Astma Volwassenen Wetenschap

Combination LABA Inhalers Compared with High-Dose Inhaled Steroids for Adults with Asthma.
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Combination LABA Inhalers Compared with High-Dose Inhaled Steroids for Adults with Asthma.

Am Fam Physician. 2018 Mar 01;97(5):Online

Authors: Aherne A, Kilpatrick J

PMID: 29671509 [PubMed - in process]



Rheumatoid arthritis is associated with increased in-hospital mortality in asthma exacerbations: a nationwide study.
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Rheumatoid arthritis is associated with increased in-hospital mortality in asthma exacerbations: a nationwide study.

Clin Rheumatol. 2018 Apr 19;:

Authors: Luo Y, Fan X, Jiang C, Arevalo Molina AB, Salgado M, Xu J

Abstract
The relationship between RA and asthma has been yielding conflicting results, with most recent studies showing a possible positive association. The study aims at the outcomes of adult patients hospitalized for asthma exacerbation in those with and without RA. We used data from the National Inpatient Sample (NIS) for the period of 2012-2014. ICD 9 code was used to identify the diagnosis. Our primary outcome was in-hospital mortality. Our secondary outcome was total asthma exacerbation hospitalizations, length of stay, and total hospital charges. Compared to those without RA, RA was associated with increased hospitalizations for asthma exacerbation (unadjusted OR 1.29, p < 0.001; adjusted OR 1.06, p = 0.002), more respiratory and systemic comorbidities, increased in-hospital mortality (unadjusted OR 1.89, p = 0.001; adjusted OR 1.60, p = 0.020), length of stay (4.5 vs 3.8; unadjusted p < 0.001, adjusted p < 0.001), and total hospital charges (30,149 vs 26,247; unadjusted p < 0.001, adjusted p = 0.048). Our study was the first to demonstrate that RA is associated with increased in-hospital mortality, length of stay, and cost using a national inpatient database. We hypothesize that in asthmatic patients with concurrent RA, their asthma may represent a distinctive subgroup that is more severe and carries a poorer prognosis, which deserves more attention and future investigation.

PMID: 29671191 [PubMed - as supplied by publisher]



Tiotropium for the Treatment of Asthma: Patient Selection and Perspectives.
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Tiotropium for the Treatment of Asthma: Patient Selection and Perspectives.

Can Respir J. 2018;2018:3464960

Authors: Chari VM, McIvor RA

Abstract
Asthma is a chronic disease of airway inflammation with a large global burden. Despite established, guideline-based stepwise therapy, a significant proportion of patients remain symptomatic and poorly controlled. As such, there is a need for additional safe, effective, convenient, and cost-effective therapies that can be broadly applied across a range of asthma phenotypes. Tiotropium is a long-acting muscarinic antagonist (LAMA) that leads to bronchodilation by blocking endogenous acetylcholine receptors in the airways. Tiotropium has long been approved for the treatment of chronic obstructive pulmonary disease, and it has recently been recognized for its safety and efficacy in improving lung function and controlling asthma. Evidence from several Phase III trials in the adult and paediatric population has shown that tiotropium is well tolerated and significantly improves a range of endpoints as an add-on treatment to ICS therapy, regardless of baseline characteristics and clinical phenotypes. Consequently, regulatory authorities worldwide have recently licensed tiotropium as the only LAMA approved for the treatment of asthma. This review provides an overview of safety and efficacy data and discusses the use of tiotropium in patients across the range of asthma severities, ages, and phenotypes.

PMID: 29670674 [PubMed - in process]



Pharmacokinetics of intranasal mometasone in the fixed-dose combination GSP301 versus two monotherapy intranasal mometasone formulations.
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Pharmacokinetics of intranasal mometasone in the fixed-dose combination GSP301 versus two monotherapy intranasal mometasone formulations.

