28 results on '"Vaghi, Adriano"'
Search Results
2. Ragweed pollen concentration predicts seasonal rhino-conjunctivitis and asthma severity in patients allergic to ragweed
- Author
-
Bonini, Maira, Monti, Gianna Serafina, Pelagatti, Matteo Maria, Ceriotti, Valentina, Re, Elisabetta Elena, Bramè, Barbara, Bottero, Paolo, Tosi, Anna, Vaghi, Adriano, Martelli, Alberto, Traina, Giovanni Maria, Rivolta, Loredana, Rivolta, Federica, and Ortolani, Claudio Maria
- Published
- 2022
- Full Text
- View/download PDF
3. Multisocieties position paper: Microbiological surveillance on flexible endoscopes
- Author
-
Bertoni, Costanza, Curti, Cesarina, Giacomini, Maurizio, Meledandri, Marcello, Palmieri, Dalia, Privitera, Gaetano, Raglio, Annibale, Tuvo, Benedetta, Colombo, Benedetta, Iannone, Teresa, Iori, Giorgio, Giaquinto, Antonella, Minenna, Angela, Petrocelli, Giulio, Valdinoci, Monia, Bortoluzzi, Francesco, Galeazzi, Francesca, Manta, Raffaele, Montalto, Paolo, Segato, Sergio, Soncini, Marco, Usai-Satta, Paolo, Vassallo, Roberto, Ferraiolo, Fabio, Roseto, Fabio, Bezziccheri, Milena, Fighera, Michele, Giampà, Ada, Mancini, Antonio, Marino, Caterina, Cerone, Marina Pisegna, Risitano, Tommaso, Sergio, Emmanuele, Sinopoli, Raffaele, De Caprio, Maria Teresa, Failla, Giuseppe, Agli, Luigi Lazzari, Majori, Maria, Toccaceli, Andrea, Marciano, Emanuele, Maurano, Attilio, Rodella, Luca, Cengia, Gianpaolo, Ciliberto, Enrico, Conigliaro, Rita, Germanà, Bastianello, Lamazza, Antonietta, Pisani, Antonio, Zagari, Rocco Maurizio, Spinzi, Giancarlo, Casini, Beatrice, Pan, Angelo, Guarini, Alessandra, Rivara, Cinzia, Zullo, Angelo, Monica, Fabio, Cimbro, Monica, Casarano, Salvatore, Inglese, Agostino, Vaghi, Adriano, Schiffino, Luigi, Capezzuto, Erminio, Da Massa Carrara, Paola, and Pasquale, Luigi
- Published
- 2021
- Full Text
- View/download PDF
4. Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial
- Author
-
Pohl, Wolfgang, Voves, Robert, Deschampheleire, Maud, Louis, Renaud, Martinot, Jean-Benoit, Peché, Rudi, Chapman, Kenneth, Cheema, Amarjit, Dorscheid, Delbert, FitzGerald, J. Mark, Gagnon, Remi, Killorn, William Patrick, Olivenstein, Ronald, Philteos, George, Ramsey, Clare, Rolf, J. Douglass, Walker, Brandie, Hilberg, Ole, Skjold, Tina, Titlestad, Ingrid, Hakulinen, Auli, Kilpeläinen, Maritta, Ben Hayoun, Michèle, Bonniaud, Philippe, Bourdin, Arnaud, Chanez, Pascal, De Blay, Frédéric, Deslee, Gaëtan, Devouassoux, Gilles, Didier, Alain, Douadi, Youcef, Fry, Stéphanie, Garcia, Gilles, Girodet, Pierre-Olivier, Leroyer, Christophe, Magnan, Antoine, Mahay, Guillaume, Nocent, Cécilia, Pison, Christophe, Roux, Pauline-Marie, Taillé, Camille, Tiotiu, Juliana-Angelica, Beck, Ekkehard, Jandl, Margret, Kaehler, Christian, Kässner, Frank, Koesters, Frank, Kronsbein, Juliane, Schaum, Thomas, Schulz, Christian, Skowasch, Dirk, Taube, Christian, Welte, Tobias, de Roux, Andrés, Beghé, Bianca, Blasi, Francesco, Canonica, Giorgio Walter, Carpagnano, Giovanna, Caruso, Cristiano, Corsico, Angelo Guido, Constantino, Elio, Crimi, Nunzio, Maestrelli, Piero, Menzella, Francesco, Milanese, Manlio, Papi, Alberto, Pelaia, Girolamo, Pini, Laura, Santus, Pierachille, Savi, Eleonora, Scichilone, Nicola, Senna, Gianenrico, Spadaro, Giuseppe, Vaghi, Adriano, Gans, Steven, Hölters, Jurgen, Langeveld, B., Pieters, Willem, Staaks, G.H.A., van Veen, Ilonka, van den Berg, J.W.K., Einvik, Gunnar, Lehmann, Sverre, Ali García, Ismael, Almonacid, Carlos, Bobolea, Irina, Campo Mozo, Paloma, de Luiz, Gustavo, Domingo Ribas, Christian, Echave-Sustaeta María-Tomé, José María, García Rivero, Juan Luis, García-Cosío Piqueras, Borja, Gómez-Bastero Fernández, Ana, González Pérez, Ruperto, Henríquez Santa, Aythamy, Martínez Rivera, Carlos, Muñoz Gall, Xavier, Ramos, Jacinto, Gregorio Soto Campos, Jose, Vidal