A Pragmatic Trial of Symptom-Based Inhaled Corticosteroid Use in African-American Children with Mild Asthma.

@article{Sumino2019APT,
  title={A Pragmatic Trial of Symptom-Based Inhaled Corticosteroid Use in African-American Children with Mild Asthma.},
  author={Kaharu Sumino and Leonard B. Bacharier and Juanita Taylor and Kelley Chadwick-Mansker and Vanessa Curtis and Alison Nash and Shawni Jackson-Triggs and Joseph Moen and Kenneth B. Schechtman and Jane Garbutt and Mario Castro},
  journal={The journal of allergy and clinical immunology. In practice},
  year={2019}
}

ICS-formoterol reliever versus ICS and short-acting β2-agonist reliever in asthma: a systematic review and meta-analysis

As-needed low-dose ICS-formoterol prolongs time to first severe asthma exacerbation compared to maintenance ICS/SABA reliever and represents an alternative for patients, particularly when severe exacerbation prevention is the primary treatment aim.

Use of inhaled corticosteroids on an intermittent or as-needed basis in pediatric asthma: a systematic review of the literature

The use of ICS on an intermittent or as-needed basis (as an add-on therapy to SABAs) has been shown to be more effective than treatment with SABA alone and to be similarly or less effective compared to regular daily ICS administration.

The management of mild asthma

Concern about patients with mild asthma not being adherent to maintenance ICS supports a recommendation that ICS/formoterol should be considered as a treatment option instead of Maintenance ICS, to avoid the risk of patients reverting to SABA alone.

Comparative efficacy of inhalers in mild-to-moderate asthma: systematic review and network meta-analysis

As-needed ICS with LABA or SABA was more effective than a similar dose of regular ICS for preventing exacerbation in mild-to-moderate asthma and some weakness in improving lung function and controlling asthma symptoms.

The Children's Anti-inflammatory Reliever (CARE) study: a protocol for a randomised controlled trial of budesonide-formoterol as sole reliever therapy in children with mild asthma

This is the first RCT to assess the safety and efficacy of as-needed budesonide-formoterol in children with mild asthma, and the results will provide a much-needed evidence base for the treatment of mild asthma in children.

Combination fixed-dose beta agonist and steroid inhaler as required for adults or children with mild asthma.

The efficacy and safety of single combined fixed-dose beta₂-agonist plus an inhaled corticosteroid inhaler only used as needed in people with mild asthma is evaluated.

Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes

Across all age groups and levels of severity, regular personalized assessment, treatment of modifiable risk factors, self-management education, skills training, appropriate medication adjustment, and review remain essential to optimize asthma outcomes.

Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for Key Changes

Across all age groups and levels of severity, regular personalized assessment, treatment of modifiable risk factors, self-management education, skills training, appropriate medication adjustment, and review remain essential to optimize asthma outcomes.

Global Initiative for Asthma (GINA) Strategy 2021 - Executive summary and rationale for key changes.

Across all age-groups and levels of severity, regular personalized assessment, treatment of modifiable risk factors, self-management education, skills training, appropriate medication adjustment and review remain essential to optimize asthma outcomes.

References

SHOWING 1-10 OF 36 REFERENCES

Comparison of physician-, biomarker-, and symptom-based strategies for adjustment of inhaled corticosteroid therapy in adults with asthma: the BASALT randomized controlled trial.

Among adults with mild to moderate persistent asthma controlled with low-dose inhaled corticosteroid therapy, the use of either biomarker-based or symptom-based adjustment of inhaled Corticosteroids was not superior to physician assessment-based adjustments in time to treatment failure.

Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children.

In adults with asthma on daily maintenance ICS, a self-initiated ICS increase to 1000 to 2000 mcg/day at the onset of an exacerbation is not associated with a statistically significant reduction in the risk of exacerbations requiring rescue oral corticosteroids, but the wide confidence interval prevents a firm conclusion.

Inhaled corticosteroids in children with persistent asthma: effects on growth.

Assessment of the impact of ICS on the linear growth of children with persistent asthma found that ICS have suppressive effects on linear growth compared with controls, but head-to-head comparisons are needed to assess the effects of different drug molecules, dose, inhalation device or patient age.

Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children.

The odds of treatment failure, defined as the need for oral corticosteroids, were not significantly reduced among those randomised to increased ICS compared with those taking their usual stable maintenance dose, and evidence was insufficient to permit assessment of impact on the duration of exacerbation.

Quintupling Inhaled Glucocorticoids to Prevent Childhood Asthma Exacerbations

In children with mild‐to‐moderate persistent asthma treated with daily inhaled glucocorticoids, quintupling the dose at the early signs of loss of asthma control did not reduce the rate of severe asthma exacerbations or improve other asthma outcomes and may be associated with diminished linear growth.

As‐Needed Budesonide–Formoterol versus Maintenance Budesonide in Mild Asthma

In patients with mild asthma, budesonide–formoterol used as needed was noninferior to twice‐daily budesonides maintenance therapy with respect to the rate of severe asthma exacerbations during 52 weeks of treatment but was inferior in controlling symptoms.

Periodic Use of Inhaled Steroids in Children With Mild Persistent Asthma: What Are Pediatricians Recommending?

Research is needed on the effectiveness of periodic ICS use for children with mild persistent asthma and on underlying reasons for differing provider practice patterns.

Inhaled Combined Budesonide–Formoterol as Needed in Mild Asthma

In patients with mild asthma, as‐needed budesonide–formoterol provided superior asthma‐symptom control to as‐ needed terbutaline, assessed according to electronically recorded weeks with well‐controlled asthma, but was inferior to budesonid maintenance therapy.

Rescue use of beclomethasone and albuterol in a single inhaler for mild asthma.

In patients with mild asthma, the symptom-driven use of inhaled beclomethasone and albuterol in a single inhaler is as effective as regular use of asthma medication and is associated with a lower 6-month cumulative dose of the inhaled corticosteroid.