Allergy Asthma Proc. 2018 May 01;39(3):232-239

Authors: Patel P, Salapatek AM, Talluri RS, Tantry SK

Abstract
BACKGROUND: GSP301 is a fixed-dose combination (FDC) of the antihistamine olopatadine hydrochloride and the corticosteroid mometasone furoate developed as a single nasal spray (NS).
OBJECTIVE: To assess the relative bioavailability of mometasone administered as GSP301 FDC versus two mometasone monotherapy NS formulations.
METHODS: In this single-dose, open-label, crossover study, healthy adults (age range, 18-65 years) were randomized equally to one of six treatment sequences for three 72-hour treatment periods with GSP301 (olopatadine 665 μg-mometasone 50 μg), the mometasone furoate monotherapy component of GSP301 (MF-sponsor, 50 μg), and U.S. Food and Drug Administration-approved mometasone (MF, 50 μg); all the treatments were administered as two sprays per nostril. To evaluate the relative bioavailability of mometasone, pharmacokinetic (PK) estimates, the maximum plasma concentration (Cmax), the area under the plasma concentration time curve (AUC) from time 0 to the last time point with measurable concentration (AUC0-t), and AUC from time 0 to time infinity (AUC0-∞) were compared by analysis of variance. Safety and tolerability were also assessed.
RESULTS: A total of 30 healthy subjects were randomized. Most subjects were white men who were not obese, mean age of ∼43 years. The geometric mean ratios for natural log transformed Cmax, AUC0-t, and AUC0-∞ of mometasone in GSP301 to MF-sponsor were 113.83, 118.36, and 118.50, respectively. For GSP301 and MF, geometric mean ratios for Cmax, AUC0-t, and AUC0-∞ were 141.84, 109.92, and 115.14, respectively. The percentages of subjects who reported treatment-emergent adverse events (TEAE) were 10.0%, 13.3%, and 10.3% for GSP301, MF-sponsor, and MF treatments, respectively. All TEAEs were mild, and none resulted in discontinuation.
CONCLUSION: Mometasone bioavailability with GSP301 was comparable with MF-sponsor and MF monotherapies. A slightly higher Cmax was observed with GSP301 than with MF, but AUC was comparable. The addition of olopatadine to mometasone in GSP301 did not considerably affect the PK of mometasone. GSP301 was well tolerated, with only mild adverse events reported.

PMID: 29669668 [PubMed - in process]



Pharmacokinetics of intranasal olopatadine in the fixed-dose combination GSP301 versus two monotherapy intranasal olopatadine formulations.
Related Articles

Pharmacokinetics of intranasal olopatadine in the fixed-dose combination GSP301 versus two monotherapy intranasal olopatadine formulations.

Allergy Asthma Proc. 2018 May 01;39(3):224-231

Authors: Patel P, Salapatek AM, Talluri RS, Tantry SK

Abstract
BACKGROUND: GSP301 is a fixed-dose combination of the antihistamine olopatadine hydrochloride and the corticosteroid mometasone furoate developed as a single nasal spray.
OBJECTIVE: To assess the relative bioavailability of olopatadine administered as GSP301 versus two olopatadine monotherapy nasal spray formulations.
METHODS: In this single-dose, open-label, crossover study, healthy adults (18-65 years old) were equally randomized to one of six treatment sequences for three 48-hour treatment periods with GSP301 (olopatadine 665 μg-mometasone 50 μg), the olopatadine monotherapy component of GSP301 (OLO-sponsor; 665 μg) and U.S. Food and Drug Administration approved olopatadine (OLO; 665 μg); each treatment was administered as a single dose (two sprays in each nostril). To assess the relative bioavailability of olopatadine in the fixed-dose nasal spray versus two monotherapies, pharmacokinetic (PK) estimates, maximum plasma concentration (Cmax), area under the plasma concentration time curve (AUC) from time 0 to the last time point with measurable concentration (AUC0-t), and AUC from time 0 to time infinity (AUC0-∞) were compared by analysis of variance. Safety and tolerability were also evaluated.
RESULTS: A total of 30 healthy adults (mean age, 43.1 years) were randomized. The majority of the subjects were white men. The geometric mean ratios for natural log transformed Cmax, AUC0-t, and AUC0-∞ of olopatadine in GSP301 and OLO-sponsor were 86.63, 86.92, and 92.83, respectively. For GSP301 and OLO, geometric mean ratios for Cmax, AUC0-t, and AUC0-∞ were 84.68, 87.87, and 93.80, respectively. The percentage of subjects who reported treatment-emergent adverse events (AE) for GSP301, OLO-sponsor, and OLO were 13.8, 10.3, and 10.0%, respectively, with mild AEs reported. One subject withdrew from the study due to an AE (minor oropharyngeal pain) during OLO treatment, before receiving GSP301.
CONCLUSION: Olopatadine bioavailability with GSP301 was comparable with OLO-sponsor and OLO. The presence of mometasone in GSP301 did not considerably affect the PK of olopatadine. GSP301 was well tolerated, with only mild AEs reported.

PMID: 29669667 [PubMed - in process]



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