Pan, Carmen, Stenfors, Nikolai, Tunsäter, Alf, Vinge, Ines, Chaudhuri, Rekha, Harrison, Timothy, Mansur, Adel, Nasser, Shuaib, Nordstrom, Monica, Pfeffer, Paul, Saralaya, Dinesh, Short, Philip, Adlakha, Arun, Alpan, Oral, Averill, Francis, Badhwar, Anil, Bardelas, Jose, Baxter, Barbara, Bensch, George, Berger, William, Bernstein, Jonathan, Bridges, Tracy, Brimeyer, Ryan, Calhoun, William, Campbell, Edward, Cherry, William Brett, Chupp, Geoffrey, Clore, Lee, Cohn, John, Cole, Jeremy, Condemi, John, Cury, James, Davis, Benjamin, DeLeon, Samuel, Delacruz, Luis, Diaz, Joseph, Erb, David, Eziri, Emeka, Fakih, Faisal, Fiedler, Douglas, Fost, David, Fritz, Stephen, Gonzalez, Erika, Goodman, Brad, Gottlieb, Peter, Gottschlich, Gregory, Gower, Richard, Hajal, Rizan, Harris, James, Heidarian-Raissy, Hengameh, Heyder, Albrecht, Hill, David, Holguin, Fernando, Hussain, Iftikhar, Illowite, Jonathan, Jacobs, Joshua, Jarratt, Mikell, Kaiser, Harold, Kao, Neil, Kashyap, Ravindra, Kaufman, David, Kent, Edward, Kim, Kenneth, Klein, Ryan, Kraft, Monica, Kono, Ritsu, Kureishy, Shahrukh, Leflein, Jeffrey, Leong, Mila, Li, Huamin, Lin, Robert, Lugogo, Njira, Marcus, Michael, Maselli Caceres, Diego Jose, Mehta, Vinay, Mello, Curtis, Millard, Mark, Milstone, Aaron, Mohan, Arjun, Moore, Wendy, Moss, Mark, Mumneh, Nayla, O'Brien, Thomas, Ostransky, David, Palumbo, Michael, Parikh, Purvi, Parikh, Sudhir, Patel, Amit, Perez, Guido, Pleskow, Warren, Prenner, Bruce, Puppala, Dileep, Ramey, John, Reibman, Joan, Reyes, Ramon, Robinette, Emory, Rodicio, Ileana, Ryan, Stephen, Sekhsaria, Sudhir, Sigal, Barry, Sikand, Vinay, Soong, Weily, Spangenthal, Selwyn, St. John, Roy, Steven, Gary, Subramaniam, Vijay, Sumino, Kaharu, Sztejman, Eric, Tan, Ricardo A., Tanus, Tonny, Thompson, Charles, Thornblade, Carl, Villareal, Manuel, Wenzel, Sally, Zafra, Heidi, Ziedalski, Tomasz, Harrison, Tim W, Cosio, Borja G, Lugogo, Njira L, Burden, Annie, McDermott, Lawrence, Garcia Gil, Esther, and Zangrilli, James G
- Published
- 2021
- Full Text
- View/download PDF
5. Italian pulmonologist units and COVID-19 outbreak: “mind the gap”!
- Author
-
Scala, Raffaele, Renda, Teresa, Corrado, Antonio, and Vaghi, Adriano
- Published
- 2020
- Full Text
- View/download PDF
6. How Do Storms Affect Asthma?
- Author
-
D’Amato, Gennaro, Annesi-Maesano, Isabella, Vaghi, Adriano, Cecchi, Lorenzo, and D’Amato, Maria
- Published
- 2018
- Full Text
- View/download PDF
7. Diagnosis of mediastinal tuberculosis: two clinical cases of patients coming from Pakistan
- Author
-
Rescaldani, Cristina, Arosio, Cristina, Re, Marina, Re, Luisa, Candelieri, Gabriella, Ottaviano, Roberto, Vaghi, Adriano, and Giuliani, Giuseppe
- Published
- 2016
- Full Text
- View/download PDF
8. Inhaler mishandling is very common in patients with chronic airflow obstruction and long-term home nebuliser use
- Author
-
Melani, Andrea S., Canessa, PierAldo, Coloretti, Isotta, DeAngelis, Giuseppe, DeTullio, Renato, Del Donno, Mario, Giacobbe, Raffaela, Scarlato, Ines, Serafini, Antonella, Barbato, Natalino, Vaghi, Adriano, and Sestini, Piersante
- Published
- 2012
- Full Text
- View/download PDF
9. ARIA-ITALY multidisciplinary consensus on nasal polyposis and biological treatments
- Author
-
Lombardi, Carlo, Asero, Riccardo, Bagnasco, Diego, Blasi, Francesco, Bonini, Matteo, Bussi, Mario, Canevari, Rikki F., Canonica, Giorgio Walter, Castelnuovo, Paolo, Cecchi, Lorenzo, Cosmi, Lorenzo, Gelardi, Matteo, Heffler, Enrico, Indinnimeo, Luciana, Landi, Massimo, Licari, Amelia, Liotta, Francesco, Macchi, Alberto, Malvezzi, Luca, Marseglia, Gianluigi, Micheletto, Claudio, Musarra, Antonino, Peroni, Diego, Piacentini, Giorgio, Poletti, Venerino, Richeldi, Luca, Santoni, Angela, Schiappoli, Michele, Senna, Gianenrico, Vaghi, Adriano, Villani, Alberto, and Passalacqua, Giovanni
