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respiratory
Asthma

In their own words: patients describe the benefits and limits of mAbs for severe asthma

Patients with severe asthma experience significant improvements in quality-of-life and participation in life with add-on monoclonal antibody therapies but there’s still more to be done. Semi-structured interviews with 20 Australian patients revealed four emergent themes - that life is just easier,...

Patients with severe asthma experience significant improvements in quality-of-life and participation in life with add-on monoclonal antibody therapies but there’s...

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asthma

Dupilumab listed on the PBS for severe asthma

Dupilumab (Dupixent) will be added to the PBS from Thursday, April 1 for adolescents from age 12 years and adults with uncontrolled severe type 2 asthma. The PBS listing of the monoclonal antibody, which targets both IL-4 and IL-13, will benefit...

Dupilumab (Dupixent) will be added to the PBS from Thursday, April 1 for adolescents from age 12 years and adults...
asthma

Targeting the eosinophil key in severe allergic asthma, studies suggest

The clinical response to anti-IL5/5R drugs mepolizumab and benralizumab appears to be the same in patients whether or not they have a severe allergic component to their asthma, research suggests. A team at Guy’s Severe Asthma Centre in London compared clinical...

The clinical response to anti-IL5/5R drugs mepolizumab and benralizumab appears to be the same in patients whether or not they...
asthma

News in brief: lung transplant in bronchiectasis; improving CPAP adherence;

Bronchiectasis outcomes distinctly different from other post-transplant patients Non-CF bronchiectasis patients have poorer outcomes after lung transplantation, including a lower 5-yr survival, than patients with other indications. A retrospective study of consecutive lung transplant patients at Melbourne’s Alfred Hospital found mortality was...

Bronchiectasis outcomes distinctly different from other post-transplant patients Non-CF bronchiectasis patients have poorer outcomes after lung transplantation, including a lower 5-yr...
asthma

Maternal asthma associated with lower lung function in male babies

Male babies born to mothers with asthma have a significantly lower lung function, which may affect their lung function trajectory and risk of developing respiratory disease, Australian research shows. The finding is based on analysis of lung function data from more...

Male babies born to mothers with asthma have a significantly lower lung function, which may affect their lung function trajectory...
asthma

News in brief: FDC inhaler listed on PBS; 13 recommendation on severe asthma; Silica dust compensation landmark

Combination inhaler listed on PBS for asthma Atectura Breezhaler, a fixed dose combination (FDC) of the inhaled corticosteroid (ICS) mometasone furoate with long-acting beta-agonist (LABA) indacaterol, has been listed on the PBS for the maintenance treatment of asthma. The listing was...

Combination inhaler listed on PBS for asthma Atectura Breezhaler, a fixed dose combination (FDC) of the inhaled corticosteroid (ICS) mometasone furoate...
asthma

News in brief: What wheeze looks like; Nebuliser advice for asthma patients; Lung Foundation wants action on vape flavours

Video shows the ‘violent’ physical processes in bronchioles that cause wheezing, A team of Cambridge University bio-engineers have developed a video representation of the oscillations of the bronchioles that for the basis of wheeze. Applying the complex mathematics of fluid mechanics...

Video shows the ‘violent’ physical processes in bronchioles that cause wheezing, A team of Cambridge University bio-engineers have developed a ...
asthma

How is long-term azithromycin being used by respiratory physicians in Australia?

Long-term, low-dose azithromycin is effective but underused in patients with persistent asthma and other obstructive airway disease (OAD), according to findings from a study of real-world prescribing patterns of the macrolide in Australia. Investigators from Hunter Medical Research Institute (HMRI) in...

Long-term, low-dose azithromycin is effective but underused in patients with persistent asthma and other obstructive airway disease (OAD), according to...
asthma

Asthma biologics have substantial impact on oral steroid use

Mepolizumab use has led to a significant and sustained reduction in oral corticosteroids (OCS) use in patients with severe eosinophilic asthma, Australian research indicates. Observational data from 309 patients in the Australian Mepolizumab Registry shows that in the 48% of...

Mepolizumab use has led to a significant and sustained reduction in oral corticosteroids (OCS) use in patients with severe eosinophilic...
asthma

TGA rejects proposal for OTC sales of budesonide/formoterol inhalers

The TGA has knocked back an application to allow OTC sales of combination  budesonide/formoterol inhalers for as-needed reliever therapy in people with mild asthma. In rejecting the application for pharmacy sales, the TGA acknowledged there was evidence that a combination of...

The TGA has knocked back an application to allow OTC sales of combination  budesonide/formoterol inhalers for as-needed reliever therapy in...
asthma

Bronchial thermoplasty benefits sustained beyond a decade

The first study to follow up asthma patients treated with bronchial thermoplasty beyond five years has shown that the benefits persist for at least a decade, and the procedure has an acceptable safety profile. Patients with severe uncontrolled asthma who participated...

The first study to follow up asthma patients treated with bronchial thermoplasty beyond five years has shown that the benefits...
asthma

In Other News

Honours for respiratory specialists Dr Gerard Ryan of Victoria has received an AM in the Australia Day Honours for his significant service to respiratory medicine, and to people living with cystic fibrosis. Dr Ryan was a consultant physician in respiratory medicine...

Honours for respiratory specialists Dr Gerard Ryan of Victoria has received an AM in the Australia Day Honours for his significant...
asthma

Respiratory researcher wins a ‘Science Oscar’

Respiratory pharmacologist Professor Carol Armour of the Woolcock Institute of Medical Research, Sydney, has been named as the recipient of the 2020 Eureka Prize for Outstanding Mentor of Young Researchers Announced on 24 November as part of an online awards ceremony...

Respiratory pharmacologist Professor Carol Armour of the Woolcock Institute of Medical Research, Sydney, has been named as the recipient of...
asthma

Women and elderly feature in rising asthma death toll

The latest data from the Australian Bureau of Statistics shows a persistent and unacceptable number of asthma-related deaths each year, many of which should be preventable. The data, commissioned by the National Asthma Council Australia, showed there were 421 asthma-related...

The latest data from the Australian Bureau of Statistics shows a persistent and unacceptable number of asthma-related deaths each year,...
asthma

Consensus on tapering to curb excessive use of oral corticosteroids

An international consensus statement on tapering oral corticosteroids (OCS) in asthma may be an important step in reducing excessive exposure in the absence of clear guidance, experts say. After a study process involving 131 experts from around the world, it was...

An international consensus statement on tapering oral corticosteroids (OCS) in asthma may be an important step in reducing excessive exposure...
asthma

Burst therapy at home helps asthmatic children avoid hospital admission

Children who have frequent emergency department (ED) visits because of asthma may be able to avoid hospitalisation by using ‘burst therapy’ with high dose inhaled salbutamol at home, Victorian clinicians have shown. In a pilot study, doctors at the Royal...

Children who have frequent emergency department (ED) visits because of asthma may be able to avoid hospitalisation by using ‘burst...
asthma

5 treatable traits have impact on quality of life

There are five ‘treatable traits’ in chronic airways disease that have a major impact on patient quality of life, according to an Australian study. Researchers at the Newcastle University, NSW, analysed the results from two local trials of treatment targeted...

There are five ‘treatable traits’ in chronic airways disease that have a major impact on patient quality of life, according...
asthma

More evidence to ban the blue puffer in favour of as-needed ICS-LABA

In patients with mild asthma, even a single day of repeated use of as-needed ICS–formoterol can protect against short term risk of a severe exacerbation as effectively as regular maintenance ICS, new research shows. While studies such as the 2018 SYGMA...

In patients with mild asthma, even a single day of repeated use of as-needed ICS–formoterol can protect against short term...
asthma

Face mask exemptions for respiratory patients not ‘evidence based’: experts

People with respiratory conditions should not be exempt from wearing face masks in public, a team of international respiratory experts say. Writing in a paper published in the European Respiratory Journal, the Respiratory Effectiveness Group, which includes Professor...

People with respiratory conditions should not be exempt from wearing face masks in public, a team of international respiratory...
asthma

Stay on ICS: analysis shows no harm or benefit in COVID-19

Regular use of inhaled corticosteroids (ICS) does not appear to either increase or decrease mortality from COVID-19 in patients with asthma or COPD, say UK researchers. In response to speculation that ICS may confer a potential protective effect in COVID-19, analysis...

Regular use of inhaled corticosteroids (ICS) does not appear to either increase or decrease mortality from COVID-19 in patients with...
asthma

Oral steroid overuse in asthma a red flag for review

More than a quarter of Australians who use inhaled corticosteroids (ICS) to control their asthma are dispensed high and potentially toxic cumulative levels of oral corticosteroids (OCS), a new study suggests. An analysis of a 10% random sample of PBS...

More than a quarter of Australians who use inhaled corticosteroids (ICS) to control their asthma are dispensed high and potentially...
asthma

Dupilumab safety and efficacy confirmed in extension study

An open-label extension trial of dupilumab for up to three years in adults and adolescents with moderate-to-severe asthma has confirmed the safety and efficacy profile observed in shorter duration phase 2 and 3 studies. The LIBERTY ASTHMA TRAVERSE study, presented at...

An open-label extension trial of dupilumab for up to three years in adults and adolescents with moderate-to-severe asthma has confirmed...
asthma

Biomarker-based steroid reduction difficult to achieve in real world

Use of a biomarker-based strategy to safely reduce corticosteroid use in severe asthma did not show a significant impact - possibly because a high number of patients failed to follow treatment advice, according to UK researchers. Presenting their results at the...

Use of a biomarker-based strategy to safely reduce corticosteroid use in severe asthma did not show a significant impact -...
asthma

Paediatric asthma: why is the rate of readmission rising?

When a child gets admitted to hospital for their asthma it is an opportunity to make a plan for staying out of hospital. But why is the rate of readmission rising? Asthma is the most common chronic illness in Australian children,...

When a child gets admitted to hospital for their asthma it is an opportunity to make a plan for staying...
asthma

What’s new in Australian Asthma Handbook version 2.1?

The latest version of the Australian Asthma Handbook confirms the previously flagged changes away from an over-reliance on SABA-only relievers in mild asthma. Version 2.1 of the Handbook outlines the Level 2 treatment option of as-needed low dose budesonide-formoterol for...

The latest version of the Australian Asthma Handbook confirms the previously flagged changes away from an over-reliance on SABA-only...
asthma

Asthma attacks need their own revolution: experts

Acute asthma attack outcomes will only improve if they are recognised as a heterogeneous condition that needs to be managed with a phenotype-directed personalised treatment approach, respiratory researchers say. Writing in a Thorax state of the art review...

Acute asthma attack outcomes will only improve if they are recognised as a heterogeneous condition that needs to be...
asthma

Australian pollen study reveals early inflammatory effect on respiratory impact

Short-term exposure to grass pollens is associated with airway inflammation in 1-2 days and airway obstruction in 2-3 days in people at risk of atopy due to their family history. A study of 936 participants in the Melbourne Atopy Cohort...

Short-term exposure to grass pollens is associated with airway inflammation in 1-2 days and airway obstruction in 2-3 days in...
asthma

Vitamin D has no benefit for severe asthma attacks

Vitamin D supplements do not prevent severe asthma attacks in at-risk children, results from the first placebo-controlled clinical trial show. Study lead author Professor Juan Carlos Celedón, chief of pediatric pulmonary medicine at UPMC Children's Hospital of Pittsburgh said...

Vitamin D supplements do not prevent severe asthma attacks in at-risk children, results from the first placebo-controlled clinical trial...
asthma

Asthma in 2020: the 3 biggest developments according to ATS

Three of the biggest developments in asthma in 2020 have involved the areas of prevention, treatment of mild disease, and new guidelines for management of severe asthma, according to a keynote presentation at  ATS 2020 virtual meeting. Hope that asthma might...

Three of the biggest developments in asthma in 2020 have involved the areas of prevention, treatment of mild disease, and...
asthma

Ventolin inhalers to get dose counters

Ventolin (salbutamol) metered dose inhalers will come with dose counters, manufacturer GSK has announced. The new inhalers will be phased in over the next four to six months and are listed on the PBS from 1 August, 2020. The dose counter allows...

Ventolin (salbutamol) metered dose inhalers will come with dose counters, manufacturer GSK has announced. The new inhalers will be phased in...
asthma

COVID-19 anxiety is triggering asthma attacks

Asthma attacks triggered by anxiety over the threat of COVID-19 disease are just one of several major impacts of the pandemic on people with asthma in Australia, according to a new report. A survey by Asthma Australia has found that 44%...

