Monday, May 16, 2011
The recommendations for patients with asthma that is not well-controlled are inhaled corticosteroids (ICS) and long-acting β(2)-agonists (LABAs). Many of these patients, however, continue to have inadequately controlled asthma. In a previous study (Humbert et al. Allergy 2005;60(3):309-16), it was found that the annualized rate of severe exacerbations was reduced by 29% in patients receiving omalizumab in addition to guideline-defined therapy. In a large study in 850 patients aged 12 to 75 years who had inadequately controlled asthma despite treatment with high-dose ICS plus LABAs, with or without other controllers, omalizumab reduced exaberbations by 25% over 48 weeks (Hanania et al. Ann Intern Med 2011;154: 573-8). Are you using omalizumab in patients with severe uncontrolled asthma? We want to hear about your experience.
Monday, May 9, 2011
In the May 5, 2011, issue of the New England Journal of Medicine, Price et al. (N Engl J Med 2011; 364:1695-1707) http://www.nejm.org/doi/full/10.1056/NEJMoa1010846 report on two parallel, multicenter trials that compared the real-world effectiveness of a leukotriene-receptor antagonist (LTRA) with either an inhaled glucocorticoid being used as a first-line asthma-controller therapy, or a long-acting beta-agonist (LABA) being used as an add-on therapy in patients who were already being given inhaled glucocorticoids. The authors assigned patients to 2 years of open-label therapy. After 2 months, the efficacy of the LTRA was equivalent to the use of an inhaled glucocorticoid as first-line controller therapy and to LABA as an add-on therapy. However, equivalence after 2 years was not proven. The two groups did not show a significant difference in either rate of exacerbations or ACQ scores. Is this what you find in your practice?