- Published
- 2021
- Full Text
- View/download PDF
10. Which Mask for Noninvasive Ventilation in Acute Respiratory Failure?
- Author
-
Barbarito, Nicola, Vaghi, Adriano, and De Mattia, Elisa
- Published
- 2011
- Full Text
- View/download PDF
11. Adult Pulmonary Intensive and Intermediate Care Units: The Italian Thoracic Society (ITS-AIPO) Position Paper.
- Author
-
Renda, Teresa, Scala, Raffaele, Corrado, Antonio, Ambrosino, Nicolino, and Vaghi, Adriano
- Subjects
HOSPITAL respiratory services ,PULMONOLOGISTS ,RESPIRATORY insufficiency ,PROFESSIONS ,HEALTH services administration ,RESPIRATORY therapy equipment ,MATHEMATICAL models ,REGULATORY approval ,SUBACUTE care ,MEDICAL care use ,RESPIRATORY therapy ,CRITICAL care medicine ,HOSPITAL wards ,QUALITY assurance ,THEORY ,ADULTS - Abstract
The imbalance between the prevalence of patients with acute respiratory failure (ARF) and acute-on-chronic respiratory failure and the number of intensive care unit (ICU) beds requires new solutions. The increasing use of non-invasive respiratory tools to support patients at earlier stages of ARF and the increased expertise of non-ICU clinicians in other types of supportive care have led to the development of adult pulmonary intensive care units (PICUs) and pulmonary intermediate care units (PIMCUs). As in other European countries, Italian PICUs and PIMCUs provide an intermediate level of care as the setting designed for managing ARF patients without severe non-pulmonary dysfunction. The PICUs and PIMCUs may also act as step-down units for weaning patients from prolonged mechanical ventilation and for discharging patients still requiring ventilatory support at home. These units may play an important role in the on-going coronavirus disease 2019 pandemic. This position paper promoted by the Italian Thoracic Society (ITS-AIPO) describes the models, facilities, staff, equipment, and operating methods of PICUs and PIMCUs. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
12. Mepolizumab as the first targeted treatment for eosinophilic granulomatosis with polyangiitis: a review of current evidence and potential place in therapy
- Author
-
Faverio,Paola, Bonaiti,Giulia, Bini,Francesco, Vaghi,Adriano, and Pesci,Alberto
- Subjects
Therapeutics and Clinical Risk Management - Abstract
Paola Faverio,1,2 Giulia Bonaiti,1,2 Francesco Bini,3 Adriano Vaghi,3 Alberto Pesci1,2 1School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; 2Respiratory Unit, San Gerardo Hospital, ASST di Monza, Monza, Italy; 3ASST-Rhodense, UOC Pneumologia, Garbagnate Milanese, Milan, Italy Abstract: Mepolizumab is an anti-interleukin-5 (IL-5) humanized monoclonal antibody that binds to free IL-5. It induces bone marrow eosinophil maturation arrest and decreases eosinophil progenitors and subsequent maturation in the blood and bronchial mucosa. Its use has been extensively studied in severe eosinophilic asthma at a dose of 100 mg subcutaneously (SC) every 4 weeks and, more recently, in other hypereosinophilic syndromes. Eosinophilic granulomatosis with polyangiitis (EGPA) is an eosinophilic vasculitis that may involve multiple organs. Characteristic clinical manifestations are asthma, sinusitis, transient pulmonary infiltrates and neuropathy. Among the numerous pathways involved in the pathogenesis of EGPA, the Th-2 phenotype has a main role, as suggested by the prominence of the asthmatic component, in triggering the release of key cytokines for the activation, maturation and survival of eosinophils. In particular, IL-5 is highly increased in active EGPA and its inhibition can represent a potential therapeutic target. In this scenario, mepolizumab may play a therapeutic role. After some positive preliminary observations on the use of mepolizumab in small case series of EGPA patients with refractory or relapsing disease despite standard of care treatment, a randomized controlled trial was published in 2017. Mepolizumab at a dose of 300 mg administered by SC injection every 4 weeks proved effective in prolonging the period of remission of the disease, allowing for reduced steroid use. The positive results of this study, which met both of the primary endpoints, led to the approval in the USA of mepolizumab in adult patients with EGPA by the Food and Drug Administration in 2017. Therefore, mepolizumab can be officially considered as an add-on therapy with steroid-sparing effect in cases of relapsing or refractory EGPA. However, the most appropriate dose and duration of therapy still need to be determined. Future studies on larger multinational populations with prolonged follow-up are warranted. Keywords: mepolizumab, eosinophilic granulomatosis with polyangiitis, Churg–Strauss syndrome
- Published
- 2018
13. Could NSAIDs Have a Role as Antiasthmatic Agents?
- Author
-
Bianco, Sebastiano, Pieroni, Maria Grazia, Refini, Rosa Metella, Robuschi, Maria, Vaghi, Adriano, and Sestini, Piersante
- Published
- 1994
- Full Text
- View/download PDF
14. Multisocieties position paper: Microbiological surveillance on flexible endoscopes.
- Author
-
Casini, Beatrice, Pan, Angelo, Guarini, Alessandra, Rivara, Cinzia, Zullo, Angelo, Monica, Fabio, Cimbro, Monica, Casarano, Salvatore, Inglese, Agostino, Vaghi, Adriano, Schiffino, Luigi, Capezzuto, Erminio, Da Massa Carrara, Paola, and Pasquale, Luigi
- Abstract
Transmission with endoscopes, particularly duodenoscope, of potential lethal infections prompted different scientific societies to deliver recommendations aimed reducing this risk. Some International societies extended recommendations on microbial surveillance to all the endoscopes and devices used in the reprocessing procedure. Considering the relevance of the topic, 8 Italian scientific societies of physicians, nurses and technical operators prepared a concerted document taking into account Institutional advisories and facilities in Italy. The rules for a correct microbial surveillance on endoscopes were detailed in term of what, how and when to perform the procedure, also suggesting behaviors in case of contamination. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
15. Different Effects of Inhaled Aspirinlike Drugs on Allergen-Induced Early and Late Asthmatic Responses
- Author
-
SESTINI, PIERSANTE, REFINI, ROSA METELLA, PIERONI, MARIA GRAZIA, VAGHI, ADRIANO, ROBUSCHI, MARIA, and BIANCO, SEBASTIANO
- Published
- 1999
- Full Text
- View/download PDF
16. Protective effect of inhaled lysine acetylsalicylate on allergen-induced early and late asthmatic reactions
- Author
-
Sestini, Piersante, Refini, Rosa Metella, Pieroni, Maria Grazia, Vaghi, Adriano, Robuschi, Maria, and Bianco, Sebastiano
- Published
- 1997
17. Severe asthma in adults does not significantly affect the outcome of COVID‐19 disease: Results from the Italian Severe Asthma Registry.
- Author
-
Antonicelli, Leonardo, Tontini, Chiara, Manzotti, Giuseppina, Ronchi, Luca, Vaghi, Adriano, Bini, Francesco, Scartabellati, Alessandro, Menzella, Francesco, De Michele, Fausto, Musarra, Antonino, Micheletto, Claudio, and Bilò, Maria Beatrice
- Subjects
COVID-19 ,ASTHMA ,COVID-19 pandemic - Abstract
Asthma, asthma treatment, biologics, infections, virus Severe asthma in adults does not significantly affect the outcome of COVID-19 disease: Results from the Italian Severe Asthma Registry Keywords: asthma; asthma treatment; biologics; infections; virus EN asthma asthma treatment biologics infections virus 902 905 4 03/09/21 20210301 NES 210301 To the Editor, Severe asthma is a chronic disease affecting around 3%-8% of adult asthma population in Europe, with the refractory form estimated to occur in 0.1% of the general population.1,2 Severe asthma is characterized by increased use of healthcare resources (ie, emergency room/hospital admissions, access to intensive care units (ICU), and use of biologics) due to exacerbations compared with the less severe form. [Extracted from the article]
- Published
- 2021
- Full Text
- View/download PDF
18. Protective effect of inhaled piretanide on the bronchial obstructive response to ultrasonically nebulized H2O: a dose-response study
- Author
-
Bianco, Sebastiano, Robuschi, Mariella, Vaghi, Adriano, Pieroni, Maria Grazia, and Sestini, Piersante
- Subjects
Bronchial spasm -- Drug therapy ,Diuretics -- Evaluation ,Health ,Drug therapy ,Evaluation - Abstract
Inhaled furosemide prevents the obstructive response to several bronchoconstrictor stimuli in asthma. To verify whether this protective effect is also shared by other loop diuretics, we investigated the effect of [...]