Asthma attacks triggered by anxiety over the threat of COVID-19 disease are just one of several major impacts of the...
asthma

Children’s asthma and sleep apnoea has improved during lockdown – a clinician explains why that might be

          It’s Monday morning and I’m running my regular children’s sleep clinic. Except it’s not a Monday morning like any other I have had in my 20 years of practice. I am running the clinic on my laptop, seeing patients and...

          It’s Monday morning and I’m running my regular children’s sleep clinic. Except it’s not a Monday morning like any other...
asthma

Biomarker response to asthma treatment shouldn’t be neglected

Biomarkers can guide treatment choice in severe asthma but may also provide clinically useful information from the subsequent effects of treatment on biomarkers, Australian researchers say. A review of the evidence, led by Professor John Upham from the University of...

Biomarkers can guide treatment choice in severe asthma but may also provide clinically useful information from the subsequent effects of...
asthma

Asthma app closes the language gap for Aboriginal and Torres Strait Islander families

Asthma education for Aboriginal and Torres Strait Islander families and health practitioners in northern and central Australia is closing the language gap. A new interactive app, produced by the Menzies School of Health...

Asthma education for Aboriginal and Torres Strait Islander families and health practitioners...
asthma

Too early to use thermoplasty before biologics in severe asthma: expert

It would be premature to offer bronchial thermoplasty before mepolizumab in severe asthma despite a study showing unique benefits of the procedure, a respiratory physician says. Professor Peter Wark from the Centre of Excellence in Severe Asthma in Newcastle says a...

It would be premature to offer bronchial thermoplasty before mepolizumab in severe asthma despite a study showing unique benefits of...
asthma

Asthma biomarkers not yet fully adopted in daily practice

Despite the growing body of research on the use of biomarkers to guide asthma treatment, clinicians are still resistant to their use in daily practice, research shows. A survey of Australian members of the TSANZ Asthma Special Interest Group found...

Despite the growing body of research on the use of biomarkers to guide asthma treatment, clinicians are still resistant to...
asthma

Bushfire asthma toll shows need for revised public health approaches

People with asthma were unable to protect themselves against bushfire-smoke induced asthma attacks despite following public health advice, a report from Asthma Australia has found. The long duration and intensity of the bushfires in late 2019 and early 2020 resulted in...

People with asthma were unable to protect themselves against bushfire-smoke induced asthma attacks despite following public health advice, a report...
asthma

As-needed ICS now available on PBS for mild asthma

The PBS-approved indication for budesonide/formoterol (Symbicort Turbuhaler 200/6 and Rapihaler 100/3) has now been extended to include as-needed management of patients 12 years and over with mild asthma. The change is in line with an early update to the Australian...

The PBS-approved indication for budesonide/formoterol (Symbicort Turbuhaler 200/6 and Rapihaler 100/3) has now been extended to include as-needed management of...
asthma

Lung function testing can resume: TSANZ

Pulmonary function testing can be resumed with some safety precautions against the risk of COVID-19 transmission, professional organisations have advised. After suspending all but clinically essential testing in March due to the pandemic, the Thoracic Society Australia & New Zealand...

Pulmonary function testing can be resumed with some safety precautions against the risk of COVID-19 transmission, professional organisations have advised. After...
asthma

Consensus statement on severe asthma amid COVID-19

New Clinical Recommendations For COVID-19 In Severe Asthma emphasise the importance of maintaining usual asthma therapy including monoclonal antibodies and oral corticosteroids when indicated. The consensus document, from the Centre of Excellence in Severe Asthma in Newcastle, said there was...

New Clinical Recommendations For COVID-19 In Severe Asthma emphasise the importance of maintaining usual asthma therapy including monoclonal antibodies and...
asthma

Keep calm and carry on with steroids: living guidelines for COVID-19

People with asthma or COPD who have COVID-19 disease should continue taking corticosteroids as prescribed and avoid stopping them, according to a consensus recommendation in Australia’s ‘living guidelines’ for COVID-19. While acknowledging there is currently little available evidence about outcomes...

People with asthma or COPD who have COVID-19 disease should continue taking corticosteroids as prescribed and avoid stopping them, according...
asthma

Asthma not a risk factor for severe COVID-19, large study shows

Asthma does not appear to be a risk factor for severe COVID-19, an analysis of almost 17,000 UK patients who were admitted to hospital suggests. The ISARIC4C study, which has yet to be peer-reviewed,  included COVID-19-positive patients admitted to 166 hospitals and...

Asthma does not appear to be a risk factor for severe COVID-19, an analysis of almost 17,000 UK patients who were...
asthma

Airway smooth muscle work wins TSANZ Research Medal for Prof Alan James

Professor Alan James remembers the first time he saw a patient die from asthma. He was just starting out in medicine, working in hospitals in London and then Singapore. He recalls the small Changi Hospital with no emergency department. “A person...

Professor Alan James remembers the first time he saw a patient die from asthma. He was just starting out in...
asthma

COPD and asthma under-represented among COVID-19 patients

Both asthma and COPD are reported at lower than expected levels in patients with COVID-19 say researchers, who have called for more research into the possible reasons for the finding. It is “striking” that both COPD and asthma seem to be...

Both asthma and COPD are reported at lower than expected levels in patients with COVID-19 say researchers, who have called...
asthma

Stop spirometry and respiratory therapies: TSANZ

Lung function testing and the use of respiratory therapies such as nebulisers should be stopped in all but medically essential cases because of the risk of COVID19 transmission, the Thoracic Society of Australia and New Zealand (TSANZ) has advised. There...

Lung function testing and the use of respiratory therapies such as nebulisers should be stopped in all but medically essential...
asthma

Mepolizumab ‘super responders’ seen in severe eosinophilic asthma

Real world patients with severe eosinophilic asthma show the same good outcomes with mepolizumab as seen in clinical trials – with a particular group of ‘super responders’ with a T2 phenotype, an Australian study has shown. A registry based study...

Real world patients with severe eosinophilic asthma show the same good outcomes with mepolizumab as seen in clinical trials –...
asthma

Professional groups call to stop routine pulmonary function testing

Pulmonary function testing should be avoided for non-urgent cases professional groups say in light of the risks of COVID-19 transmission. The American Thoracic Society says that while the evidence for COVID-19 is rapidly changing, it believes that the risks of...

Pulmonary function testing should be avoided for non-urgent cases professional groups say in light of the risks of COVID-19 transmission. The...
asthma

Professor Helen Reddel: eosinophils of less use for guiding treatment in mild asthma

Blood eosinophils have less of a role in predicting exacerbations or guiding treatment in mild asthma than in severe asthma, according to an analysis from the multinational Novel START study. The study comprised 675 adults with...

Blood eosinophils have less of a role in predicting exacerbations or guiding treatment in mild asthma than in...
asthma

Lung iron levels regulate severity of asthma

Iron levels in the lung play a crucial role in regulation of asthma severity, Australian research suggests. Scientists at Newcastle University, NSW say their data from asthma patient samples and mouse models is the first to definitively show a relationship between...

Iron levels in the lung play a crucial role in regulation of asthma severity, Australian research suggests. Scientists at Newcastle University,...
asthma

Changes in EOS after ICS treatment may predict response, research shows

Changes in blood eosinophil (EOS) count after starting treatment with inhaled corticosteroids can predict response in patients with COPD, a study which appears to turn accepted wisdom on its head has suggested. Reanalysis of data from the three-year, 700-patient ISOLDE...

Changes in blood eosinophil (EOS) count after starting treatment with inhaled corticosteroids can predict response in patients with COPD, a...
asthma

Recommendation to lift PBS restrictions on ICS+LABA access in children

Clinician concerns about the PBS age restrictions for ICS+LABA fixed dose combination (FDC) products in asthma have led to a proposed change in PBS listings to allow second line treatment. At its December 2019 meeting, the Pharmaceutical Benefits Advisory Committee (PBAC)...

Clinician concerns about the PBS age restrictions for ICS+LABA fixed dose combination (FDC) products in asthma have led to a...
asthma

FOT better than spirometry for identifying poor asthma control

An alternative method for measuring lung function, oscillometry, is better at identifying patients with poorly controlled asthma when compared to spirometry, according to NSW researchers Measurement of bronchodilator response (BDR) with the...

An alternative method for measuring lung function, oscillometry, is better at...
asthma

Benralizumab used to treat near-fatal asthma

Benralizumab has been used to treat an acute asthma attack in a patient with a serious adverse reaction to steroids, respiratory physicians in the UK report. The anti-IL5ra monoclonal antibody is licensed in the UK for the prevention of...

Benralizumab has been used to treat an acute asthma attack in a patient with a serious adverse reaction to...
asthma

Biologic prescribing restrictions eased for severe asthma

PBS restrictions have been eased on prescribing of the biologics in severe asthma from 1 December. The PBS has adopted the following recommendation made by the Pharmaceutical Benefits Advisory Committee (PBAC) at its May meeting: Initial treatment: Amendment of the eosinophil cut-off...

PBS restrictions have been eased on prescribing of the biologics in severe asthma from 1 December. The PBS has adopted the...
asthma

RCT confirms efficacy of treatable traits approach in severe asthma

An Australian clinical trial has confirmed the feasibility and efficacy of managing severe asthma  with a personalised ‘Treatable Traits’ approach. In a study involving 140 patients with  severe asthma, clinicians at Newcastle University and John Hunter Hospital, NSW showed that a...

An Australian clinical trial has confirmed the feasibility and efficacy of managing severe asthma  with a personalised ‘Treatable Traits’ approach. In...
asthma

Critical shortage of EpiPen Jr forces patients to rely on contaminated product

Supplies of Epipen Jr (150mcg adrenaline) products have run out in Australia and families of children with with allergic asthma are being advised to keep their expired auto-injectors for emergency use until replacement stock becomes available in late December 2019. Manufacturer...

Supplies of Epipen Jr (150mcg adrenaline) products have run out in Australia and families of children with with allergic asthma...
asthma

Thunderstorm asthma rumbles on into persistent, undertreated disease

Survivors of Melbourne’s thunderstorm asthma event of 2016 are experiencing persistent  symptoms that suggest worsening in disease trajectory and loss of asthma control, researchers say One year after being affected by the  epidemic thunderstorm asthma event, most patients had a “pivotal...

Survivors of Melbourne’s thunderstorm asthma event of 2016 are experiencing persistent  symptoms that suggest worsening in disease trajectory and loss...
asthma

GOLD places greater emphasis on non-pharmacological approach

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has updated its strategy for the diagnosis, management and prevention of COPD, reinforcing the role for non-pharmacological treatment. GOLD board member Professor David Halpin, a UK respiratory physician, ...

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has updated its strategy for the diagnosis, management and...
asthma

Twitter algorithm gives early warning of thunderstorm asthma

An algorithm that monitors Twitter for breathing problem keywords could detect a thunderstorm asthma event nine hours ahead of official reports, its CSIRO developers say. Scientists tested several different keyword algorithms on retrospective social media posts covering the period around the...

An algorithm that monitors Twitter for breathing problem keywords could detect a thunderstorm asthma event nine hours ahead of official...
asthma

FeNO-guided treatment benefit seen in non-eosinophilic asthma in pregnancy

Women with non-eosinophilic asthma in pregnancy benefit from treatment adjustment with a FENO-guided algorithm,  according to a new analysis of the landmark Managing Asthma in Pregnancy (MAP) study. Professor Peter Gibson’s 2011 study conducted at the Hunter Medical Research Institute in...

Women with non-eosinophilic asthma in pregnancy benefit from treatment adjustment with a FENO-guided algorithm,  according to a new analysis of...
asthma

Obesity leads to fat deposition in the airways

Fatty airways could be contributing to problems with respiratory function in overweight and obese people, according to new research led by a WA team. A study of cross-sectional tissues samples from postmortem lungs has demonstrated adipose tissue accumulates within the...

Fatty airways could be contributing to problems with respiratory function in overweight and obese people, according to new research led...
asthma

Lung elasticity linked to airflow obstruction

Increased lung compliance and loss of lung elastic recoil has been observed in older people with asthma and fixed airflow obstruction (FAO). However the association appears to be independent of likely contributing factors such as age or asthma duration. The small Australian...

Increased lung compliance and loss of lung elastic recoil has been observed in older people with asthma and fixed airflow...
asthma

High doses of oral steroids in asthma revealed

Almost a third of patients with severe asthma are taking potentially harmful doses of oral steroids, according to a Dutch study presented at the 2019 ERS Congress. The study used a pharmacy database of more than 500,000 Dutch residents to identify...

