment is facing a crisis, produced by burgeoning costs, burdensome regulatory requirements, and other factors that…
- March 3, 2011
- Moss A.J., Francis C.W., Ryan D.
- N Engl J Med 2011; 364:789 - 791
Burgeoning costs, burdensome regulatory requirements, and other factors are reducing the likelihood of successfully completing pivotal clinical trials. Conducting clinical trials in a collaborative manner would overcome many of these problems.
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Editorial
Barnyard Microbes and Childhood Asthma
It is easy to imagine why children who are raised on farms might grow up healthy: there is plenty of fresh air, exercise, and exposure to sunlight. In fact, studies from Europe, North America, and Australasia provide convincing evidence that allergic diseases and asthma are less likely to develop…
- February 24, 2011
- Gern J.E.
- N Engl J Med 2011; 364:769 - 770
It is easy to imagine why children who are raised on farms might grow up healthy: there is plenty of fresh air, exercise, and exposure to sunlight. In fact, studies from Europe, North America, and Australasia provide convincing evidence that allergic ...
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Original Article
Exposure to Environmental Microorganisms and Childhood Asthma
Environmental exposure to microorganisms has repeatedly been found to be inversely related to the manifestation of atopic diseases such as asthma and hay fever. This observation has been made in various contexts, including the studies conducted in the Republic of Karelia (Russia) and North Karelia (…
- February 24, 2011
- Ege M.J., Mayer M., Normand A.-C., et al.
- N Engl J Med 2011; 364:701 - 709
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Growing up on a farm protects children from asthma. In this study, the investigators show that the diversity of microbial exposure of farm children as compared with children in the reference group can explain the observed protective effect.
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Editorial
Anticholinergics for Patients with Asthma?
Current guidelines for treating patients with asthma whose symptoms are not controlled by a low dose of an inhaled glucocorticoid alone recommend either doubling the glucocorticoid dose or adding a long-acting beta-agonist (LABA). However, inhaled glucocorticoids have a relatively flat…
- October 28, 2010
- Smith L.J.
- N Engl J Med 2010; 363:1764 - 1765
Current guidelines for treating patients with asthma whose symptoms are not controlled by a low dose of an inhaled glucocorticoid alone recommend either doubling the glucocorticoid dose or adding a long-acting beta-agonist (LABA).¹ However, inhaled ...
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Browse Asthma

Showing 1 to 20 of 463 Articles

Filter Results

The Risks and Benefits of Indacaterol — The FDA's Review

Daily or Intermittent Budesonide in Preschool Children with Recurrent Wheezing

Mechanisms of Disease: Filaggrin Mutations Associated with Skin and Allergic Diseases

Genomewide Association between GLCCI1 and Response to Glucocorticoid Therapy in Asthma

A Step toward Personalized Asthma Treatment

Asthma Phenotypes and Interleukin-13 — Moving Closer to Personalized Medicine

Lebrikizumab Treatment in Adults with Asthma

Active Albuterol or Placebo, Sham Acupuncture, or No Intervention in Asthma

Meaningful Placebos — Controlling the Uncontrollable

Assessing the Safety of Adding LABAs to Inhaled Corticosteroids for Treating Asthma

Effect of Bronchoconstriction on Airway Remodeling in Asthma

Physical Forces and Airway Remodeling in Asthma

Statistics in Medicine: Pragmatic Trials — Guides to Better Patient Care?

Leukotriene Antagonists as First-Line or Add-on Asthma-Controller Therapy

Asthma Treatment Guidelines Meet the Real World

Randomized Trial of Omalizumab (Anti-IgE) for Asthma in Inner-City Children

Collaborative Clinical Trials

Barnyard Microbes and Childhood Asthma

Exposure to Environmental Microorganisms and Childhood Asthma

Anticholinergics for Patients with Asthma?

Medical Meetings Conferences and Meetings

American Association for the Study of Liver Diseases

Trends: Most Viewed (Last Week)