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Hanania N, Chipps B, Griffin N, Trzaskoma B, Iqbal A, Casale T. Decreased Exacerbations and Improvement in Asthma Symptom Control in Asthma COPD Overlap Treated With Omalizumab: Data From the Prospero Cohort Study. Chest 2017. [DOI: 10.1016/j.chest.2017.08.807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lee LK, Obi E, Paknis B, Kavati A, Chipps B. Asthma control and disease burden in patients with asthma and allergic comorbidities. J Asthma 2017; 55:208-219. [PMID: 28586296 DOI: 10.1080/02770903.2017.1316394] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess asthma control and associations with health-related quality of life (HRQoL) and economic outcomes among patients with asthma and allergic comorbidities treated with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) combination therapy. METHODS Data from the 2011-2013 US National Health and Wellness Survey were used to identify patients with asthma currently treated with ICS and LABA combination therapy (N = 1923). Patients were included if they self-reported a physician diagnosis of asthma and at least one allergic/asthma-related comorbid condition (e.g., nasal allergies, atopic dermatitis). Asthma Control Test scores categorized patients as very poorly (scores ≤ 15; 29.3%), not well (16-19; 25.1%), or well controlled (20-25; 45.7%). Outcomes included HRQoL (SF-36v2; SF-12v2), work productivity and activity impairment, healthcare utilization (HRU), and annual indirect and direct costs. Generalized linear models, controlling for covariates, examined whether outcomes differed by asthma control. RESULTS Over half of the patients had very poorly or not well-controlled asthma (54.4%). Patients with very poorly controlled versus well-controlled asthma reported significantly greater decreases in HRQoL, greater overall work impairment, and higher HRU (all, p < 0.05). Very poorly controlled patients incurred over double the indirect costs and nearly one and a half times the direct and total costs of well-controlled patients. CONCLUSIONS Increasing level of asthma control was related to improved HRQoL and lower costs. The considerably high prevalence of uncontrolled asthma among patients on ICS and LABA suggests poor treatment adherence or unmet needs in current treatment and may require step-up therapy in appropriate patients according to clinical guidelines.
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Lieberman P, Vos W, Van Holsbeke C, Chipps B, Panettieri R, De Backer J. P146 Influence of inhalation technique on lung deposition using flunisolide HFA, fluticasone HFA and beclomethasone HFA. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Luskin A, Haselkorn T, Rosen K, Mink D, Chipps B. O018 Asthma exacerbations and triggers in children with severe/difficult-to-treat asthma: Impact on quality of life. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Teague W, Antonova E, Farr A, Ding Y, Iqbal A, Chipps B. P120 Burden of severe or poorly-controlled asthma in school-age children: healthcare use and allergic co-morbidities. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Paknis B, Lee L, Obi E, Kavati A, Chipps B. Associations Between Asthma Control and Health-Related Quality of Life Among Patients With Allergic Asthma on Inhaled Corticosteroids and Long-Acting Beta Agonists Combination Therapy. Chest 2016. [DOI: 10.1016/j.chest.2016.