Assessment of anti-inflammatory effect from addition of a long-acting beta-2 agonist to inhaled corticosteroid

2016 ◽  
Vol 37 (5) ◽  
pp. 387-393 ◽  
Author(s):  
Terufumi Shimoda ◽  
Yasushi Obase ◽  
Reiko Kishikawa ◽  
Hiroshi Mukae ◽  
Tomoaki Iwanaga
Keyword(s):  
Inhaled Corticosteroid ◽  
Beta 2 ◽  
Anti Inflammatory ◽  
Long Acting ◽  
Inflammatory Effect

Add-on tiotropium versus step-up inhaled corticosteroid plus long-acting beta-2‐agonist in real-world patients with asthma

2020 ◽  
Vol 41 (4) ◽  
pp. 248-255
Author(s):  
Bradley Chipps ◽  
Giselle Mosnaim ◽  
Sameer K. Mathur ◽  
Asif Shaikh ◽  
Samir Khoury ◽  
...  
Keyword(s):  
Real World ◽  
Index Date ◽  
Group Versus ◽  
Group Index ◽  
Inhaled Corticosteroid ◽  
Ed Visits ◽  
Exacerbation Risk ◽  
Beta 2 ◽  
Long Acting ◽  
The Impact

Background: A step-up approach (increasing inhaled corticosteroid [ICS] dose and/or add-on treatment) is recommended for asthma that is uncontrolled despite ICS plus long-acting beta-2‐agonist (LABA) combination treatment. Understanding the impact of different treatment options on health outcomes can help guide treatment decision-making. Objective: To compare the effectiveness of add-on tiotropium 1.25 µg (two puffs once daily) versus an increased ICS plus LABA dose in a real-world cohort of patients with asthma initiated on ICS plus LABA. Methods: De-identified data from patients ages ≥12 years and with asthma who were initiated on ICS plus LABA, and then had tiotropium added (Tio group; index date) or an ICS plus LABA dose increased (inc-ICS group; index date) were collected from two medical and pharmacy claims data bases (2014‐2018). To account for population/group differences, propensity score matching was performed. The primary end point was the exacerbation risk after the index date. Secondary end points included exacerbation rates 6 and 12 months postindex, health-care resource utilization, costs, and short-acting beta-2‐agonist (SABA) refills 12 months postindex. Results: Overall, 7857 patients (Tio group, 2619; inc-ICS group, 5238) were included. The exacerbation risk was 35% lower in the Tio group than in the inc-ICS group (hazard ratio 0.65 [95% confidence interval, 0.43‐0.99]; p = 0.044). Exacerbation rates in the Tio group also were significantly lower within 6 and 12 months postindex (64% and 73%, respectively). All-cause and asthma-related emergency department (ED) visits were 47% and 74% lower, respectively (p < 0.0001 for both), and all-cause and asthma-related hospitalizations were 48% (p < 0.01) and 76% (p < 0.001) lower, respectively, in the Tio group. Also, significantly fewer patients in the Tio group versus the inc-ICS group required SABA refills (56% versus 67%, p < 0.0001). Conclusion: Add-on tiotropium significantly decreased the risk and rate of exacerbations, decreased all-cause and asthma-related ED visits and hospitalizations, and reduced SABA refills compared with increasing the ICS plus LABA dose. The findings supported the use of add-on tiotropium for patients with uncontrolled asthma taking ICS plus LABA.

scholarly journals Autologous Red Blood Cell Delivery of Betamethasone Phosphate Sodium for Long Anti-Inflammation

Pharmaceutics ◽  
2018 ◽  
Vol 10 (4) ◽  
pp. 286 ◽  
Author(s):  
Xiumei Zhang ◽  
Mingfeng Qiu ◽  
Pengcheng Guo ◽  
Yumei Lian ◽  
Enge Xu ◽  
...  
Keyword(s):  
Side Effects ◽  
Osmotic Fragility ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Anti Inflammatory ◽  
Loading Amount ◽  
Long Acting ◽  
Inflammatory Effect

Although glucocorticoids are highly effective in treating various types of inflammation such as skin disease, rheumatic disease, and allergic disease, their application have been seriously limited for their high incidence of side effects, particularly in long term treatment. To improve efficacy and reduce side effects, we encapsulated betamethasone phosphate (BSP) into biocompatible red blood cells (RBCs) and explored its long acting-effect. BSP was loaded into rat autologous erythrocytes by hypotonic preswelling method, and the loading amount was about 2.5 mg/mL cells. In vitro, BSP loaded RBCs (BSP-RBCs) presented similar morphology, osmotic fragility to native RBCs (NRBCs). After the loading process, the loaded cells can maintain around 70% of Na+/K+-ATPase activity of natural cells. In vivo, a series of tests including survival, pharmacokinetics, and anti-inflammatory effect were carried out to examine the long-acting effect of BSP-RBCs. The results shown that the loaded cells could circulate in plasma for over nine days, the release of BSP can last for over seven days and the anti-inflammatory effect can still be observed on day 5 after injection. Totally, BSP-loaded autologous erythrocytes seem to be a promising sustained releasing delivery system with long anti-inflammatory effect.

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