Document Detail


Targeting the small airways asthma phenotype: if we can reach it, should we treat it?
MedLine Citation:
PMID:  23535085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the available methods of evaluating the small airways disease in asthma and the therapeutic strategies to achieve better control using emerging extrafine particle inhaler technologies.
DATA SOURCES: The PubMed, MEDLINE (Ebsco), Scirus, Scopus, and Google Scholar databases were all scanned with Cross-search using the following keywords: asthma, small airways, hydrofluoroalkane 134a, extrafine particle, inhaled corticosteroid, long-acting β-agonist, spirometry, impulse oscillometry, nitrogen washout, exhaled nitric oxide, airway hyperresponsiveness, and adrenal suppression.
STUDY SELECTION: Key clinical studies considered to being relevant to the topic under review were evaluated.
RESULTS: There is an unmet need in current asthma guidelines for those individuals who exhibit the small airways asthma phenotype with a preserved forced expiratory volume in 1 second but abnormal forced midexpiratory flow and peripheral airway resistance, which tends to be associated with poorer control. Extrafine hydrofluoroalkane solution formulations of inhaled corticosteroid either alone or in combination with long-acting β-agonist may improve small airways outcomes and associated control.
CONCLUSION: From a pragmatic perspective, it makes sense to try to deliver asthma treatment to more of the lung to improve clinical outcomes, especially in patients who exhibit the small airways asthma phenotype.
Authors:
Brian Lipworth
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology     Volume:  110     ISSN:  1534-4436     ISO Abbreviation:  Ann. Allergy Asthma Immunol.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-28     Completed Date:  2013-05-23     Revised Date:  2013-10-11    
Medline Journal Info:
Nlm Unique ID:  9503580     Medline TA:  Ann Allergy Asthma Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  233-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Asthma and Allergy Research Group, Ninewells Hospital and Medical School, Dundee, Scotland. B.j.lipworth@dundee.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage,  therapeutic use
Adrenergic beta-Agonists / administration & dosage,  therapeutic use
Airway Resistance
Anti-Asthmatic Agents / administration & dosage,  therapeutic use
Asthma / drug therapy*,  physiopathology
Clinical Trials as Topic
Drug Therapy, Combination
Humans
Hydrocarbons, Fluorinated / administration & dosage,  therapeutic use
Nebulizers and Vaporizers
Phenotype
Respiratory Function Tests
Respiratory System / pathology,  physiopathology*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Adrenergic beta-Agonists; 0/Anti-Asthmatic Agents; 0/Hydrocarbons, Fluorinated; 431-89-0/HFA 134a
Comments/Corrections
Comment In:
Ann Allergy Asthma Immunol. 2013 Sep;111(3):233   [PMID:  23987209 ]
Ann Allergy Asthma Immunol. 2013 Sep;111(3):234   [PMID:  23987210 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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