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[RESOLVED] What Is Ics And Laba?

Overall, budesonide/formoterol self-administered according to the MART regimen reduced the risk of a first severe exacerbation, with a hazard ratio of 0.49 (95% CI 0.34–0.70). As expected in an analysis involving small numbers of adolescents in each study, with different comparator treatments, there was significant heterogeneity. Budesonide/formoterol MART was more effective than fixed-dose ICS regimens and was comparable to, or more effective than, fixed-dose ICS/LABA regimens. In contrast to the exacerbation findings, the benefit in terms of asthma control was not clinically significant (the mean difference in the Asthma Control Questionnaire (ACQ) was −0.07, 95% CI −0.15–0.01). While the authors suggest that the MART regimen in adolescents has comparable efficacy to that in adults, noting that the hazard ratio for time to first severe exacerbation in adults was 0.65 (95% CI 0.50–0.72), the reporting of interaction tests comparing adults with adolescents would have been informative and would have enabled us to better understand the strength of evidence supporting this interpretation 😎 [1]
In 2011 the British asthma guidelines recommended for the first time that long-acting beta agonists (LABAs) should be prescribed in fixed dose combination inhaled corticosteroid (ICS)/LABA inhalers in the treatment of asthma.1 This represented a revision to the 2009 BTS guidelines in which LABAs were recommended if used with ICS, either as separate inhalers or as a combination ICS/LABA inhaler.2 The revision was based on the evidence that LABAs have the potential to increase the risk of asthma mortality when used by patients with unstable asthma without concomitant ICS therapy or scheduled medical review,3 that there is no evidence of an increased risk of asthma mortality with combination ICS/LABA inhaler therapy in asthma,4 and that it is only with combination ICS/LABA products that it could be guaranteed that LABA monotherapy can be avoided.5 It recognised that the use of separate inhalers inevitably results in periods of LABA monotherapy in a proportion of patients, because patients who are poorly adherent to prescribed ICS therapy may continue using their LABA inhaler for symptomatic relief.5–7 (last revised 70 days ago by Keah Busch from Wroclaw, Poland) [2]
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Bryn Shearer at erj.ersjournals.com, mentions how overall, budesonide/formoterol self-administered according to the MART regimen reduced the risk of a first severe exacerbation, with a hazard ratio of 0.49 (95% CI 0.34–0.70). As expected in an analysis involving small numbers of adolescents in each study, with different comparator treatments, there was significant heterogeneity. Budesonide/formoterol MART was more effective than fixed-dose ICS regimens and was comparable to, or more effective than, fixed-dose ICS/LABA regimens. In contrast to the exacerbation findings, the benefit in terms of asthma control was not clinically significant (the mean difference in the Asthma Control Questionnaire (ACQ) was −0.07, 95% CI −0.15–0.01). While the authors suggest that the MART regimen in adolescents has comparable efficacy to that in adults, noting that the hazard ratio for time to first severe exacerbation in adults was 0.65 (95% CI 0.50–0.72), the reporting of interaction tests comparing adults with adolescents would have been informative and would have enabled us to better understand the strength of evidence supporting this interpretation. (modified by Wacey Ogle on August 2, 2020) [3]
Image #3
Kellyn Downey from erj.ersjournals.com, describes how results: Both groups were similar regarding to age and sex. At the beginning of the study there were no differences in FEV1, ACQ, HR and BP between groups. After 16 weeks pts of both groups demonstrate increasing in FEV1, however in Group I this improvement was higher than in Group II (198.0 ml vs. 172.0 ml, p=0.035). Asthma control was reached in pts of both groups, but ACQ were significantly better in Group I (0.6) than in Group II (1.2), p=0.019. There was no any significant difference in number of asthma exacerbations and respiratory infections episodes during 16 weeks between groups. HR and BP did not change significantly from baseline in both groups. (last revised 2 weeks ago by Edmond Ramirez from Khamis Mushayt, Saudi Arabia) [4]

Article References

  1. https://erj.ersjournals.com/content/51/1/1702338
  2. https://thorax.bmj.com/content/68/2/119
  3. https://erj.ersjournals.com/content/51/1/1702338?rss=1
  4. https://erj.ersjournals.com/content/50/suppl_61/PA3562
Mehreen Alberts

Written by Mehreen Alberts

I'm a creative writer who has found the love of writing once more. I've been writing since I was five years old and it's what I want to do for the rest of my life. From topics that are close to my heart to everything else imaginable!

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