- Published
- 1993
19. Incidence, Predictors, and Clinical Implications of Discontinuing Therapy with Inhaled Long-Acting Bronchodilators among Patients with Chronic Obstructive Pulmonary Disease.
- Author
-
Arfè, Andrea, Nicotra, Federica, Cerveri, Isa, de Marco, Roberto, Vaghi, Adriano, Merlino, Luca, and Corrao, Giovanni
- Subjects
OBSTRUCTIVE lung disease treatment ,BRONCHODILATOR agents ,INHALATION administration ,PUBLIC health ,HEALTH risk assessment ,THERAPEUTICS - Abstract
Incidence, predictors and effect of discontinuation of long-acting bronchodilators on the risk of death or hospital admission among adults with Chronic Obstructive Pulmonary Disease (COPD) were assessed in a large population-based prospective study carried out by linking Italian healthcare utilization databases. Specifically, the cohort of 17,490 beneficiaries of the National Health Service in the Italian Region of Lombardy, aged 40 years or older, who started long-acting bronchodilators therapy during 2005–2008 was followed from first dispensation until 2012. During this period, patients who experienced discontinuation of long-acting bronchodilators were identified. Hospitalizations for COPD and deaths for any cause (composite clinical outcome) were also identified during follow-up. A Cox proportional hazards model was fitted to identify predictors of discontinuation. The case-crossover design was used to assess the implications of treatment discontinuation on the clinical outcome risk. Cumulative incidences of discontinuation were, respectively, 67%, 80%, and 92% at 6 months, 1 year, and 5 years since initial treatment. Significant predictors of discontinuation were female gender, younger age, starting treatment with fixed-dose combination of inhaled bronchodilators and corticosteroids, using antibiotics, inhaled long-acting bronchodilators and corticosteroids and not using short-acting bronchodilators, other respiratory drugs and systemic corticosteroids during follow-up. Odds ratios (95% confidence intervals) for the clinical outcome associated with not discontinuing long-acting bronchodilators was 0.64 (0.50 to 0.82). In conclusion, in the real-life setting, discontinuation of inhaled long-acting bronchodilators in adults with COPD is high even after just 6 months, even though persistence to these drugs reduces the risk of severe outcomes. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
- Full Text
- View/download PDF
20. Increased Incidence of Spontaneous Pneumothorax in Very Young People: Observations and Treatment
- Author
-
Bellaviti, Nadia, Bini, Francesco, Pennacchi, Luca, Pepe, Giuseppe, Bodini, Bruno, Ceriani, Roberto, D'Urbano, Corrado, and Vaghi, Adriano
- Published
- 2016
- Full Text
- View/download PDF
21. Multiple primary synchronous malignant tumors.
- Author
-
Testori, Alberto, Cioffi, Ugo, De Simone, Matilde, Bini, Francesco, Vaghi, Adriano, Lemos, Alessandro A., Ciulla, Michele M., and Alloisio, Marco
- Subjects
CANCER diagnosis ,CYSTS (Pathology) ,CANCER patient medical care ,CANCER-related mortality ,DIAGNOSIS ,MORTALITY risk factors - Abstract
Background: Patients with primary multiple malignancies are progressively increasing due to prolonged survival of cancer patients and to the advances in diagnostic techniques and therapeutic options. Case presentation: Here we present a 66 year-old caucasian patient with four synchronous primary malignant tumors affecting the lung, oropharynx, large bowel and prostate gland, respectively, treated with multidisciplinary approach. Conclusions: The increased incidence of multiple malignant tumors is a real challenge to the clinician and clinical attention should be made to avoid a misdiagnosis. In addition an early diagnosis is essential to achieve a radical treatment. We believe that the treatment modality should be carefully made and tailored on the individual patient suffering from this disease. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
22. Endovascular Treatment of a Ruptured Pulmonary Artery Aneurysm in a Patient with Behçet's Disease Using the Amplatzer Vascular Plug 4.
- Author
-
Ianniello, Andrea, Carrafiello, Gianpaolo, Nicotera, Paolo, Vaghi, Adriano, and Cazzulani, Alberto
- Published
- 2013
- Full Text
- View/download PDF
23. Persistence with inhaled corticosteroids reduces the risk of exacerbation among adults with asthma: A real-world investigation.
- Author
-
Corrao, Giovanni, Arfè, Andrea, Nicotra, Federica, Ghirardi, Arianna, Vaghi, Adriano, De Marco, Roberto, Pesci, Alberto, Merlino, Luca, and Zambon, Antonella
- Subjects
CORTICOSTEROIDS ,ASTHMA ,ANTIBIOTICS ,ASTHMATICS ,THERAPEUTICS research - Abstract
