| Optimizing maintenance therapy in pediatric asthma. | |
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MedLine Citation:
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PMID: 19904206 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: There are different phenotypes of asthma, with phenotype-specific differences in medication response observed. RECENT FINDINGS: Tobacco smoke exposure reduces corticosteroid responsiveness. Treatment for tobacco smoke-triggered asthma must start with treatment of tobacco dependence. Obesity-associated asthma responds to weight loss and treatment of comorbidities. Immunotherapy and omalizumab are specific therapies for atopic asthma, though its use is limited by expense, inconvenience, need for injections, and toxicities. Leukotriene modifier response is more prominent in viral-triggered asthma. Research on intermittent escalation of controller therapy for asthma shows best results when escalation is substantial and early. Inhaled corticosteroid medications in low-to-moderate doses remain the most important maintenance medication for a broad variety of asthma phenotypes, reducing both impairment and risk. When impairment is not fully controlled by an inhaled corticosteroid, combination with a long-acting beta-agonist, leukotriene modifier, or theophylline can be effective. Inhaled corticosteroid use in children does not appear to influence airway caliber or asthma severity after the medication is stopped. SUMMARY: Optimizing maintenance therapy for asthma is not one size fits all. It is important to assess the asthma phenotype in addition to the symptom pattern, in determining optimal maintenance therapy. |
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Authors:
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Harold J Farber |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review |
Journal Detail:
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Title: Current opinion in pulmonary medicine Volume: 16 ISSN: 1531-6971 ISO Abbreviation: Curr Opin Pulm Med Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-09 Completed Date: 2010-03-11 Revised Date: 2011-01-14 |
Medline Journal Info:
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Nlm Unique ID: 9503765 Medline TA: Curr Opin Pulm Med Country: United States |
Other Details:
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Languages: eng Pagination: 25-30 Citation Subset: IM |
Affiliation:
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Pediatric Pulmonary Section, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA. hjfarber@texaschildrens.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Inhalation Adolescent Adrenal Cortex Hormones / administration & dosage, therapeutic use Anti-Asthmatic Agents / therapeutic use* Asthma / drug therapy*, etiology Child Child, Preschool Humans Phenotype* Smoking / adverse effects Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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R01 ES015794-01A1/ES/NIEHS NIH HHS; R01 ES015794-02/ES/NIEHS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Anti-Asthmatic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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