Almost a third of patients with severe asthma are taking potentially harmful doses of oral steroids, according to a Dutch...
asthma

Popular blue puffer won’t go quietly

Changing beliefs about SABA-only reliever therapy in order to implement the new GINA guidelines on asthma management isn’t going to be easy, an expert warns. Because patients, and especially parents of paediatric...

Changing beliefs about SABA-only reliever therapy in order to implement the...
asthma

Bronchial thermoplasty can be safely offered to patients with FEV1 <50%

Bronchial thermoplasty (BT) can now “confidently” be offered to patients with severe asthma and a baseline FEV1 30-50%, Australian researchers say. The most severely obstructed patients have sometimes been excluded from thermoplasty because of safety concerns about transient worsening of asthma...

Bronchial thermoplasty (BT) can now “confidently” be offered to patients with severe asthma and a baseline FEV1 30-50%, Australian researchers...
asthma

Language matters: why the term ‘exacerbation’ should be dropped

Clinicians should avoid the term asthma ‘exacerbation’ because it confuses and misleads patients who think it means a slight deterioration in lung function or modest increase in symptoms, an Australian study has found. Asthma ‘attack’ should be the preferred language...

Clinicians should avoid the term asthma ‘exacerbation’ because it confuses and misleads patients who think it means a slight deterioration...
asthma

Combo inhaler now indicated for as-needed use in mild asthma

TGA indications for Symbicort Turbuhaler 200/6 and Rapihaler 100/3 have been extended to include the as-needed management of mild asthma in adults and adolescents from the age of 12 years. The change is supported by growing evidence and international guidance, as...

TGA indications for Symbicort Turbuhaler 200/6 and Rapihaler 100/3 have been extended to include the as-needed management of mild asthma...
asthma

Is it time to monitor fungal spore levels as well as pollen counts?

Exposure to outdoor fungal spores can cause acute respiratory effects in vulnerable individuals such as people with asthma, a Victorian study shows. And the finding that fungal spore counts are related to adverse effects on lung function and airway inflammation suggests...

Exposure to outdoor fungal spores can cause acute respiratory effects in vulnerable individuals such as people with asthma, a Victorian...
asthma

‘Extreme’ SABA overuse seen with pharmacy OTC inhalers

Lax rules that allow people to buy asthma reliever inhalers in retail pharmacies without medical supervision is contributing to widespread overuse of short-acting beta-agonists (SABA), Australian research suggests. A survey of 412 people who bought a SABA inhaler over the counter...

Lax rules that allow people to buy asthma reliever inhalers in retail pharmacies without medical supervision is contributing to widespread...
asthma

Prescribing SABA alone in adults with asthma ‘negligent’ says leading expert

Prescribing a single agent SABA inhaler to adults with asthma should be considered negligent, a leading respiratory physician has said. Professor Andy Bush from the Royal Brompton in London was responding to a recent study that found the use of a...

Prescribing a single agent SABA inhaler to adults with asthma should be considered negligent, a leading respiratory physician has said. Professor...
asthma

Care gaps identified for kids with asthma

Low adherence to clinical practice guidelines in general practice is contributing to a significant variation in care for children with asthma, an Australian study shows. The CARETRACK KIDS study reviewed medical records for 881 children aged 0-15 years across Queensland,...

Low adherence to clinical practice guidelines in general practice is contributing to a significant variation in care for children with...
asthma

Inhaled steroids and inhaler types differ in effects on growth: Cochrane review

When it comes to effects on growth in children, there are differences between inhaled corticosteroid molecules used for asthma treatment and also the type of inhaler device, a Cochrane review has found. Fluticasone seemed to inhibit growth less than beclomethasone and...

When it comes to effects on growth in children, there are differences between inhaled corticosteroid molecules used for asthma treatment...
asthma

Adrenaline autoinjectors may be effective long past their expiry date

Expiry dates for adrenaline autoinjectors may be too short as many retain a high percentage of active ingredient beyond the official 12-18 month use-by date when they are recommended for replacement, US researchers say. In an evaluation of 46 autoinjectors that...

Expiry dates for adrenaline autoinjectors may be too short as many retain a high percentage of active ingredient beyond the...
asthma

Time to tweak asthma biologics process

Respiratory physicians are hopeful there might be some relaxation of the current requirement to wait six months before transferring patients with severe asthma from one biologic to another. The PBAC, which met with key stakeholders including industry representatives in December 2018,...

Respiratory physicians are hopeful there might be some relaxation of the current requirement to wait six months before transferring patients...
asthma

Indoor and outdoor factors combine to make asthma worse

Co-exposure to elevated levels of endotoxin from house dust and ambient air pollutants appears to have a synergistic impact on respiratory health, a US study...

Co-exposure to elevated levels of...
asthma

Single ICS-LABA inhaler backed for mild asthma

A single inhaler containing long-acting beta-2 agonist (LABA) and inhaled corticosteroid (ICS) might be the first step in mild asthma treatment instead of a short-acting beta agonist (SABA) for as-needed reliever therapy, a major study has shown. Findings from the ...

A single inhaler containing long-acting beta-2 agonist (LABA) and inhaled corticosteroid (ICS) might be the first step in mild asthma...
asthma

GINA: time to take mild asthma seriously

In a major change to the management of patients with mild asthma, the Global Initiative for Asthma (GINA) has recommended against starting any patients with asthma on short-acting β2 agonist (SABA) relievers alone. Instead, GINA recommends that all adults and...

In a major change to the management of patients with mild asthma, the Global Initiative for Asthma (GINA) has recommended...
asthma

Lung disease patients have low health literacy

People with asthma have the lowest overall health literacy according to a national health survey conducted by Australian Bureau of Statistics (ABS). Alongside people with mental health and behaviour problems, those with asthma indicated they struggled more with managing their...

People with asthma have the lowest overall health literacy according to a national health survey conducted by Australian Bureau...
asthma

Avoid reflux therapies for chronic cough in children: new guidelines

Anti-reflux medications such as proton pump inhibitors have little or no value in the management of chronic cough in children, according to new expert guidelines. An update to 2006 CHEST Pediatric Cough guideline, led by Professor Anne Chang of the...

Anti-reflux medications such as proton pump inhibitors have little or no value in the management of chronic cough in children,...
asthma

Paracetamol and childhood asthma link not causal?

New research that concludes that paracetamol taken during pregnancy is not directly responsible for the increased  asthma risk seen in children has been criticised for having “flawed logic”. The UK research involving a...

New research that concludes that paracetamol taken during pregnancy is not directly responsible for the increased  asthma risk...
asthma

Head to head biologics trial addresses ‘age discrimination’ in severe asthma

The paediatric respiratory community in the UK is to address “age discrimination” against children with severe asthma, announcing plans to undertake a pragmatic clinical trial that will compare biologics in children with severe therapy-resistant asthma (STRA) and assess the benefits...

The paediatric respiratory community in the UK is to address “age discrimination” against children with severe asthma, announcing plans to...
asthma

Revamped asthma guidelines more age-specific

A substantial update of the Australian Asthma Handbook has introduced separate recommendations for 1-5 year-olds and children 6 years and over, and expanded the advice on management of acute and life-threatening asthma. The Handbook, launched in Melbourne last week by...

A substantial update of the Australian Asthma Handbook has introduced separate recommendations for 1-5 year-olds and children 6 years and...
asthma

Severe asthma hampers intimacy

Having severe asthma compromises sexual intimacy and strains relationships, UK research shows, yet healthcare professionals are not addressing this sensitive topic. In a qualitative study analysing interviews with nine severe asthma patients, researchers found the condition affected people’s physical ability...

Having severe asthma compromises sexual intimacy and strains relationships, UK research shows, yet healthcare professionals are not addressing this sensitive...
asthma

Tiotropium to be listed on PBS for children with severe asthma

The long-acting muscarinic antagonist (LAMA) tiotropium inhaler (Spiriva Respimat) will be listed on the PBS for children age six and over with severe asthma from 1 March. Federal Minister for Health Greg...

The long-acting muscarinic antagonist (LAMA) tiotropium inhaler (Spiriva Respimat) will be...
asthma

Clinical trial rethink needed to address unmet needs in severe asthma

A major rethink is needed on how clinical trials are conducted in severe asthma, leading respiratory physicians say. Innovation in trial design, effective partnerships with patient groups and multi-national trials consortia are urgently needed to tackle "significant and major" unmet...

A major rethink is needed on how clinical trials are conducted in severe asthma, leading respiratory physicians say. Innovation in...
asthma

Trial will inform choice between mAbs in severe asthma

Respiratory physicians in NSW are seeking research collaborators to take part in a head to head trial of mepolizumab and omalizumab in patients with severe allergic and eosinophilic asthma. Professor Peter...

Respiratory physicians in NSW are seeking research collaborators to take part...
asthma

Soccer coaches are offside when it comes to asthma goals

Volunteer soccer coaches have limited knowledge on how to manage asthma in young players, a large-scale study finds. Canadian researchers found 93% of coaches who responded to a 22-question online survey had not received any asthma-related...

Volunteer soccer coaches have limited knowledge on how to manage asthma in young players, a large-scale study...
asthma

Call to do better in non-drug asthma management

Management of adult asthma is still below par in Australia with a minority of patients receiving a written Asthma Action Plan, regular review or a doctor checking their inhaler technique. The ...

Management of adult asthma is still below par in Australia with...
asthma

4 respiratory medicine experts in 2019 Australia Day Honours List

Four respiratory medicine clinicians have been recognised in the Australia Day 2019 Honours List. Professor Carol Armour, a respiratory pharmacologist and Executive Director of the Woolcock Institute of Medical Research in Sydney, was made a Member of the Order of Australia...

Four respiratory medicine clinicians have been recognised in the Australia Day 2019 Honours List. Professor Carol Armour, a respiratory pharmacologist and...
asthma

Can respiratory guidelines be trusted to be unbiased?

Academics are questioning whether Australian respiratory guidelines can be trusted after finding that almost half the authors have undisclosed links with industry. A review of 33 NHMRC-endorsed clinical guidelines – including four covering asthma – found that only 14% of guideline...

Academics are questioning whether Australian respiratory guidelines can be trusted after finding that almost half the authors have undisclosed links...
asthma

Age-dependent RSV asthma risk creates vaccine conundrum

The risk of asthma linked to infant RSV infection is much greater if a child acquires the infection later in infancy, NSW researchers have shown. Children who contract severe RSV disease after the age of six months are more than twice...

The risk of asthma linked to infant RSV infection is much greater if a child acquires the infection later in...
asthma

Benralizumab gets PBS listing

Benralizumab (Fasenra) has been listed on the PBS from 1 December for the treatment of uncontrolled severe eosinophilic asthma. The listing will provide subsidised access for around 670 patients to the monoclonal antibody-based subcutaneous injections, which would otherwise cost up to...

Benralizumab (Fasenra) has been listed on the PBS from 1 December for the treatment of uncontrolled severe eosinophilic asthma. The listing...
asthma

Figure placed on obesity and asthma link in kids 

In a world first, researchers have come up with a figure on how many cases of paediatric asthma are directly attributable to obesity. In the study published in Pediatrics, the research team from several states in the US reviewed asthma...

In a world first, researchers have come up with a figure on how many cases of paediatric asthma are directly...
asthma

Autophagy the new target in airways remodelling

The cellular mechanism of autophagy, previously linked with tissue fibrosis in organs such as the kidney and liver, is selectively enhanced in asthma patients and drives airway remodeling in the lungs. According to research led by the University of...

The cellular mechanism of autophagy, previously linked with tissue fibrosis in organs such as the kidney and liver, is selectively...
asthma

Trial eligibility hampers severe asthma progress

Randomised controlled trials evaluating phenotype targeted biological therapies in severe asthma do not reflect real-world populations and are poorly generalisable to clinical practice, a new study shows. Comparing data for 342 severe asthma patients within the Wessex Severe Asthma Cohort (WSAC)...

Randomised controlled trials evaluating phenotype targeted biological therapies in severe asthma do not reflect real-world populations and are poorly generalisable...
asthma

TSANZ’s ‘Do Not Do’ recommendations for child respiratory illnesses

Recommendations against first line use of combination asthma inhalers and prescribing antibiotics for asthma exacerbations top a paediatric-focused “Choosing Wisely” list released by the Thoracic Society of Australia and New Zealand. The five recommendations are the latest updates to the...

Recommendations against first line use of combination asthma inhalers and prescribing antibiotics for asthma exacerbations top a paediatric-focused “Choosing...
asthma

$45,000 fine for testimonials should be warning to other practitioners: AHPRA

A registered Chinese Medicine practitioner has been fined $45,000 for using testimonials claiming he could cure asthma. Mr Qi Xin Chen, who operates the Australian Natural Medicine Centre in Sydney pleaded guilty to 30 charges of false, misleading or deceptive advertising...

A registered Chinese Medicine practitioner has been fined $45,000 for using testimonials claiming he could cure asthma. Mr Qi Xin Chen,...
asthma

Uncontrolled asthma common in school students: survey

High rates of asthma are reported by Australian school students, among whom around two thirds have poorly controlled or uncontrolled disease. Almost 14% of students aged 10-14 years said they had current asthma, in a survey of 9663 students at 103...

High rates of asthma are reported by Australian school students, among whom around two thirds have poorly controlled or uncontrolled...
asthma

Long-term mepolizumab data ‘reassuring’ in severe eosinophilic asthma

An international study including Australian patients has confirmed the long-term safety and efficacy of mepolizumab in patients with severe eosinophilic asthma. In the COLUMBA study, an open label extension of patients previously enrolled in the DREAM study, 347 patients received...

An international study including Australian patients has confirmed the long-term safety and efficacy of mepolizumab in patients with severe eosinophilic...
asthma

New MBS items will increase fees for lung function testing

Revisions to MBS items for spirometry and complex lung function tests  from 1 November include two new items for FeNO with spirometry and Cardiopulmonary Exercise Testing. The revisions are based on recommendations of the MBS Review Taskforce and include a...

Revisions to MBS items for spirometry and complex lung function tests  from 1 November include two new items for FeNO...
asthma

Asthma’s 10 treatable traits revealed

Ten traits in asthma that can help predict exacerbation risk have been identified by Newcastle University respiratory researchers. Their investigation of severe versus non-severe asthma in adults identified pulmonary traits such as eosinophilic inflammation, extrapulmonary traits such as depression and anxiety,...

Ten traits in asthma that can help predict exacerbation risk have been identified by Newcastle University respiratory researchers. Their investigation of...
asthma

Respiratory trials still flouting the rules

A significant proportion of respiratory clinical trials  are registered after the trial has started despite a long-standing policy on mandatory prospective trial registration, a new study shows. The study published in ERJ Express reviewed all of the randomised trials published in...

A significant proportion of respiratory clinical trials  are registered after the trial has started despite a long-standing policy on mandatory...
asthma

Peter Gibson’s ERS Gold Medal in Asthma: Macrolides and macrophages

The effect of macrolides in reducing exacerbations in obstructive airways disease is probably less to do with their anti-inflammatory effects or direct antimicrobial action and more to do with their ability to modify macrophage function. That's the message from Professor Peter...

The effect of macrolides in reducing exacerbations in obstructive airways disease is probably less to do with their anti-inflammatory effects...
asthma

Timing crucial when measuring sputum eosinophils

The time of day that a patient with severe asthma is seen in clinic could impact the ability to accurately diagnose and effectively treat the condition, new research suggests. The most comprehensive circadian study of biomarkers in asthma to date has...

The time of day that a patient with severe asthma is seen in clinic could impact the ability to accurately...
asthma

OSA and asthma: sleep specialists show optimism about CPAP effects

Unrecognised obstructive sleep apnoea often co-exists with asthma and CPAP may improve some aspects of asthma patients' quality of life, a pioneering study has shown. In what has been described as the first randomised controlled trial of OSA treatment in...

Unrecognised obstructive sleep apnoea often co-exists with asthma and CPAP may improve some aspects of asthma patients' quality of life,...
asthma

Why it’s time to rebut milk-mucus myth

The widely held belief that drinking milk promotes excessive mucus production in the lungs needs to be rebutted, a UK paediatric respiratory specialist says. Dr Ian Balfour-Lynn, of the Royal Brompton Hospital in London, says his department's staff are constantly told by...

The widely held belief that drinking milk promotes excessive mucus production in the lungs needs to be rebutted, a UK paediatric...
asthma

“No safe threshold of exposure”: air pollution affecting Aussie kids

Australia enjoys air quality superior to most countries in the world, but a study of exposure to relatively low levels of outdoor nitrogen dioxide (NO2) confirms an adverse effect on respiratory health. The...

Australia enjoys air quality superior to most countries in the world,...
asthma

Trump inhaler triggers strong reactions on social media

A UK respiratory physician has highlighted on social media how one of her patients has recycled an old asthma inhaler into a Donald Trump lookalike device. Dr Binita Kane, (...

A UK respiratory physician has highlighted on social media how one...
asthma

Machine learning could give early warning of respiratory epidemics

A national surveillance system for respiratory epidemics could use machine learning to analyse real time data and give early warning of emerging events such as thunderstorm asthma, an expert panel has been told. A national workshop of stakeholders convened in...

A national surveillance system for respiratory epidemics could use machine learning to analyse real time data and give early warning...
asthma

Weighty evidence that burgers are bad for asthma

As if we need another reason to sit down and cook at home to avoid fast foods, a systematic review of the evidence has found quick and easy but low quality...

As if we need another reason to sit down and cook...
asthma

Nurse prescribing model unveiled for chronic disease outpatient clinics

An extended scope of practice model proposed for nurses will enable them to prescribe in outpatient clinics to free up doctors' time for more complex patients. The “prescribing in partnership” model released for consultation by the Nursing and Midwifery Board of...

An extended scope of practice model proposed for nurses will enable them to prescribe in outpatient clinics to free up...
asthma

Repeat of thunderstorm asthma event feared with SA dust storms

Dust storms in South Australia have prompted warnings for people with respiratory and cardiac conditions to take precautions to avoid a “thunderstorm asthma” like event With the Bureau of Meteorology reporting strong northerly winds creating dust ahead of a massive old...

Dust storms in South Australia have prompted warnings for people with respiratory and cardiac conditions to take precautions to avoid...
asthma

Spirometry interpretation: still working towards clarity & consistency

Variations in spirometry interpretation between labs in Australia is leading to inconsistencies in diagnosis and management  of obstructive lung disease, a study suggests. Findings from a survey of 36 TSANZ-accredited lung function laboratories in Australia and New Zealand reveal 'substantial'...

Variations in spirometry interpretation between labs in Australia is leading to inconsistencies in diagnosis and management  of obstructive lung disease,...
asthma

Have your say on National Strategic Action Plan for Lung Conditions

Input from respiratory specialists is being sought on Australia’s first National Strategic Action Plan for Lung Conditions. Working with support from the Federal Department of Health, the Lung Foundation of Australia (LFA) is working on a national plan that will define...

Input from respiratory specialists is being sought on Australia’s first National Strategic Action Plan for Lung Conditions. Working with support from...
asthma

New safety review of montelukast leads to “risk mitigation activities”

Ongoing concerns about possible neuropsychiatric side effects of montelukast in children and adolescents have prompted the TGA to call for active education of parents and caregivers at the time of prescription of the leukotriene receptor antagonist for asthma. In a  safety...

Ongoing concerns about possible neuropsychiatric side effects of montelukast in children and adolescents have prompted the TGA to call for...
asthma

Severe asthma: more finesse required on oral corticosteroids

For all the excitement about monoclonal antibodies in the management of severe asthma, oral corticosteroids are here to stay for the foreseeable future, leading respiratory physicians say. And this means there needs to be more work on how to better titrate...

For all the excitement about monoclonal antibodies in the management of severe asthma, oral corticosteroids are here to stay for...
asthma

Breathing easier: a regulator of the body clock provides the key to TGF-Beta and steroid resistance in asthma

Steroid resistance in the lungs is a critical problem for severe asthmatics, but researchers have tracked down the molecular cause - TGF-Beta - and a new inhaled treatment is on the way Asthma is a readily controllable condition for most asthmatics,...

Steroid resistance in the lungs is a critical problem for severe asthmatics, but researchers have tracked down the molecular cause...
asthma

Fish oil in pregnancy fails to halt the march to infant wheeze

The apparent protective effect of prenatal omega-3 supplements against allergic wheeze and rhinitis in babies does not endure in children beyond one year of age, Australian research suggests. While studies have shown maternal omega-3 supplementation in pregnancy may protect offspring against...

The apparent protective effect of prenatal omega-3 supplements against allergic wheeze and rhinitis in babies does not endure in children...
asthma

Curb your enthusiasm for eosinophil-tailored asthma therapy

Tailoring of asthma therapy based on FeNO (fractional exhaled nitric oxide) or sputum eosinophils has been shown to be effective in decreasing asthma exacerbations in adults. However an Australian-led systematic review...

Tailoring of asthma therapy based on FeNO (fractional exhaled nitric oxide)...
asthma

Medical expert gives evidence at thunderstorm asthma inquest

An inquest into the deaths of 10 people in Melbourne's thunderstorm asthma event of 2016 has been told the time from onset of asthma flare-up to respiratory arrest was just 15 minutes. Giving evidence to the Victorian coronial inquest, Professor Jo Douglass,...

An inquest into the deaths of 10 people in Melbourne's thunderstorm asthma event of 2016 has been told the time...
asthma

ICS/LABA safe and cut exacerbations: FDA explains why ‘black box’ removed

Members of an FDA safety committee have explained why they took the unusual step of removing 'black box' safety warnings from combined inhaled corticosteroid-long acting beta agonist inhalers in December 2017. The warnings were originally put in place in 2011...

Members of an FDA safety committee have explained why they took the unusual step of removing 'black box' safety...
asthma

NSW asthma researchers win prestigious European awards

NSW asthma researchers Professors Peter Gibson and Jodie Simpson have been awarded two of the European Respiratory Society’s most prestigious awards.Professor Gibson, a respiratory physician at John Hunter Hospital and University of Newcastle is the 2018 recipient of the ERS...

NSW asthma researchers Professors Peter Gibson and Jodie Simpson have been awarded two of the European Respiratory Society’s most prestigious...
asthma

Respiratory physicians in Queen’s Birthday Honours List

Several prominent respiratory and sleep medicine clinicians have been recognised in the 2018 Queen’s Birthday Honours list.Professor Christine McDonald, Director of the Department of Respiratory and Sleep Medicine at Austin Health, Melbourne, is named as a Member in the General...

Several prominent respiratory and sleep medicine clinicians have been recognised in the 2018 Queen’s Birthday Honours list.Professor Christine McDonald, Director...
asthma

New mAb halves exacerbation rates and cuts steroid reliance in severe asthma

Dupilumab, a monoclonal antibody against the interleukin-4 receptor, has been shown to reduce exacerbations and improve lung function in moderate-severe uncontrolled asthma and also reduce reliance on steroids. The phase 3 trials, presented at ATS 2018 and published in the New...

Dupilumab, a monoclonal antibody against the interleukin-4 receptor, has been shown to reduce exacerbations and improve lung function in moderate-severe...
asthma

Targeting viral infections before asthma

Prostaglandin D2 (PGD2) antagonists may be useful antivirals for the treatment of viral bronchiolitis and possibly as primary preventatives for asthma. Queensland-led research has shown that respiratory syncytial virus (RSV) infection up-regulates hematopoietic prostaglandin D synthase expression resulting in PGD2 release...

Prostaglandin D2 (PGD2) antagonists may be useful antivirals for the treatment of viral bronchiolitis and possibly as primary preventatives for...
asthma

Home monitoring hope for asthma patients

A device which uses sound waves to detect lung function is hoped to give people with asthma a new way to self-monitor at home, predict flare-ups and stay out of hospital. The cloud-based device being trialled by the Woolcock Institute of...

A device which uses sound waves to detect lung function is hoped to give people with asthma a new way...
asthma

Inhaler technique guide gets an update

The National Asthma Council Australia has published an update to its popular Inhaler technique for people with asthma or COPD  guide to incorporate new medicines and devices that have come to market in the last two years. “It’s really hard...

The National Asthma Council Australia has published an update to its popular Inhaler technique for people with asthma...
asthma

Bronchial thermoplasty: might not be all hot air

Complex modeling of the human lung has shown a likely explanation for how bronchial thermoplasty reduces health care needs and improves quality of life in patients with moderate to severe asthma. The study found the observed benefits of bronchial thermoplasty...

Complex modeling of the human lung has shown a likely explanation for how bronchial thermoplasty reduces health care needs and...
asthma

Asthma management in pregnancy ‘poor’

Asthma management in pregnancy has not improved over the last decade, according to research from NSW.  The research team from the Priority Research Centre Grow Up Well at the University of Newcastle in NSW used data from...

Asthma management in pregnancy has not improved over the last decade, according to research from NSW.  The...
asthma

PBS listings approved for novel asthma and IPF treatments

Another anti-interleukin-5 monoclonal antibody drug, benralizumab (Fasenra), has been recommended for PBS listing for the treatment of uncontrolled severe eosinophilic asthma. At its March 2018 meeting the Pharmaceutical Benefits Advisory Committee (PBAC) recommended the Section 100 (Highly Specialised Drug Program) Authority...

Another anti-interleukin-5 monoclonal antibody drug, benralizumab (Fasenra), has been recommended for PBS listing for the treatment of uncontrolled severe eosinophilic...
asthma

Childhood asthma linked to 2 common household exposures

A significant proportion of childhood asthma in Australia is attributable to damp housing and use of gas cookers, new research suggests. Using data from several peer-reviewed studies and the Australian Bureau of Statistics' Census, Queensland researchers have estimated that exposure to...

A significant proportion of childhood asthma in Australia is attributable to damp housing and use of gas cookers, new research...
asthma

Webinar to address uncontrolled asthma

Respiratory specialist clinicians are to take part in a NPS MedicineWise webinar on poorly controlled asthma on 1 May. Professor Helen Reddel of the Woolcock Institute of Medical Research, University of Sydney will be joined by three other clinicians in...

Respiratory specialist clinicians are to take part in a NPS MedicineWise webinar on poorly controlled asthma on 1 May. Professor...
asthma

Window of opportunity for kids with asthma

Aiming for optimal asthma control in children as soon as they are diagnosed appears to be a promising strategy for stopping the disease in its tracks, an international expert says. The research presented by Francine Ducharme,...

Aiming for optimal asthma control in children as soon as they are diagnosed appears to be a promising...
asthma

Severe asthma management at your fingertips

A practical resource developed by clinicians for clinicians aims to translate the recent knowledge gained in treating severe asthma into clinical practice in Australia. Launched at the TSANZSRS18 conference here in Adelaide Professor Vanessa McDonald, co-director of the NHMRC Centre...

A practical resource developed by clinicians for clinicians aims to translate the recent knowledge gained in treating severe asthma...
asthma

Non-adherence rates over 50% in patients with severe asthma: Victorian study

Alarmingly high rates of non-adherence to medication occur in patients whose asthma is severe enough to make them eligible for biologics or thermoplasty, Victorian researcher say. Respiratory physicians at a special clinic for patients with difficult asthma at The Alfred hospital,...

Alarmingly high rates of non-adherence to medication occur in patients whose asthma is severe enough to make them eligible for...
asthma

Children don’t ‘grow into asthma’ if maternal asthma is well managed with ICS

Children whose mothers have asthma are 50% less likely to develop asthma themselves if their mother’s asthma is well controlled with inhaled steroids in pregnancy, an Australian study has shown. The findings come from a long term follow up study...

Children whose mothers have asthma are 50% less likely to develop asthma themselves if their mother’s asthma is well controlled...
asthma

Respiratory disease rates appear higher at coal seam gas sites

Children living near coal seam gas extraction sites are more likely to be hospitalised for respiratory diseases than children in other areas, an Australian study has found. Queensland University researchers compared age-specific hospitalisation rates for almost 81,000 children living in...

Children living near coal seam gas extraction sites are more likely to be hospitalised for respiratory diseases than children in...
asthma

High dose, low impact: why we need to rethink ICS asthma strategy

Escalating doses of inhaled corticosteroids in an effort to head off impending asthma exacerbations is unsuccessful in children and of limited value in adults. US research showed increasing the regular dose of inhaled steroids by a factor of five at...

Escalating doses of inhaled corticosteroids in an effort to head off impending asthma exacerbations is unsuccessful in children and of...
asthma

Sublingual immunotherapy tablets are best protection against thunderstorm asthma

Sublingual immunotherapy has been proposed as the mainstay of protection against future epidemics of thunderstorm asthma based on findings from a small Victorian study. Seventeen patients with seasonal allergic rhinitis showed no symptoms during Melbourne’s severe thunderstorm asthma event of...

Sublingual immunotherapy has been proposed as the mainstay of protection against future epidemics of thunderstorm asthma based on findings from...
asthma

Minister orders urgent review of montelukast safety

Media reports have prompted Federal Minister for Health Greg Hunt to order an urgent investigation into the psychiatric adverse effects of montelukast in children. The minister has told the TGA to follow...

Media reports have prompted Federal Minister for Health Greg Hunt to...
asthma

First COPD triple therapy recommended for PBS listing

The first triple therapy inhaler for COPD containing a LAMA, LABA and inhaled steroid has been recommended for PBS listing. At its December 2017 meeting the Pharmaceutical Benefits Advisory Committee recommended an Authority Required (Streamlined) listing for GSK’s Trelegy Ellipta...

The first triple therapy inhaler for COPD containing a LAMA, LABA and inhaled steroid has been recommended for PBS listing. At...
asthma

Five key goals in new National Asthma Strategy

The new 2018 National Asthma Strategy calls for major changes in areas where there are big gaps between evidence and practice, such as such as underuse of asthma management plans. The roadmap, launched this week by the National Asthma Council,...

The new 2018 National Asthma Strategy calls for major changes in areas where there are big gaps between evidence and...
asthma

Budget cuts will ‘decimate’ asthma services

Asthma Australia warns budget cuts will “decimate” its programs and prevent it from helping thousands of Australians manage their airways disease. The national organisation runs support and education programs used by over 50,000 people, including a phone hotline, with 60% of...

Asthma Australia warns budget cuts will “decimate” its programs and prevent it from helping thousands of Australians manage their airways...
asthma

Respiratory disease the focus for many Australian clinical trials: report

Respiratory conditions are among the top ten study areas for clinical trials in Australia, with latest figures showing there have been 620 trials studying asthma, COPD and sleep apnoea over the last decade. In its latest report, the Australian New...

Respiratory conditions are among the top ten study areas for clinical trials in Australia, with latest figures showing there have...
asthma

Oral steroids cut hospital stays for children with viral wheeze: WA study

The controversial question of whether preschool children with virus-associated wheeze benefit from oral corticosteroids has been answered by a randomised controlled trial from Western Australia. Emergency department stays are cut by about three hours when wheezy children...

The controversial question of whether preschool children with virus-associated wheeze benefit from oral corticosteroids has been answered by...
asthma

What does 2018 hold for respiratory medicine?

What will be biggest challenges in respiratory medicine in 2018? We ask Australia's respiratory physicians. AsthmaIn 2018 Australia has found itself losing the battle for asthma control, says Professor Peter Gibson, respiratory physician and co-director of the University of Newcastle’s Priority...

What will be biggest challenges in respiratory medicine in 2018? We ask Australia's respiratory physicians. AsthmaIn 2018 Australia has found itself...
asthma

Respiratory drugs highlighted in PBS costs report

Fixed dose combination inhalers for COPD have been flagged as high growth prescription items for the Pharmaceutical Benefits Scheme. In its annual expenditure report, the PBS highlights the LABA/LAMA combo tiotropium/olodaterol (Spiolto Respimat) as one of the products with the...

Fixed dose combination inhalers for COPD have been flagged as high growth prescription items for the Pharmaceutical Benefits Scheme. In its...
asthma

LABA adverse effects may be chiral

The rare but unexplained asthma exacerbations and deaths seen with long term LABA treatment may be due one of the two optical isomers, an Australian toxicologist says. The pharmacological effects of beta...

The rare but unexplained asthma exacerbations and deaths seen with long...
asthma

Paracetamol asthma fears in kids ‘unfounded’: study

Fears paracetamol increases asthma risk in children are unfounded and based on reverse causality or confounding, according to a new systematic review and meta-analysis presented at the BTS winter meeting last week. Paracetamol is the most widely prescribed drug for young...

Fears paracetamol increases asthma risk in children are unfounded and based on reverse causality or confounding, according to a new...
asthma

Factors most likely to predict asthma attacks in kids

Researchers have identified several factors that can predict which children with asthma are at high-risk of an asthma attack. Presenting the findings at the British Thoracic Society Winter Meeting in London last week the At-Risk Child with Asthma group said the...

Researchers have identified several factors that can predict which children with asthma are at high-risk of an asthma attack. Presenting the...
asthma

BTS/SIGN asthma guidelines: the next generation

The next iteration of the British Thoracic Society/Scottish Intercollegiate Guidelines Network asthma guidelines are likely to update advice on personalised risk management, allergens, acute management of attacks, breathing training and the place of immunotherapy. The guideline development group has asked BTS...

The next iteration of the British Thoracic Society/Scottish Intercollegiate Guidelines Network asthma guidelines are likely to update advice on personalised...
asthma

Asthma guideline double up ‘confusing’ and potentially ‘harmful’

The decision by the National Institute of Clinical excellence (NICE) to go ahead with its asthma guidelines has been slated by respiratory health professionals who say they will lead to confusion and have the potential to compromise patient care. Speakers at...

The decision by the National Institute of Clinical excellence (NICE) to go ahead with its asthma guidelines has been slated...
asthma

Watch for false negatives with eosinophils

Variability of blood eosinophil counts with food, exercise, medications and the time of testing has the potential to affect patients’ eligibility for targeted therapy. Writing in Respirology, Professor Peter Gibson said ‘the most clinically accessible biomarker to aid in the...

Variability of blood eosinophil counts with food, exercise, medications and the time of testing has the potential to affect patients’...
asthma

Time to focus on asthma management in older women

Older women are nearly three times more likely to die from asthma than men of the same age, according to the latest asthma mortality data. According to data from the Australian Bureau of Statistics (ABS), 455 asthma-related deaths (312 females, 143...

Older women are nearly three times more likely to die from asthma than men of the same age, according to...
asthma

Asthma and allergy share genetic risk factors

Australian led research has identified hundreds of genetic risk factors shared between patients with asthma, hay fever and eczema. The research, published in Nature Genetics, analysed the genomes of more than 360,000 people across seven countries. It compared people with at least one...

Australian led research has identified hundreds of genetic risk factors shared between patients with asthma, hay fever and eczema. The research,...
asthma

The colour of sputum helps with asthma management

A ‘distinctive dark green sputum’ in patients with asthma relates to high total cell count and neutrophilic inflammation and might assist with clinical decision making, research suggests. An Australian study found a sputum colour score greater or equal to three...

A ‘distinctive dark green sputum’ in patients with asthma relates to high total cell count and neutrophilic inflammation and might...
asthma

Vitamin D supplementation and asthma exacerbations

In this podcast from The Lancet Professor Adrian Martineau, a  clinical Professor of Respiratory Infection and Immunity at Barts in the UK discusses his recently published meta-analysis assessing whether vitamin D supplementation can help prevent asthma exacerbations.   [embed]http://www.thelancet.com/pb-assets/Lancet/stories/audio/lanres/2017/03october_vitamind.mp3[/embed]...

In this podcast from The Lancet Professor Adrian Martineau, a  clinical Professor of Respiratory Infection and Immunity at Barts in...
asthma

Patients need to know potential risks of montelukast

Neuropsychiatric symptoms such as aggression, suicidal ideation, abnormal behaviour and nightmares are amongst the most common adverse drug reactions reported in children and adults taking montelukast (Singulair) for their asthma. A study of both Dutch and WHO Global pharmacovigilance databases...

Neuropsychiatric symptoms such as aggression, suicidal ideation, abnormal behaviour and nightmares are amongst the most common adverse drug reactions reported...
asthma

Quadruple ICS reduces severe asthma exacerbations

A self managed four-fold increase in the dose of inhaled corticosteroids reduces severe asthma exacerbations, a late breaking trial at ERS Congress reports. According to the lead author Professor Tim Harrison, a respiratory physician from the University of Nottingham in the...

A self managed four-fold increase in the dose of inhaled corticosteroids reduces severe asthma exacerbations, a late breaking trial at...
asthma

We need to radically rethink asthma: experts

Respiratory medicine experts have called for an overhaul of how asthma and other airways diseases are categorised and treated. Launching new recommendations in a specially commissioned article in The Lancet at the European Respiratory Society conference in Milan, Italy, the team of...

Respiratory medicine experts have called for an overhaul of how asthma and other airways diseases are categorised and treated. Launching ...
asthma

GPs overprescribing antibiotics for asthma

Children with asthma are more than one and a half times more likely to be prescribed antibiotics than children without asthma, a study reveals. The findings suggest that asthma symptoms  are being mistaken for respiratory tract infections, or that antibiotics are...

Children with asthma are more than one and a half times more likely to be prescribed antibiotics than children without...
asthma

Gearing up for thunderstorm asthma season

With high-pollen season looming, GPs are urged to ensure all at-risk patients have taken the steps needed to avoid developing thunderstorm asthma. The advice is issued by the National Asthma Council (NAC), which has released a series of resources to help...

With high-pollen season looming, GPs are urged to ensure all at-risk patients have taken the steps needed to avoid developing...
asthma

Thunderstorm asthma: Counting pollen to save lives

This year’s dry winter is good news for Melbourne’s hay fever sufferers, but after last year’s thunderstorm asthma event claimed nine lives, there are never any guarantees when it comes to pollen. As Melbourne slowly moves from winter into spring, most...

This year’s dry winter is good news for Melbourne’s hay fever sufferers, but after last year’s thunderstorm asthma event claimed...
asthma

Wake up call regarding asthma mortality

Australia cannot afford to take its eye off the ball when it comes to preventing asthma deaths, according to a leading respiratory physician. Professor Christine Jenkins, from the George Institute for Global Health, told the limbic improvements in asthma mortality had...

Australia cannot afford to take its eye off the ball when it comes to preventing asthma deaths, according to a...
asthma

Stormy debate over thunderstorm asthma

Clinicians are debating whether to suggest seasonal preventative corticosteroids for people who have mild asthma plus hay fever in new guidelines for thunderstorm asthma prevention in Victoria. But some are concerned the guidance may be misinterpreted, leading to patient confusion and poor medicine...

Clinicians are debating whether to suggest seasonal preventative corticosteroids for people who have mild asthma plus hay fever in new guidelines for...
asthma

ICS/LABA combination dominates Australian asthma treatment

Australians using an inhaled corticosteroid for asthma are almost twice as likely as New Zealanders to take it in combination with a long-acting beta agonist but disease control is equally poor in both countries, new research has shown. The study...

Australians using an inhaled corticosteroid for asthma are almost twice as likely as New Zealanders to take it in combination...
asthma

New CEO for National Asthma Council

The not-for-profit peak asthma body will get a new Chief Executive Officer at the end of this month as the current incumbent Ms Kristine Whorlow AM moves into retirement. Ms Whorlow has dedicated much of her professional life to helping to...

The not-for-profit peak asthma body will get a new Chief Executive Officer at the end of this month as the...
asthma

Limbic chat: Stem cells look promising for asthma

Australian research has shown that induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells can help regenerate damaged lung tissue in an experimental model of asthma. The study found that the stem cells could tackle asthma on multiple levels - reducing inflammation,...

Australian research has shown that induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells can help regenerate damaged lung tissue in...
asthma

Azithromycin an effective ‘add-on’ therapy for asthma exacerbations

People with uncontrolled asthma can significantly slash their number of exacerbations by adding azithromycin to their treatment regimen, Australian research shows. Published in The Lancet by Professor Peter Gibson and colleagues from the Hunter Medical Research Institute in Newcastle, NSW, the...

People with uncontrolled asthma can significantly slash their number of exacerbations by adding azithromycin to their treatment regimen, Australian research shows. Published...
asthma

Cancer drug shows early promise for severe asthma

Imatinib, typically used to treat chronic myeloid leukaemia, has been shown to reduce airway hyper-responsiveness in patients with poorly controlled severe asthma. The proof-of-principle study, published in NEJM and presented at the American Thoracic Society conference in Washington this week,...

Imatinib, typically used to treat chronic myeloid leukaemia, has been shown to reduce airway hyper-responsiveness in patients with poorly controlled...
asthma

No need to wait for European consensus on severe eosinophilic asthma: Expert 

The European respiratory community is working towards consensus on the diagnosis and management of severe eosinophilic asthma but there’s no need to wait for them, according to an Australian expert. Conjoint Professor Peter Wark, from the University of Newcastle’s Centre for...

The European respiratory community is working towards consensus on the diagnosis and management of severe eosinophilic asthma but there’s no...
asthma

Air pollution lawsuit will go ahead

An unprecedented legal case on behalf of people with asthma may see the UK government paying out a significant amount of compensation for failing to act on air pollution levels. Frances Lawson, the barrister who is leading the class action, said...

An unprecedented legal case on behalf of people with asthma may see the UK government paying out a significant amount...
asthma

Testosterone link to asthma

An Australian research team has contributed to experimental studies that help explain why women have twice the rate of asthma as men. The research showed male sex hormones influence Group 2 innate lymphoid cells (ILC2s) - relatively recently described as...

An Australian research team has contributed to experimental studies that help explain why women have twice the rate of asthma...
asthma

Final thunderstorm asthma review needs to be broader

The final report on the emergency response to the unprecedented thunderstorm asthma event that affected thousands of people in Victoria last year demonstrates commitment to preventing similar events but needs to be broader, an expert says. The review of the response...

The final report on the emergency response to the unprecedented thunderstorm asthma event that affected thousands of people in Victoria...
asthma

Supporting people who live with asthma

Over the past few decades the concept and application of self management of asthma have evolved, reducing both emergency service use and the day to day symptoms of asthma. In this blog, authors of a new review in ...

Over the past few decades the concept and application of self management of asthma have evolved, reducing both emergency service...
asthma

Hidden population at risk of thunderstorm asthma

Many more people than previously thought are at risk of thunderstorm asthma, particularly people who have hay fever, a survey reveals. The survey of more than 500 staff and volunteers across Eastern Health found 41% experienced symptoms of thunderstorm asthma during...

Many more people than previously thought are at risk of thunderstorm asthma, particularly people who have hay fever, a survey...
asthma

Fibre reduces airways inflammation, improves asthma control

A simple daily soluble fibre supplement could help people with stable asthma control their symptoms, results of a first-in-human trial suggest. The randomised placebo controlled three-way cross-over trial involving 17 people with asthma found a daily dose of the soluble fibre...

A simple daily soluble fibre supplement could help people with stable asthma control their symptoms, results of a first-in-human trial...
asthma

Not enough evidence for bronchial thermoplasty: experts

The suitability of bronchial thermoplasty (BT) as a treatment option for severe asthma remains up in the air because of a glaring absence of placebo controlled trials, an expert panel has concluded. In a pro and con debate that weighed more...

The suitability of bronchial thermoplasty (BT) as a treatment option for severe asthma remains up in the air because of...
asthma

$1 million response to thunderstorm asthma

Victoria won’t be caught unawares again by high levels of asthma and respiratory distress associated with thunderstorms and the associated surge in demand for emergency assistance. In response to the thunderstorm asthma event in Melbourne and Geelong last November, the Victorian...

Victoria won’t be caught unawares again by high levels of asthma and respiratory distress associated with thunderstorms and the associated...
asthma

New PBS listings give relief for severe asthma

The government has announced $130 million in federal funding to subsidise two asthma medications on the Pharmaceutical Benefits Scheme (PBS). The anti-interleukin-5 (anti-IL-5) therapy mepolizumab (Nucala® Glaxo SmithKline) is now available on the PBS under section 100 as an add-on...

The government has announced $130 million in federal funding to subsidise two asthma medications on the Pharmaceutical Benefits Scheme (PBS). The...
asthma

Bronchial thermoplasty a ‘new frontier’ in severe asthma

A relatively new bronchoscopic intervention is shaping up as a ‘new frontier’ in the treatment of severe asthma. Less than 100 patients in Australia have undergone bronchial thermoplasty in the four years since it began, and a new paper in...

A relatively new bronchoscopic intervention is shaping up as a ‘new frontier’ in the treatment of severe asthma. Less than 100...
asthma

Asthma biologic PBS listed for children

A biologic medicine to treat severe allergic asthma in patients whose symptoms are inadequately controlled on high dose preventer medications is now available to children age six and over on the PBS. Novartis' Xolair® (omalizumab) is a humanised monoclonal antibody...

A biologic medicine to treat severe allergic asthma in patients whose symptoms are inadequately controlled on high dose preventer medications...
asthma

Spirometry report highlights access barriers

A new report into the use of spirometry in the diagnosis and management of chronic airways disease has highlighted “huge barriers” to access. More than 80% of Australians with asthma and other airway conditions are missing out on recommended lung tests...

A new report into the use of spirometry in the diagnosis and management of chronic airways disease has highlighted “huge...
asthma

It’s not just about Melbourne: why we need a national approach to ‘thunderstorm asthma’

The tragic deaths of at least six people, apparently from thunderstorm asthma, highlights the risk from environmental hazards, even in seemingly safe urban centres in developed nations like Australia. Events such as these, and others like the Hazelwood...

The tragic deaths of at least six people, apparently from thunderstorm asthma, highlights the risk from environmental hazards,...
asthma

We could’ve seen thunderstorm asthma coming and there are ways to prepare

A fourth death has been attributed to Melbourne’s “thunderstorm asthma” emergency on Monday night, and it was lucky there were not more, according to the state’s health minister. More than 2,000 people suffered breathing problems when a severe...

A fourth death has been attributed to Melbourne’s “thunderstorm asthma” emergency on Monday night, and it was lucky there...
asthma

Unofficial colour code for inhalers should be formalised

With more and more asthma and COPD inhalers flooding the market there is a pressing need to formalise the current, yet unofficial, colour coding convention for inhalers, a UK group of experts says. This was particularly important for asthma reliever inhalers...

With more and more asthma and COPD inhalers flooding the market there is a pressing need to formalise the current,...
asthma

Vitamin D deficiency linked to asthma

Repeated periods of vitamin D deficiency in the first decade of life in high-risk children are associated with increased risk of asthma, eczema, and allergic sensitization that persists to age 10 years, new research shows. The study led by researchers from the...

Repeated periods of vitamin D deficiency in the first decade of life in high-risk children are associated with increased risk...
asthma

Clinicians won’t be able to solve asthma alone, says expert

The fact that asthma management has changed little since the 1960s should be a wake up call that we need a new approach to research in order to advance patient outcomes, says an international expert who delivered the Ann Woolcock...

The fact that asthma management has changed little since the 1960s should be a wake up call that we need...
asthma

Negative bronchodilator response can exclude asthma in young kids

Spirometry can be useful in preschool aged children to help predict asthma - with a bronchodilator response based on FEV0.75 shown to offer the most discrimination, Australia experts say. The research, conducted in a cohort of 720 preschoolers in Argentina, found...

Spirometry can be useful in preschool aged children to help predict asthma - with a bronchodilator response based on FEV0.75...
asthma

Holy Grail: Reducing the burden of asthma in South Australia

What’s the issue your research is trying to solve? Recent research has identified that 70% of asthma mortality is considered preventable or to have modifiable risk factors. And up to 90% of...

What’s the issue your research is trying to solve? Recent research has...
asthma

CBT may have modest benefits on quality of life in asthma

Cognitive behavioural therapy may have modest benefits on quality of life, asthma control, and anxiety levels in adults with persistent asthma, a Cochrane review suggests. According to the review that included nine randomised controlled trials and 407 adults with asthma,...

Cognitive behavioural therapy may have modest benefits on quality of life, asthma control, and anxiety levels in adults with persistent...
asthma

Potential role for vitamin D in asthma management

A Cochrane review has provided more robust evidence that adding vitamin D supplements to routine asthma management plans may benefit patients. However more research is required to confirm optimal dosing and the likely benefit in various patient sub-groups, co-author Dr Megan...

A Cochrane review has provided more robust evidence that adding vitamin D supplements to routine asthma management plans may benefit...
asthma

Vitamin D may protect against severe asthma attacks and hospitalisation

There has been some debate in recent times about the association between vitamin D levels and the risk of developing certain conditions such as diabetes, colon cancer, arthritis and infections. Studies show conflicting results. But when it comes to...

There has been some debate in recent times about the association between vitamin D levels and the risk of...
asthma

What if asthma is actually a rash?

Bold new research could dramatically change the way some patients with severe asthma are treated, scientists believe. In what is touted as a world first, researchers at with the national Centre for Research Excellence on Asthma are taking a novel approach...

Bold new research could dramatically change the way some patients with severe asthma are treated, scientists believe. In what is touted...
asthma

Adult onset asthma increases heart risk: study

People who develop asthma in adulthood have an increased risk of cardiovascular events including MI and stroke compared to people with early onset asthma and those without asthma, a large study finds. The prospective observational cohort...

People who develop asthma in adulthood have an increased risk of cardiovascular events including MI and stroke compared...
asthma

ATS publish guidelines on persistent wheezing

The American Thoracic Society has published guidelines to help clinicians evaluate infants with recurrent or persistent wheezing that is not responding to treatment with bronchodilators or corticosteroids.  "Although infantile wheezing is very common, there...

The American Thoracic Society has published guidelines to help clinicians evaluate infants with recurrent or persistent wheezing that...
asthma

Push towards consensus definition on asthma?COPD overlap syndrome

A push to have asthma–chronic obstructive pulmonary disease overlap syndrome  declared a disease in its own right is gathering momentum with the release of a draft operational definition. An article in the European Journal of Respirology details key features of...

A push to have asthma–chronic obstructive pulmonary disease overlap syndrome  declared a disease in its own right is gathering momentum...
asthma

Video: Better drug delivery

How do we improve device selection and patient compliance? In this latest instalment of ERS Vision Dr Mark Elliott from St James's University Hospital in Leeds, UK, talks about the importance of device selection, factors affecting the correct use of inhalers and...

How do we improve device selection and patient compliance? In this latest instalment of ERS Vision Dr Mark Elliott from...
asthma

Spider bites lead to potential new asthma therapy

Symptoms of bronchospasm and chest tightness caused by widow spider bites have led to an international research group, including scientists from Sydney’s Woolcock Institute, describing a potential new target for asthma therapy. Working with young Dutch researcher Dr Alen Faiz, they...

Symptoms of bronchospasm and chest tightness caused by widow spider bites have led to an international research group, including scientists...
asthma

Illicit drug use a red-flag for ICU

People with asthma and a history of illicit drug use are almost four times as likely to require intensive care for an exacerbation, research shows. Of 482 asthma patients admitted consecutively to Melbourne hospitals between 2010 and 2014, 39 required intensive...

People with asthma and a history of illicit drug use are almost four times as likely to require intensive care...
asthma

Early and late adult asthma: similar but different

Early and late onset adult asthma has similar clinical manifestations but major phenotypic differences, the world’s longest running population study of respiratory diseases confirms. The Tasmanian Longitudinal Health Study spanning over four decades found that early-onset adult asthma was associated...

Early and late onset adult asthma has similar clinical manifestations but major phenotypic differences, the world’s longest running population study...
asthma

One-third of asthma diagnoses may be incorrect

Up to one-third of adults newly diagnosed with asthma might not have the disease, a Canadian study presented at ATS2016 has suggested. Dr Shawn Aaron from the University of Ottawa told the ATS meeting that very high rates of lifetime diagnosis...

Up to one-third of adults newly diagnosed with asthma might not have the disease, a Canadian study presented at ATS2016...
asthma

Persistent childhood asthma can develop into COPD

A study in this week’s NEJM adds to a growing body of evidence linking childhood asthma to the development of COPD in early adulthood.  The CAMP study of 684 children with persistent asthma discovered that by early adulthood three-quarters of...

A study in this week’s NEJM adds to a growing body of evidence linking childhood asthma to the development of...
asthma

Leading Australian respiratory physician agrees childhood asthma is over diagnosed

Over diagnosis of childhood asthma and inappropriate prescribing is rife in Australia, while children continue to die unnecessarily from the disease, says a leading respiratory physician. Professor Adam Jaffe, John Beveridge Professor of Paediatrics and Head of Discipline of Paediatrics at...

Over diagnosis of childhood asthma and inappropriate prescribing is rife in Australia, while children continue to die unnecessarily from the...
asthma

Ways to mind the million patient gap in asthma

A group of respiratory physicians have proposed radical steps to curb excessive reliance on relievers, enhance preventer adherence, encourage asthma review, and provide specialised evaluation for complex patients. Writing in a perspective article in the MJA Tunn Ren Tay from...

A group of respiratory physicians have proposed radical steps to curb excessive reliance on relievers, enhance preventer adherence, encourage asthma...
asthma

Rhinitis a strong risk factor for adult-onset asthma: Martinez

Non-allergic rhinitis in early life is strongly associated with an increased risk of adult onset asthma, the conference has heard. Speaking at a plenary session on the early origins of asthma and COPD Professor Fernando Martinez from the Arizona Respiratory Center...

Non-allergic rhinitis in early life is strongly associated with an increased risk of adult onset asthma, the conference has heard. Speaking...
asthma

Primary care a ‘chronic failure’: Report

An outdated model of health service delivery in Australia is failing patients with chronic diseases like asthma and costing the country millions of unnecessary dollars. The claim comes in a controversial new Grattan Institute report titled Chronic failure in primary...

An outdated model of health service delivery in Australia is failing patients with chronic diseases like asthma and costing the...
asthma

Effects of smoking no worse in people with child-onset asthma

Research from New Zealand challenges the assumption that children with asthma are more vulnerable to the airway damage inflicted by smoking. The Dunedin Study of over 1,000 people followed to the age of 38 found children with asthma that persisted...

Research from New Zealand challenges the assumption that children with asthma are more vulnerable to the airway damage inflicted by...
asthma

Experts call for label-free approach to asthma and COPD

The current approach to defining a patient's symptoms using the diagnostic labels of asthma and COPD is outdated and fails to provide optimal care in a significant number of patients, experts claim. Writing in a perspective article in the European...

The current approach to defining a patient's symptoms using the diagnostic labels of asthma and COPD is outdated and fails...
asthma

Striking variations by ethnic group in asthma in Scotland

British researchers have discovered striking variations in risk of hospital admission and/or death for asthma by ethnic group. Their findings cannot be explained by migration related factors, or low socio-economic status. In this blog they talk about their research and...

British researchers have discovered striking variations in risk of hospital admission and/or death for asthma by ethnic group. Their findings...
asthma

C-sections unlikely to cause asthma

A large observational study published in JAMA this week found a small increase in asthma risk with planned C-section delivery compared to vaginal delivery. Here's what the experts had to say about the findings.  Professor Jonathan Morris is Professor of...

A large observational study published in JAMA this week found a small increase in asthma risk with planned C-section delivery compared...
asthma

Atlas reveals wide variation in asthma meds

Wide variations in prescribing rates for asthma medications have been revealed in the first Australian Atlas of Healthcare Variation. The Atlas published by the Australian Commission on Safety and Quality in Health Care gives a clear picture of substantial variation in healthcare use...

Wide variations in prescribing rates for asthma medications have been revealed in the first Australian Atlas of Healthcare Variation. The Atlas...
asthma

Oral contraceptive linked to asthma in overweight women

Women who use hormonal contraception for a long time are at an increased risk of developing asthma in middle age if they are overweight or obese, new Australian research shows. The study involving 2,764 perimenopausal women from the Tasmanian Longitudinal Health...

Women who use hormonal contraception for a long time are at an increased risk of developing asthma in middle age...
asthma

Evidence does not support LABA as an adjunct in children

Adding a LABA to ICS treatment in school-aged children with persistent asthma does not reduce the risk of exacerbations requiring steroid treatment, a Cochrane review confirms. The review of 33 studies found that stepping up therapy with the addition of LABA...

Adding a LABA to ICS treatment in school-aged children with persistent asthma does not reduce the risk of exacerbations requiring...
asthma

Asthma cost report highlights persisting issues

A report on the cost of asthma in Australia has highlighted persisting issues around the diagnosis and management of the disease. The Hidden Costs of Asthma report revealed the disease is costing Australia almost $28 billion a year, with the majority...

A report on the cost of asthma in Australia has highlighted persisting issues around the diagnosis and management of the...
asthma

Azithromycin may reduce wheezing severity

Giving azithromycin to children with a history of recurrent severe lower respiratory tract illness may reduce the severity of further episodes, a randomised double blind placebo controlled trial reports. Published in JAMA the study randomised...

Giving azithromycin to children with a history of recurrent severe lower respiratory tract illness may reduce the severity...
asthma

277 things that cause workplace asthma

Researchers have developed an Australian specific list of chemicals and dusts that can contribute to adult on-set asthma in the workplace. Project leader Professor Lin Fritschi from Curtin’s School of Public Health said between 1,000 and 3,000 new cases of asthma...

Researchers have developed an Australian specific list of chemicals and dusts that can contribute to adult on-set asthma in the...
asthma

British model would significantly improve patient care

People with respiratory conditions would be better protected from flare-ups if Australia followed Britain’s lead and introduced a system that regularly reviewed people with asthma and COPD, specialists say. A similar system introduced in the United Kingdom has triggered a 20...

People with respiratory conditions would be better protected from flare-ups if Australia followed Britain’s lead and introduced a system that...
asthma

Asthma drug boosts memory in old rats

A drug currently used to treat asthma may have a role in preventing age-related cognitive decline, an exploratory study suggests. Treatment with the asthma drug montelukast successfully restored cognitive function and increased the creation of new brain cells in old rats,...

A drug currently used to treat asthma may have a role in preventing age-related cognitive decline, an exploratory study suggests. Treatment...
asthma

Podcast GINA: the latest iteration of a magnificent journey

In this podcast from the ERJ editor Marc Humbert and Associate Professor Helen Reddel, of the Woolcock Institute of Medical Research at the University of Sydney and chair of the GINA Scientific Committee, talk about the changes introduced in the 2015 update...

In this podcast from the ERJ editor Marc Humbert and Associate Professor Helen Reddel, of the Woolcock Institute of Medical Research...
asthma

Bronchospasm linked to preventive inhaler

Bronchospasm induced by the inhaled corticosteroid ciclesonide may be an under-recognised yet easily identified side effect of the inhaler, asthma specialists report. Writing in this week’s MJA three respiratory specialists from the Children’s Hospital at Westmead, Sydney report the cases...

Bronchospasm induced by the inhaled corticosteroid ciclesonide may be an under-recognised yet easily identified side effect of the inhaler, asthma...
asthma

Treating the trigger: assessing the evidence for sublingual immunotherapy for asthma

1. What is sublingual immunotherapy and how might it help people with asthma? For about half of the 300 million people worldwide with asthma, allergies may be an important trigger for their symptoms and asthma attacks. People can...

1. What is sublingual immunotherapy and how might it help people with asthma? For about half of the...
asthma

Biomarker helps tailor steroid treatment in severe asthma

Tailoring the dose of oral corticosteroids in people with severe asthma according to their levels of blood eosinophils can reduce the number of exacerbations, improve asthma symptoms and reduce overall steroid usage, a small Australian pilot study shows. Speaking to the...

Tailoring the dose of oral corticosteroids in people with severe asthma according to their levels of blood eosinophils can reduce...
asthma

Major changes ahead for asthma management

Making low dose steroid inhalers available over the counter and allowing practice nurses to write asthma action plans are just some of the radical suggestions put forward in the draft National Asthma Strategy released for public consultation this week. A pilot trial...

Making low dose steroid inhalers available over the counter and allowing practice nurses to write asthma action plans are just...
asthma

The conundrums in evaluating asthma study outcomes

A recent study is a perfect illustration of the difficulties physicians face in comparing one biological asthma drug to another, experts say. Writing in the Lancet Respiratory Medicine Phillip Korenblat and James Wedner from the Washington School of Medicine say the diversity...

A recent study is a perfect illustration of the difficulties physicians face in comparing one biological asthma drug to another, experts...
asthma

Asthma ‘roadmap’ focuses on practical advice

A new ‘roadmap to asthma control’ focuses on how to implement the guidelines of the Global Initiative for Asthma (GINA), aiming to be “less like a textbook and more like a practical manual”. Associate Professor Helen Reddel, of the Woolcock Institute...

A new ‘roadmap to asthma control’ focuses on how to implement the guidelines of the Global Initiative for Asthma (GINA),...
asthma

Ambitious research program targets steroid non-responsive asthma

A new study in the United Kingdom will explore the use of biomarkers to identify patients with severe asthma who are non-responsive to corticosteroids and might benefit from novel treatment approaches. Professor Liam Heaney, from Queen’s University of Belfast, and colleagues...

A new study in the United Kingdom will explore the use of biomarkers to identify patients with severe asthma who...
asthma

Asthma patients not in control: survey

The level of control people have over their asthma is strikingly lower than recommended in national guidelines, a global study confirms. The Asthma Management and Insight survey of over 10,000 people with asthma also revealed there had been little improvement in...

The level of control people have over their asthma is strikingly lower than recommended in national guidelines, a global study...
asthma

Is it time to trial animal furs in asthma?

It might be time to bite the bullet and trial bringing elements of the farmyard indoors, an asthma expert from New Zealand has suggested. Professor Julian Crane from the Wellington Asthma...

It might be time to bite the bullet and trial...
asthma

Child asthma deaths reveal communication breakdown

Half of the children who died from an asthma attack in the last 10 years in NSW had not been seen by specialist for their asthma, a review finds. Furthermore, the review of  20 deaths from asthma in the last 10...

Half of the children who died from an asthma attack in the last 10 years in NSW had not been...
asthma

Aerobic exercise an important adjuvant therapy in asthma

Aerobic exercise should be added to drug treatment in people with asthma say researchers who found it reduces bronchial hyper-responsiveness and systemic inflammation. The study randomised 58 people with moderate to severe asthma to either a 30 minute yoga breathing...

Aerobic exercise should be added to drug treatment in people with asthma say researchers who found it reduces bronchial hyper-responsiveness...
asthma

Soy supplements don’t help asthma

Soy supplements do not improve lung function in people with asthma, a randomised trial shows. Writing in JAMA the US researchers say previous data had suggested that supplementation with soy isoflavone may be an effective treatment for patients with poorly controlled...

Soy supplements do not improve lung function in people with asthma, a randomised trial shows. Writing in JAMA the US...
asthma

LABA or LAMA for uncontrolled asthma?

Is it better to add long-acting muscarinic antagonists or long-acting beta2-agonists to inhaled corticosteroids for people with uncontrolled asthma? According to the Cochrane Airways Group an answer to this question is important as long-acting beta...

Is it better to add long-acting muscarinic antagonists or long-acting beta2-agonists to inhaled corticosteroids for people with uncontrolled asthma? ...
asthma

Cochrane ‘disappointed’ by lack of LABA/ICS studies in kids

Cochrane says it is disappointed to find that there are no studies on the effects of stopping LABA in children whose asthma is well controlled on ICS/LABA. The finding is particularly disappointing given the importance of the...

Cochrane says it is disappointed to find that there are no studies on the effects of stopping LABA...
asthma

PBAC rejects inhaler restrictions

The Pharmaceutical Benefits Advisory Committee has rejected moves to change PBS restrictions on fixed dose combination LABA/ICS inhalers for children to “authority streamlined”. In a response to the Department of Health’s review of PBS Medicines Used to Treat Asthma in Children...

The Pharmaceutical Benefits Advisory Committee has rejected moves to change PBS restrictions on fixed dose combination LABA/ICS inhalers for children to...
asthma

Umbrella terms not keeping the rain off: Bush

The editor of Thorax agrees with a recent review by Peter Gibson and Vanessa McDonald recommending the term ACOS be abandoned, but he goes even further by saying the terms...

The editor of Thorax agrees with a recent review by...
asthma

Asthma is not “solved”

Almost half of Australian adults with asthma have poor symptom control, and nearly a third had required urgent medical treatment for their condition in the past year, the first nationally representative study of asthma in adults reveals. Published in the MJA...

Almost half of Australian adults with asthma have poor symptom control, and nearly a third had required urgent medical...
asthma

Abandon ACOS as a specific phenotype

Asthma-COPD overlap syndrome should be abandoned as a specific phenotype, say Peter Gibson and Vanessa McDonald. Writing in a review published in Thorax the  authors note that there are several phenotypes that might fall under the asthma-COPD overlap (ACOS) banner but appear to have...

Asthma-COPD overlap syndrome should be abandoned as a specific phenotype, say Peter Gibson and Vanessa McDonald. Writing in a review published in Thorax the...
asthma

Inhalers underused and overused: Report

There is substantial over- and under-use of certain medications for asthma and COPD, reveals a new report from the Australian Centre for Airways disease Monitoring. Prescription respiratory medications were dispensed to over 2 million people in Australia in 2013 but figures from...

There is substantial over- and under-use of certain medications for asthma and COPD, reveals a new report from the Australian Centre...
asthma

Old osteoporosis drug could be breakthrough for asthma

A class of drugs originally developed as a treatment for osteoporosis may have a role to play in the treatment of asthma, researchers say. Using mouse models of asthma and human airway tissue from people with and without asthma the research...

A class of drugs originally developed as a treatment for osteoporosis may have a role to play in the treatment...
asthma

A closer look at stem cells

The online resource a Closer Look at Stem Cells website has been expanded to help patients make informed decisions about stem cell treatments. The website, once patient focused, is now a comprehensive destination for those interested in stem cell science and...

The online resource a Closer Look at Stem Cells website has been expanded to help patients make informed decisions about...
asthma

Twitter predicts asthma emergency visits

By looking at twitter posts and air quality information researchers were able to predict with 75% accuracy how many asthma-related emergency room visits a hospital can expect on a given day. The research highlights the important role that big...

By looking at twitter posts and air quality information researchers were able to predict with 75% accuracy how many asthma-related...
asthma

Key clinical changes to Asthma Handbook

Clarification on the use of low-dose inhaled corticosteroids in children, the role of FEV1/FVC in diagnosis and how newly available combination therapy fits into the prescribing framework are just some of the changes made to the updated Australian Asthma Handbook...

Clarification on the use of low-dose inhaled corticosteroids in children, the role of FEV1/FVC in diagnosis and how newly...
asthma

‘Junk’ apps for asthma

A comprehensive review of asthma apps has revealed a proliferation of commercially driven ones that make it hard for healthcare professionals and patients to filter out the 'junk'. The review by researchers from the Imperial College in London found...

A comprehensive review of asthma apps has revealed a proliferation of commercially driven ones that make it hard for...
asthma

Asthma and suicide link supported by review

The link between asthma and an increased risk of suicide is supported in a review by researchers from the Australian Institute for Suicide Research and Prevention. The majority of the 19 studies included in the systematic review supported the association between asthma...

The link between asthma and an increased risk of suicide is supported in a review by researchers from the Australian...
asthma

Lancet Commission to address asthma stagnation

The Lancet has launched a Commission on asthma in the hope of liberating airway diseases from the "intellectually destitute umbrella term 'asthma'”. It will also examine why after 20 years therapy has not advanced "from the blue and brown inhaler, measurement...

The Lancet has launched a Commission on asthma in the hope of liberating airway diseases from the "intellectually destitute umbrella...
asthma

‘Asthma control’ means something different to patients

Asthma patients seem to have a different view of what 'asthma control' means compared to the healthcare professionals who look after them, a study shows. In an online survey of 2686 asthma patients over the age of 15 only a third...

Asthma patients seem to have a different view of what 'asthma control' means compared to the healthcare professionals who look...
asthma

Charlie’s four big questions

This morning delegates were treated to a chat from Charles Irvin from the University of Vermont on revisiting the mechanics in obstructive airways disease -- do we know it all? Taking the stage in a packed auditorium Dr Irvin...

This morning delegates were treated to a chat from Charles Irvin from the University of Vermont on revisiting the mechanics...
asthma

Bronchial thermoplasty ‘a pudding worth trying’

Bronchial thermoplasty improves quality of life and reduces exacerbations in patients with severe asthma -- and its effects appear to be long lasting, Martin Phillips from Sir Charles Gairdner Hospital has told TSANZSRS 2015. Taking delegates through the procedure, Phillips said...

Bronchial thermoplasty improves quality of life and reduces exacerbations in patients with severe asthma -- and its effects appear to...
asthma

Easy way not always the best way

Measuring sputum eosinophils is still the best method of identifying eosinophilic airway inflammation, authors of a review conclude. In a systematic review and meta-analysis of 24 adult studies and eight studies involving children Daniel Korevaar from the University of Amsterdam...

Measuring sputum eosinophils is still the best method of identifying eosinophilic airway inflammation, authors of a review conclude. In a...
asthma

Asthma by numbers

Latest data from the AIHW shows 1 in 10 people in Australia have asthma and only 20% of those have a written action plan. However the data does show the number of hospitalisations for asthma is declining, with 37,500 occurring...

Latest data from the AIHW shows 1 in 10 people in Australia have asthma and only 20% of those have...
asthma

Clarithromycin:  asthma’s white knight?

The macrolide clarithromycin could be an effective therapy for both steroid sensitive and severe steroid-insensitive asthma, largely because of its anti-inflammatory properties, finds an Australian study published in Thorax. Carried out at the University of Newcastle, the study by Professor Philip...

The macrolide clarithromycin could be an effective therapy for both steroid sensitive and severe steroid-insensitive asthma, largely because of its...
asthma

Short-term steroids for asthma not linked to weight gain

People prescribed a short course of oral steroids for an asthma exacerbation can be reassured by new findings that it won't lead to weigh gain. The double-blinded, randomised, placebo-controlled cross-over trial of 60 patients with...

People prescribed a short course of oral steroids for an asthma exacerbation can be reassured by new findings that it won't...
asthma

Smoking device easily confused with inhaler TGA warns

The TGA has issued a safety advisory warning patients to make sure they don't confuse their inhalers with a smoking device currently on the market. According to the advisory PUFFiT™ and PUFFiTX™ smoking devices closely resemble Metered Dose Inhalers (MDI). The...

The TGA has issued a safety advisory warning patients to make sure they don't confuse their inhalers with a...
asthma

Lean forward for best results

The pulmonary effects of salbutamol can be improved by inhaling in a forward leaning body posture with the neck extended, researcher say.  The pilot study of 41 asthmatic children found that leaning forward in the so called...

The pulmonary effects of salbutamol can be improved by inhaling in a forward leaning body posture with the...
asthma

Inappropriate LABA use may explain child asthma deaths

Inappropriate use of ICS–LABA combination therapy may be behind the 20 child asthma deaths in NSW over the last decade, an expert says. Writing in a perspective article in this week's MJA Professor Peter van Asperen, a...

Inappropriate use of ICS–LABA combination therapy may be behind the 20 child asthma deaths in NSW over the last...
asthma

13 respiratory conditions on Cochrane priority list

Acute respiratory and airways conditions have made it onto the Cochrane priority list of topics to review 13 times. Published for the first time, Cochrane says the list sets out topics that 'best meet the needs of healthcare and health policy decision...

Acute respiratory and airways conditions have made it onto the Cochrane priority list of topics to review 13 times. Published for the...
asthma

Draft guideline for asthma diagnosis

The UK's clinical advisory body has issued draft guidelines for diagnosis and monitoring of asthma.  According to the NICE guideline, which is open for consultation until next month, patients older than 5 years should be offered a fractional exhaled...

The UK's clinical advisory body has issued draft guidelines for diagnosis and monitoring of asthma.  According to the NICE...
asthma

Heritability of asthma overstated

Rare and low frequency genetic mutations thought to explain missing heritability in asthma are unlikely to play a major role, scientists say.  The researchers from the University of Chicago evaluated nearly 33,000 rare or low frequency genetic mutations in...

Rare and low frequency genetic mutations thought to explain missing heritability in asthma are unlikely to play a...
asthma

Asthma a risk factor for OSA

Asthma increases the chances of clinically relevant obstructive sleep apnea in adulthood, a prospective study finds. Participants with preexisting asthma had a nearly 40 percent increased risk for new OSA compared with those without asthma, according to the research published...

Asthma increases the chances of clinically relevant obstructive sleep apnea in adulthood, a prospective study finds. Participants with preexisting asthma had...
asthma

Cold viruses affect day-to-day asthma

Asthma symptoms are significantly linked to the presence of human rhinovirus in the airways, a study of 67 Australian children finds. The presence of the virus increased the risk of cough and phlegm by 27% and increased the...

Asthma symptoms are significantly linked to the presence of human rhinovirus in the airways, a study of...
asthma

Co-sleeping ups asthma risk

Sharing a bed with parents at the age of 2 was associated with an increased risk of wheezing and asthma in later childhood. The findings were not explained by parents monitoring existing asthma symptoms, the Dutch researchers said....

Sharing a bed with parents at the age of 2 was associated with an increased risk of wheezing and asthma...
asthma

Patient perceptions relevant in clinical practice

Patient perceived changes in their respiratory health could be used in clinical practice to assess the overall disease trajectory, researchers say. Asthma patients were more likely to perceive a change, particularly those with persistent asthma. Perceived deterioration was related...

Patient perceived changes in their respiratory health could be used in clinical practice to assess the overall disease trajectory,...
asthma

Childhood asthma ups adult airway issues

Childhood asthma increases the risk of adult airway obstruction 20-fold. Unsurprisingly smoking also increased risk but only in people who had asthma after the age of ten found the large European study that included researchers from the School of...

Childhood asthma increases the risk of adult airway obstruction 20-fold. Unsurprisingly smoking also increased risk but only in people who...
asthma

Paracetamol asthma risk ‘overstated’

The link between early exposure paracetamol and an increased risk of childhood asthma has been ‘overstated,’ according to a review by Australian experts. There is certainly not enough evidence of a link to change current practice guidelines, the researchers...

The link between early exposure paracetamol and an increased risk of childhood asthma has been ‘overstated,’ according to a...
asthma

Morning routine does wonders for adherence

Adding inhalers to the morning ablutions does wonders for adherence. Keeping inhaled corticosteroids in the bathroom or incorporating them into a daily routine increased the likelihood of compliance by threefold (16% adherent vs. 5% nonadherent) found the study of...

Adding inhalers to the morning ablutions does wonders for adherence. Keeping inhaled corticosteroids in the bathroom or incorporating them into...