Background and objective Real-world evidence suggests that persistence with inhaled corticosteroids (ICS), the mainstay of asthma drug therapy, is generally poor. The effect of persistence with ICS on the risk of asthma exacerbation was addressed in a population-based study. Methods The cohort of 2335 beneficiaries of the National Health Service provided by the Italian Region of Lombardy, aged 18-40 years and newly treated with ICS during 2005-2008, was followed from their first ICS dispensation until 2010. Discontinuation of treatment with ICS and starting oral corticosteroid therapy during follow-up were respectively regarded as proxies of poor persistence with asthma medication and asthma exacerbation (outcomes). A proportional hazards model was fitted to identify predictors of ICS discontinuation. Case-crossover and case-case-time-control designs and conditional logistic regressions were used to estimate the association between persistence with ICS and asthma exacerbation. Results Cumulative incidences of discontinuation were 36%, 57% and 78% at 6 months, 1 year and 5 years, respectively. Predictors of poor persistence were female gender, use of antibiotics during follow-up, absence of use of short-acting beta-agonists prior to and after starting treatment with ICS and starting and maintaining ICS monotherapy during follow-up. The odds ratios of asthma exacerbation (and 95% confidence intervals) associated with ICS exposure during the current period, contrasted with exposure during the reference period, were 0.4 (0.2, 0.9) and 0.3 (0.1, 1.0) from case-crossover and case-case-time-control estimates, respectively. Conclusion Persistence with ICS treatment in adults with asthma reduces the risk of exacerbation in the real-life setting. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
24. Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial
- Author
-
Harrison, Tim W, Chanez, Pascal, Menzella, Francesco, Canonica, Giorgio Walter, Louis, Renaud, Cosio, Borja G, Lugogo, Njira L, Mohan, Arjun, Burden, Annie, McDermott, Lawrence, Garcia Gil, Esther, Zangrilli, James G, Wolfgang Pohl, Robert Voves, Maud Deschampheleire, Renaud Louis, Jean-Benoit Martinot, Rudi Peché, Kenneth Chapman, Amarjit Cheema, Delbert Dorscheid, J Mark FitzGerald, Remi Gagnon, William Patrick Killorn, Ronald Olivenstein, George Philteos, Clare Ramsey, J Douglass Rolf, Brandie Walker, Ole Hilberg, Tina Skjold, Ingrid Titlestad, Auli Hakulinen, Maritta Kilpeläinen, Michèle Ben Hayoun, Philippe Bonniaud, Arnaud Bourdin, Pascal Chanez, Frédéric De Blay, Gaëtan Deslee, Gilles Devouassoux, Alain Didier, Youcef Douadi, Stéphanie Fry, Gilles Garcia, Pierre-Olivier Girodet, Christophe Leroyer, Antoine Magnan, Guillaume Mahay, Cécilia Nocent, Christophe Pison, Pauline-Marie Roux, Camille Taillé, Juliana-Angelica Tiotiu, Ekkehard Beck, Margret Jandl, Christian Kaehler, Frank Kässner, Frank Koesters, Juliane Kronsbein, Thomas Schaum, Christian Schulz, Dirk Skowasch, Christian Taube, Tobias Welte, Andrés de Roux, Bianca Beghé, Francesco Blasi, Giorgio Walter Canonica, Giovanna Carpagnano, Cristiano Caruso, Angelo Guido Corsico, Elio Constantino, Nunzio Crimi, Piero Maestrelli, Francesco Menzella, Manlio Milanese, Alberto Papi, Girolamo Pelaia, Laura Pini, Pierachille Santus, Eleonora Savi, Nicola Scichilone, Gianenrico Senna, Giuseppe Spadaro, Adriano Vaghi, Steven Gans, Jurgen Hölters, B Langeveld, Willem Pieters, G H A Staaks, Ilonka van Veen, J W K van den Berg, Gunnar Einvik, Sverre Lehmann, Ismael Ali García, Carlos Almonacid, Irina Bobolea, Paloma Campo Mozo, Gustavo de Luiz, Christian Domingo Ribas, José María Echave-Sustaeta María-Tomé, Juan Luis García Rivero, Borja García-Cosío Piqueras, Ana Gómez-Bastero Fernández, Ruperto González Pérez, Aythamy Henríquez Santa, Carlos Martínez Rivera, Xavier Muñoz Gall, Jacinto Ramos, Jose Gregorio Soto Campos, Carmen Vidal Pan, Nikolai Stenfors, Alf Tunsäter, Ines Vinge, Rekha Chaudhuri, Timothy Harrison, Adel Mansur, Shuaib Nasser, Monica Nordstrom, Paul Pfeffer, Dinesh Saralaya, Philip Short, Arun Adlakha, Oral Alpan, Francis Averill, Anil Badhwar, Jose Bardelas, Barbara Baxter, George Bensch, William Berger, Jonathan Bernstein, Tracy Bridges, Ryan Brimeyer, William Calhoun, Edward Campbell, William Brett Cherry, Geoffrey Chupp, Lee Clore, John Cohn, Jeremy Cole, John Condemi, James Cury, Benjamin Davis, Samuel DeLeon, Luis Delacruz, Joseph Diaz, David Erb, Emeka Eziri, Faisal Fakih, Douglas Fiedler, David Fost, Stephen Fritz, Erika Gonzalez, Brad Goodman, Peter Gottlieb, Gregory Gottschlich, Richard Gower, Rizan Hajal, James Harris, Hengameh Heidarian-Raissy, Albrecht Heyder, David Hill, Fernando Holguin, Iftikhar Hussain, Jonathan Illowite, Joshua Jacobs, Mikell Jarratt, Harold Kaiser, Neil Kao, Ravindra Kashyap, David Kaufman, Edward Kent, Kenneth Kim, Ryan Klein, Monica Kraft, Ritsu Kono, Shahrukh Kureishy, Jeffrey Leflein, Mila Leong, Huamin Li, Robert Lin, Njira Lugogo, Michael Marcus, Diego Jose Maselli Caceres, Vinay Mehta, Curtis Mello, Mark Millard, Aaron Milstone, Arjun Mohan, Wendy Moore, Mark Moss, Nayla Mumneh, Thomas O'Brien, David Ostransky, Michael Palumbo, Purvi Parikh, Sudhir Parikh, Amit Patel, Guido Perez, Warren Pleskow, Bruce Prenner, Dileep Puppala, John Ramey, Joan Reibman, Ramon Reyes, Emory Robinette, Ileana Rodicio, Stephen Ryan, Sudhir Sekhsaria, Barry Sigal, Vinay Sikand, Weily Soong, Selwyn Spangenthal, Roy St John, Gary Steven, Vijay Subramaniam, Kaharu Sumino, Eric Sztejman, Ricardo A Tan, Tonny Tanus, Charles Thompson, Carl Thornblade, Manuel Villareal, Sally Wenzel, Heidi Zafra, Tomasz Ziedalski, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Tim W, Harrison, Pascal, Chanez, Francesco, Menzella, Giorgio