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Morgan WJ, VanDevanter DR, Pasta DJ, Foreman AJ, Wagener JS, Konstan MW, Liou T, McColley S, McMullen A, Quittner A, Regelmann W, Ren C, Rosenfeld M, Sawicki G, Schechter M, VanDevanter D, Wagener J, Woo M, Brasfield D, Lyrene R, Sindel L, Roberts D, Carroll J, Warren R, Nassri L, Anderson P, Brown M, Silverthorn A, Radford P, Gong G, Legris G, Greene G, Sudhakar R, Platzker A, Nickerson B, Hardy K, Harwood I, Shay G, Quick B, Lieberthal A, Moss R, Landon C, Fanous Y, Lieberman J, Spiritus E, Chipps B, McDonald R, Pian M, Cropp G, Lewis N, Nielson D, Shapiro B, Wagener J, Accurso F, Saavedra M, Daigle K, Hen J, Palazzo R, Dodds K, Pad-man R, Goodill J, Winnie G, Davies L, Kriseman T, Sallent J, Chiaro J, Kubiet M, Goldfinger S, Schwartzman M, Diaz C, Maupin K, Riff E, Geller D, Livingston F, Mavunda K, Birriel J, Faverio L, Rosenberg D, Schaeffer D, Sherman J, Wagner M, Light M, Schnapf B, Montgomery G, Kirchner K, Weatherly M, Caplan D, Guill M, Hudson V, Akhter J, Davison D, Boas S, McColley S, Chung Y, Latner R, Aljadeff G, Chan Y, Kraut J, Stone A, Still JL, Sharma G, Eagleton L, Hopkins P, Chatrath U, Lester L, Kim YJ, Anthony V, Eigan H, Howenstine M, James P, Gergesha E, Harris J, Plant R, Zivkovich V, Collins A, Nassif E, Ahrens R, Doornbos D, Kanarek J, Leff R, Shaw P, Demoss E, Riva M, Sullivan L, Anstead M, Kanga J, Eid N, Morton R, Hilman B, Jones K, Davis S, Harder R, Lever T, Cairns AM, Caldwell E, Zuckerman J, Mogayzel P, Rosenstein B, McQuestion J, Perry D, Rosenberg S, Gerstle R, Colin A, Wohl ME, Lapey A, Yee W, O'Sullivan B, Zwerdling R, Abdulhamid I, O'Hagan A, Schuen J, Kurlandsky L, Honicky R, Homnick D, Marks J, Pichurko B, Maxvold N, Nasr S, Simon R, Tsai W, Kissner D, McNamara J, Henry N, Marker S, Pryor M, Regelmann W, Walker L, Woodward J, Mizell L, Miller S, Rosenbluth D, Black P, McCubbin M, Cohen A, Ferkol T, Mallory G, Rejent A, Rubin B, Graff G, Konig P, Colombo J, Murphy P, Boyle W, Parker W, Patton C, Zanni R, Atlas A, Turcios N, Laraya-Cuasay L, Bisberg D, Aguila H, Allen S, James D, Perkett E, Thompson M, Budhecha S, Diaz R, Rosen J, Kaslovsky R, Percciacante R, Borowitz D, Cronin J, McMahon C, Quittell L, Giusti R, Cohen R, DeCelie-Germana J, Gorvoy J, Patel K, Kattan M, Dozor A, DiMango E, Berdella M, Anbar R, Ianuzzi D, Sexton J, Tayag-Kier C, McBride J, Ren C, Voter K, Dimaio M, Georgitis J, Majure JM, Martinez M, McIntosh C, Leigh M, Schechter M, Black H, Hughes J, Kantak A, Wilmott R, Omlor G, Stone R, McCoy K, Acton J, Doershuk C, Konstan M, Fink R, Steffan M, Vauthy P, Joseph P, Reyes S, Kramer J, Royall J, Eisenberg J, Wall M, Fiel S, Scanlin T, Phadke S, Winnie G, Weinberg J, Sexauer W, Wolf S, Holsclaw D, Klein D, Warren S, Kinsey R, Perez C, Ganeshanathan M, Shinnick J, Panitch H, Varlotta L, Robinson C, Santana JR, Passero MA, Gwinn J, Baker R, Bowman M, Flume P, Brown D, Marville R, Wallace J, Parry R, Ellenburg D, Rogers J, Mohon R, Ledbetter J, Hanissian A, Schoumacher R, Campbell P, Harris C, Slovis B, Stokes D, Hale K, Katz M, Seilheimer D, Sockrider M, Frank A, Daniel J, Cunningham J, Browning I, Bray J, Dove A, Mandujano F, Tremper L, Morse M, Willey-Courand D, Copenhaver S, Pohl J, McWilliams B, Martine-Logvinoff M, Wallace M, Klein R, Amaro R, Couch L, Brown M, Prestidge C, Inscore S, Lipton A, Chatfield B, Liou T, Marshall B, Lahiri T, Swartz D, Whittaker L, Karlson K, Ropoll I, Rubio T, Schmidt J, Thomas D, Osborn J, Froh D, Gaston B, