Once-Daily Tiotropium Reduces Risk of Exacerbations and Asthma Worsening in Patients With Symptomatic Asthma Despite Treatment With Inhaled Corticosteroids and Long-Acting β 2 -Agonists

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 90A ◽  
Author(s):  
Donald P Tashkin ◽  
Petra Moroni-Zentgraf ◽  
Michael Engel ◽  
Hendrik Schmidt ◽  
Huib AM Kerstjens
Keyword(s):  
Inhaled Corticosteroids ◽  
Once Daily ◽  
Symptomatic Asthma ◽  
Long Acting

Once-Daily Tiotropium Is Well Tolerated as Add-On to Standard Treatment for Patients With Symptomatic Asthma Despite Receiving Inhaled Corticosteroids and Long-Acting β 2 -Agonists

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 89A ◽  
Author(s):  
Jonathan A Bernstein ◽  
Huib AM Kerstjens ◽  
Petra Moroni-Zentgraf ◽  
Michael Engel ◽  
Hendrik Schmidt ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Inhaled Corticosteroids ◽  
Once Daily ◽  
Symptomatic Asthma ◽  
Long Acting

Once-daily fluticasone furoate is efficacious in patients with symptomatic asthma on low-dose inhaled corticosteroids

2012 ◽  
Vol 109 (5) ◽  
pp. 353-358.e4 ◽  
Author(s):  
Eugene R. Bleecker ◽  
Eric D. Bateman ◽  
William W. Busse ◽  
Ashley Woodcock ◽  
Lucy Frith ◽  
...  
Keyword(s):  
Low Dose ◽  
Inhaled Corticosteroids ◽  
Fluticasone Furoate ◽  
Once Daily ◽  
Symptomatic Asthma

β 2-Adrenoceptor polymorphism and bronchoprotective sensitivity with regular short- and long-acting β2-agonist therapy

1999 ◽  
Vol 96 (3) ◽  
pp. 253-259 ◽  
Author(s):  
B. J. LIPWORTH ◽  
I. P. HALL ◽  
I. AZIZ ◽  
K. S. TAN ◽  
A. WHEATLEY
Keyword(s):  
Inhaled Corticosteroids ◽  
Forced Expiratory Volume ◽  
Double Blind ◽  
Geometric Means ◽  
Once Daily ◽  
Regular Treatment ◽  
Parallel Group ◽  
Long Acting ◽  
To Receive ◽  
Β2 Agonist

The aim of the present study was to investigate bronchoprotective sensitivity in patients receiving regular treatment with short- and long-acting β2-agonists and to evaluate any possible association with genetic polymorphism. Thirty-eight patients with stable mild to moderate asthma and receiving inhaled corticosteroids were randomized in a parallel group, double-blind, double-dummy fashion to receive 2 weeks of treatment with either formoterol (12μg once daily, 6μg twice daily or 24μg twice daily) or terbutaline (500μg four times daily). Bronchoprotection against methacholine challenge (as a provocative dose to produce a 20% fall in forced expiratory volume in 1.0 ;s: PD20) was measured at baseline (unprotected) after an initial 1 week run-in without β2-agonist, and at 1 ;h after the first and last doses of each treatment. The PD20 values were log-transformed and calculated as change from baseline. Percentage desensitization of log PD20 for first- versus last-dose bronchoprotection was calculated and analysed according to effects of treatment and β2-adrenoceptor polymorphism at codon 16 or 27. The mean degree of desensitization for bronchoprotection was comparable with all four treatments and there were no significant differences in absolute PD20 values after 2 weeks of chronic dosing. The PD20 values were (as μg of methacholine, geometric means±S.E.M.): formoterol, 12μg once daily, 99±42μg; formoterol, 6μg twice daily, 107±44μg; formoterol, 24μg twice daily, 108±45μg; terbutaline, 500μg four times daily, 88±37μg. All patients receiving formoterol, 24μg twice daily, exhibited a loss of protection greater than 30% which was unrelated to polymorphism at codon 16 or 27. For codon 16, the use of lower doses of formoterol (12μg once daily or 6μg twice daily) showed wider variability in the propensity for protection loss in patients who were heterozygous, in contrast to a more uniform protection loss seen with homozygous glycine patients. The amount of protection loss was not significantly related to polymorphism at codon 16 or 27, expressed as values (mean±S.E.M.) for percentage desensitization according to each genotype (pooled treatments): Gly-16, 66±11%; Het-16, 53±8%; Arg-16, 69±18%; Glu-27, 68±12%; Het-27, 58±8%; Gln-27, 52±12%. The results of this preliminary study showed that bronchoprotective desensitization occurred readily in response to short- or long-acting β2-agonist exposure irrespective of β2-adrenoceptor polymorphism at codon 16 or 27. Further studies with larger patient numbers are required to further evaluate the effects of polymorphisms with lower doses of regular formoterol.

Once-Daily Tiotropium Respimat Added-On to Inhaled Corticosteroids in a 1-Year Study in Adolescent Patients With Symptomatic Asthma Is Efficacious and Well Tolerated

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 699A
Author(s):  
Jonathan Bernstein ◽  
Attilio Boner ◽  
Eckard Hamelmann ◽  
Mandy Avis ◽  
John Downie ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Once Daily ◽  
Adolescent Patients ◽  
Symptomatic Asthma

Adherence and usage patterns of inhaled corticosteroids‐long-acting beta-agonists by using inhaler-monitoring technology

2020 ◽  
Vol 41 (4) ◽  
pp. 256-264
Author(s):  
Richard H. Stanford ◽  
Carlyne M. Averell ◽  
Phaedra T. Johnson ◽  
Erin K. Buysman ◽  
Maureen H. Carlyle
Keyword(s):  
Rescue Medication ◽  
Claims Data ◽  
Inhaled Corticosteroids ◽  
Medication Use ◽  
Two Phase ◽  
Once Daily ◽  
Beta Agonists ◽  
Pharmacy Claims ◽  
Long Acting

Background: Results of previous research indicate that adherence to prescribed inhaled corticosteroid‐long-acting beta2-agonist (ICS-LABA) asthma controller medications is suboptimal, yet actual daily-use patterns are unclear and may be influenced by regimen complexity or dosing frequency. Objective: To investigate real-world use of asthma medications by using inhaler sensors for the ICS-LABA controllers: twice-daily fluticasone propionate (FP) plus salmeterol (SAL) and once-daily fluticasone furoate (FF) plus vilanterol (VI); and albuterol rescue medication. Methods: This longitudinal, two-phase, observational study included adults with asthma-prescribed FP-SAL (phase I) or FF-VI (phase II), and albuterol metered-dose inhalers. The participants completed baseline and follow-up surveys, and used clip-on inhaler sensors to monitor real-time inhaler use over the 6-month study period. Pharmacy claims data for the 6-month follow-up period were used to assess refills of ICS-LABA and albuterol inhalers. Results: Patients who used twice-daily FP-SAL received a sufficient dose (≥2 actuations/day) approximately one third of the time, those on once-daily FF-VI received a sufficient dose (≥1 actuation/day) ∼60% of the time. Patients who used once-daily FF-VI were more likely to take their medication as prescribed versus those who used twice-daily FP-SAL. There were no significant differences in the percentage of albuterol-free days (FP-SAL, 68.06% [n = 241]; FF-VI, 72.67% [n = 127]; p = 0.230). Exploratory outcomes are reported in this article's Online Supplemental Material. Claims-based measures of adherence were higher than sensor-based measures, hence claims data may have overestimated adherence, whereas sensors may have more accurately measured patients' medication use. Conclusion: These data supported the use of inhaler sensors as tools to directly and accurately measure ICS-LABA adherence and rescue medication use, and the adherence benefits of once-daily versus twice-daily ICS-LABA regimens.

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