Walter, Canonica, Renaud, Loui, Borja G, Cosio, Njira L, Lugogo, Arjun, Mohan, Annie, Burden, Lawrence, Mcdermott, Esther, Garcia Gil, Zangrilli, G, Jame, Pohl, Wolfgang, Voves, Robert, Deschampheleire, Maud, Louis, Renaud, Martinot, Jean-Benoit, Peché, Rudi, Chapman, Kenneth, Cheema, Amarjit, Dorscheid, Delbert, Mark FitzGerald, J, Gagnon, Remi, Patrick Killorn, William, Olivenstein, Ronald, Philteos, George, Ramsey, Clare, Douglass Rolf, J, Walker, Brandie, Hilberg, Ole, Skjold, Tina, Titlestad, Ingrid, Hakulinen, Auli, Kilpeläinen, Maritta, Ben Hayoun, Michèle, Bonniaud, Philippe, Bourdin, Arnaud, Chanez, Pascal, De Blay, Frédéric, Deslee, Gaëtan, Devouassoux, Gille, Didier, Alain, Douadi, Youcef, Fry, Stéphanie, Garcia, Gille, Girodet, Pierre-Olivier, Leroyer, Christophe, Magnan, Antoine, Mahay, Guillaume, Nocent, Cécilia, Pison, Christophe, Roux, Pauline-Marie, Taillé, Camille, Tiotiu, Juliana-Angelica, Beck, Ekkehard, Jandl, Margret, Kaehler, Christian, Kässner, Frank, Koesters, Frank, Kronsbein, Juliane, Schaum, Thoma, Schulz, Christian, Skowasch, Dirk, Taube, Christian, Welte, Tobia, de Roux, André, Beghé, Bianca, Blasi, Francesco, Walter Canonica, Giorgio, Carpagnano, Giovanna, Caruso, Cristiano, Guido Corsico, Angelo, Constantino, Elio, Crimi, Nunzio, Maestrelli, Piero, Menzella, Francesco, Milanese, Manlio, Papi, Alberto, Pelaia, Girolamo, Pini, Laura, Santus, Pierachille, Savi, Eleonora, Scichilone, Nicola, Senna, Gianenrico, Spadaro, Giuseppe, Vaghi, Adriano, Gans, Steven, Hölters, Jurgen, Langeveld, B, Pieters, Willem, A Staaks, G H, van Veen, Ilonka, K van den Berg, J W, Einvik, Gunnar, Lehmann, Sverre, Ali García, Ismael, Almonacid, Carlo, Bobolea, Irina, Campo Mozo, Paloma, de Luiz, Gustavo, Domingo Ribas, Christian, María Echave-Sustaeta María-Tomé, José, Luis García Rivero, Juan, García-Cosío Piqueras, Borja, Gómez-Bastero Fernández, Ana, González Pérez, Ruperto, Henríquez Santa, Aythamy, Martínez Rivera, Carlo, Muñoz Gall, Xavier, Ramos, Jacinto, Gregorio Soto Campos, Jose, Vidal Pan, Carmen, Stenfors, Nikolai, Tunsäter, Alf, Vinge, Ine, Chaudhuri, Rekha, Harrison, Timothy, Mansur, Adel, Nasser, Shuaib, Nordstrom, Monica, Pfeffer, Paul, Saralaya, Dinesh, Short, Philip, Adlakha, Arun, Alpan, Oral, Averill, Franci, Badhwar, Anil, Bardelas, Jose, Baxter, Barbara, Bensch, George, Berger, William, Bernstein, Jonathan, Bridges, Tracy, Brimeyer, Ryan, Calhoun, William, Campbell, Edward, Brett Cherry, William, Chupp, Geoffrey, Clore, Lee, Cohn, John, Cole, Jeremy, Condemi, John, Cury, Jame, Davis, Benjamin, Deleon, Samuel, Delacruz, Lui, Diaz, Joseph, Erb, David, Eziri, Emeka, Fakih, Faisal, Fiedler, Dougla, Fost, David, Fritz, Stephen, Gonzalez, Erika, Goodman, Brad, Gottlieb, Peter, Gottschlich, Gregory, Gower, Richard, Hajal, Rizan, Harris, Jame, Heidarian-Raissy, Hengameh, Heyder, Albrecht, Hill, DAVID STANLEY, Holguin, Fernando, Hussain, Iftikhar, Illowite, Jonathan, Jacobs, Joshua, Jarratt, Mikell, Kaiser, Harold, Kao, Neil, Kashyap, Ravindra, Kaufman, David, Kent, Edward, Kim, Kenneth, Klein, Ryan, Kraft, Monica, Kono, Ritsu, Kureishy, Shahrukh, Leflein, Jeffrey, Leong, Mila, Li, Huamin, Lin, Robert, Lugogo, Njira, Marcus, Michael, Jose Maselli Caceres, Diego, Mehta, Vinay, Mello, Curti, Millard, Mark, Milstone, Aaron, Mohan, Arjun, Moore, Wendy, Moss, Mark, Mumneh, Nayla, O'Brien, Thoma, Ostransky, David, Palumbo, Michael, Parikh, Purvi, Parikh, Sudhir, Patel, Amit, Perez, Guido, Pleskow, Warren, Prenner, Bruce, Puppala, Dileep, Ramey, John, Reibman, Joan, Reyes, Ramon, Robinette, Emory, Rodicio, Ileana, Ryan, Stephen, Sekhsaria, Sudhir, Sigal, Barry, Sikand, Vinay, Soong, Weily, Spangenthal, Selwyn, St John, Roy, Gary, Steven, Subramaniam, Vijay, Sumino, Kaharu, Sztejman, Eric, A Tan, Ricardo, Tanus, Tonny, Thompson, Charle, Thornblade, Carl, Villareal, Manuel, Wenzel, Sally, Zafra, Heidi, Ziedalski, Tomasz, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de pneumologie, Harrison T.W., Chanez P., Menzella F., Canonica G.W., Louis R., Cosio B.G., Lugogo N.L., Mohan A., Burden A., McDermott L., Garcia Gil E., Zangrilli J.G., Pohl W., Voves R., Deschampheleire M., Martinot J.-B., Peche R., Chapman K., Cheema A., Dorscheid D., FitzGerald J.M., Gagnon R., Killorn W.P., Olivenstein R., Philteos G., Ramsey C., Rolf J.D., Walker B., Hilberg O., Skjold T., Titlestad I., Hakulinen A., Kilpelainen M., Ben Hayoun M., Bonniaud P., Bourdin A., De Blay F., Deslee G., Devouassoux G., Didier A., Douadi Y., Fry S., Garcia G., Girodet P.-O., Leroyer C., Magnan A., Mahay G., Nocent C., Pison C., Roux P.-M., Taille C., Tiotiu J.-A., Beck E., Jandl M., Kaehler C., Kassner F., Koesters F., Kronsbein J., Schaum T., Schulz C., Skowasch D., Taube C., Welte T., de Roux A., Beghe B., Blasi F., Carpagnano G., Caruso C., Corsico A.G., Constantino E., Crimi N., Maestrelli P., Milanese M., Papi A., Pelaia G., Pini L., Santus P., Savi E., Scichilone N., Senna G., Spadaro G., Vaghi A., Gans S., Holters J., Langeveld B., Pieters W., Staaks G.H.A., van Veen I., van den Berg J.W.K., Einvik G., Lehmann S., Ali Garcia I., Almonacid C., Bobolea I., Campo Mozo P., de Luiz G., Domingo Ribas C., Echave-Sustaeta Maria-Tome J.M., Garcia Rivero J.L., Garcia-Cosio Piqueras B., Gomez-Bastero Fernandez A., Gonzalez Perez R., Henriquez Santa A., Martinez Rivera C., Munoz Gall X., Ramos J., Gregorio Soto Campos J., Vidal Pan C., Stenfors N., Tunsater A., Vinge I., Chaudhuri R., Harrison T., Mansur A., Nasser S., Nordstrom M., Pfeffer P., Saralaya D., Short P., Adlakha A., Alpan O., Averill F., Badhwar A., Bardelas J., Baxter B., Bensch G., Berger W., Bernstein J., Bridges T., Brimeyer R., Calhoun W., Campbell E., Cherry W.B., Chupp G., Clore L., Cohn J., Cole J., Condemi J., Cury J., Davis B., DeLeon S., Delacruz L., Diaz J., Erb D., Eziri E., Fakih F., Fiedler D., Fost D., Fritz S., Gonzalez E., Goodman B., Gottlieb P., Gottschlich G., Gower R., Hajal R., Harris J., Heidarian-Raissy H., Heyder A., Hill D., Holguin F., Hussain I., Illowite J., Jacobs J., Jarratt M., Kaiser H., Kao N., Kashyap R., Kaufman D., Kent E., Kim K., Klein R., Kraft M., Kono R., Kureishy S., Leflein J., Leong M., Li H., Lin R., Lugogo N., Marcus M., Maselli Caceres D.J., Mehta V., Mello C., Millard M., Milstone A., Moore W., Moss M., Mumneh N., O'Brien T., Ostransky D., Palumbo M., Parikh P., Parikh S., Patel A., Perez G., Pleskow W., Prenner B., Puppala D., Ramey J., Reibman J., Reyes R., Robinette E., Rodicio I., Ryan S., Sekhsaria S., Sigal B., Sikand V., Soong W., Spangenthal S., St. John R., Steven G., Subramaniam V., Sumino K., Sztejman E., Tan R.A., Tanus T., Thompson C., Thornblade C., Villareal M., Wenzel S., Zafra H., Ziedalski T., and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Pulmonary and Respiratory Medicine ,Spirometry ,Adult ,Male ,medicine.medical_specialty ,Exacerbation ,[SDV]Life Sciences [q-bio] ,Population ,Settore MED/10 - Malattie Dell'Apparato Respiratorio ,Placebo ,Antibodies, Monoclonal, Humanized ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Double-Blind Method ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Anti-Asthmatic Agents ,Patient Reported Outcome Measures ,education ,Sinusitis ,Asthma ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Benralizumab ,3. Good health ,Eosinophils ,030228 respiratory system ,chemistry ,Asthma Control Questionnaire ,Disease Progression ,Quality of Life ,Female ,business - Abstract
Background: ANDHI was done to assess the efficacy of benralizumab, including onset of effect and impact on health-related quality of life (HRQOL), exacerbation rate, lung function, and nasal polyposis symptoms. Methods: This phase 3b, randomised, double-blind, parallel-group, placebo-controlled ANDHI study was completed in adults (aged 18–75 years) with severe eosinophilic asthma with at least 2 exacerbations in the previous year, despite high-dose inhaled corticosteroid plus additional controllers, screening blood eosinophil counts of at least 150 cells per μL, and an Asthma Control Questionnaire 6 (ACQ-6) score of 1·5 or more. Patients who met eligibility criteria were randomly assigned (2:1; stratified by previous exacerbation count [two, or three or more], maintenance oral corticosteroid use, and region), using an integrated web-based response system, to receive benralizumab at 30 mg every 8 weeks (first three doses given 4 weeks apart) or matched placebo for 24 weeks. Primary efficacy measure was annualised asthma exacerbation rate, with rate ratio (RR) calculated over the approximate 24-week follow-up. Secondary efficacy measures included change from baseline to end of treatment (week 24) in St George's Respiratory Questionnaire (SGRQ) total score (key secondary endpoint), FEV1, peak expiratory flow (PEF), ACQ-6, Predominant Symptom and Impairment Assessment (PSIA), Clinician Global Impression of Change (CGI-C), Patient Global Impression of Change (PGI-C), and Sino-Nasal Outcome Test-22 (SNOT-22). All efficacy analyses, except for SNOT-22, were summarised and analysed using the full analysis set on an intention-to-treat population (all randomly assigned patients receiving investigational product, regardless of protocol adherence or continued participation in the study). SNOT-22 was summarised for the subgroup of patients with physician-diagnosed nasal polyposis with informed consent. This study is registered with ClinicalTrials.gov, NCT03170271. Findings: Between July 7, 2017, and Sept 25, 2019, 656 patients received benralizumab (n=427) or placebo (n=229). Baseline characteristics were consistent with severe eosinophilic asthma. Benralizumab significantly reduced exacerbation risk by 49% compared with placebo (RR estimate 0·51, 95% CI 0·39–0·65; p5%) were nasopharyngitis (30 [7%]), headache (37 [9%]), sinusitis (28 [7%]), bronchitis (22 [5%]), and pyrexia (26 [6%]). Fewer serious adverse events were reported for benralizumab (23 [5%]) versus placebo (25 [11%]), and the only common serious adverse event (experienced by >1% of patients) was worsening of asthma, which was reported for nine (2%) patients in the benralizumab group and nine (4%) patients in the placebo group. Interpretation: Our results extend the efficacy profile of benralizumab for patients with severe eosinophilic asthma, showing early clinical benefits in patient-reported outcomes, HRQOL, lung function, and nasal polyposis symptoms. Funding: AstraZeneca.
- Published
- 2021
25. Effects of biological therapies on chronic rhinosinusitis in severe asthmatic patients.
- Author
-
Bandi F, Gallo S, Preti A, Mozzanica F, Visca D, Marelli M, Maddalone E, Gambarini C, Vaghi A, Spanevello A, and Castelnuovo P
- Subjects
- Biological Therapy, Chronic Disease, Humans, Antibodies, Monoclonal therapeutic use, Asthma complications, Nasal Polyps complications, Nasal Polyps drug therapy, Rhinitis complications, Rhinitis drug therapy, Sinusitis complications, Sinusitis drug therapy
- Abstract
Objective: The introduction of monoclonal antibody (mAb) therapies represents a promising treatment for refractory chronic rhinosinusitis (CRS). We assessed the effects of selected mAbs (omalizumab, mepolizumab, benralizumab) on CRS in severe asthmatic patients in a real-life setting., Methods: A prospective observational study on severe asthmatic patients, treated with 3 different mAb (omalizumab, mepolizumab, benralizumab), and comorbid CRS was conducted. All patients were followed for 52 weeks. The degree of nasal control, SinoNasal Outcome Test (SNOT) 22, Nasal Polyp Score (NPS), Lund Kennedy Score (LKS) were collected at baseline and at 52-week., Results: 40 patients (33 with nasal polyps) were studied. 33 patients (82.5%) had uncontrolled nasal disease at baseline, and 15 (37.5%) were uncontrolled after 52 weeks. Significant improvement was observed for SNOT 22 (P < 0.001), SNOT 1-12 (P < 0.001) and degree of nasal control (P < 0.001). Differences in NPS (P = 0.130) and LKS (P = 0.124) were not significant. Net change in the above-mentioned parameters among the three treatment groups was not significantly different., Conclusions: The study shows an improvement of nasal symptoms after 52 weeks of mAb treatment, which was not associated with significant improvement of endoscopic findings. Larger studies are needed to assess the real-life efficacy of mAbs in CRS., (Copyright © 2020 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)
- Published
- 2020
- Full Text
- View/download PDF
26. How Do Storms Affect Asthma?
- Author
-
D'Amato G, Annesi-Maesano I, Vaghi A, Cecchi L, and D'Amato M
- Subjects
- Allergens, Humans, Pollen, Seasons, Asthma, Climatic Processes
- Abstract
Purpose of Review: There are observations in various geographical areas that thunderstorms occurring during pollen seasons can induce severe asthma attacks in pollinosis patients., Recent Findings: An accredited hypothesis explaining the association between thunderstorms and asthma suggests that storms can concentrate pollen grains at ground level, which may then release allergenic particles of respirable size in the atmosphere after their imbibition of water and rupture by osmotic shock. During the first 20-30 min of a thunderstorm, patients affected by pollen allergy may inhale a high quantity of the allergenic material that is dispersed into the atmosphere as a bioaerosol of allergenic particles, which can induce asthmatic reactions, often severe. Subjects without asthma symptoms, but affected by seasonal rhinitis can also experience an asthma attack. A key message is that all subjects affected by pollen allergy should be alerted to the danger of being outdoors during a thunderstorm in the pollen season, as such events may be an important cause of severe asthma exacerbations. In light of these observations, it is useful to predict thunderstorms and thus minimize thunderstorm-related events. Patients with respiratory allergy induced by pollens and molds need to be informed about a correct therapeutic approach of bronchial asthma by inhalation, including the use of bronchodilators and inhaled corticosteroids. The purpose of this review is to focalize epidemiological, etiopathogenetic, and clinical aspects of thunderstorm-related asthma.
- Published
- 2018
- Full Text
- View/download PDF
27. Long-term macrolides in diffuse interstitial lung diseases.
- Author
-
Faverio P, Bini F, Vaghi A, and Pesci A
- Subjects
- Animals, Anti-Bacterial Agents adverse effects, Bacteria pathogenicity, Drug Administration Schedule, Host-Pathogen Interactions, Humans, Lung immunology, Lung microbiology, Lung pathology, Lung Diseases, Interstitial immunology, Lung Diseases, Interstitial microbiology, Lung Diseases, Interstitial pathology, Macrolides adverse effects, Time Factors, Treatment Outcome, Anti-Bacterial Agents administration & dosage, Bacteria drug effects, Lung drug effects, Lung Diseases, Interstitial drug therapy, Macrolides administration & dosage
- Abstract
In the present review we provide currently available evidence for the use of macrolides in the treatment of diffuse interstitial lung diseases (ILDs). Up to now, research on macrolides has mainly focused on three areas. First, macrolides have shown some promising results in cellular models and case reports as antifibrotic agents, by promoting autophagy and clearance of intracellular protein aggregates and acting as regulators of surfactant homeostasis. Secondly, macrolides have an immunomodulatory effect, which has been applied in some organising pneumonia cases. In particular, macrolides have been tested in association with systemic corticosteroids as steroid-sparing agents and alone as either first-line agents in mild cases or second-line agents where steroids were poorly tolerated or had failed. Thirdly, a recent area of research concerns the possible role of macrolides as modulators of lung microbiota and the host-microbiota interaction. This function has been particularly studied in idiopathic pulmonary fibrosis patients, in whom changes in microbiota have been proved to be associated with disease progression. However, the lack of high-quality studies makes the application of macrolide therapy in ILDs a field in which research should be conducted on a large scale., Competing Interests: Conflict of interest: None declared., (Copyright ©ERS 2017.)
- Published
- 2017
- Full Text
- View/download PDF
28. Prescription bias and factors associated with improper use of inhalers.
- Author
-
Sestini P, Cappiello V, Aliani M, Martucci P, Sena A, Vaghi A, Canessa PA, Neri M, and Melani AS
- Subjects
- Administration, Inhalation, Adolescent, Adult, Aged, Aged, 80 and over, Asthma drug therapy, Clinical Competence, Female, Humans, Logistic Models, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive drug therapy, Anti-Asthmatic Agents administration & dosage, Equipment Failure, Metered Dose Inhalers statistics & numerical data
- Abstract
Many different inhalers are available for delivering aerosol therapy in respiratory medicine. As a consequence, the prescribing physicians may have some difficulty tailoring the most suitable inhaler to each patient. This multicenter, observational study using a self-administered questionnaire analyzed the characteristics of a large sample of patients (n = 1,305; 55% females; mean age 57.4, with a range of 15-88 years; most suffering from asthma or chronic obstructive pulmonary disease [COPD]) familiar with several different types of inhalers in relation to their most commonly used delivery device. Data on the inhalation technique for 2,057 observations of 1,126 patients using device-specific checklists and factors associated to misuse were also evaluated. Prevalent usage of newer dry powder inhalers (DPIs) was significantly associated with male sex, higher education, better respiratory function, and prescription from a respiratory physician. Patients using DPIs had received less instruction by health caregivers and were more likely to have read the instruction leaflet than users of metered dose inhalers (MDIs). Under these conditions, inhaler misuse was common and similar for both pressurized metered dose inhalers (pMDIs) and DPIs. For both types of inhalers, misuse was significantly and equally associated to increased age, less education, and less instruction by health care personnel. We conclude that many doctors are not familiar with the relevant characteristics of currently available inhalers. The prescription of newer DPIs may be subjected to gender, socio-economic, and instruction bias. The simple change of device from the pMDI to the newer DPIs is not associated with improved inhalation technique.
- Published
- 2006
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.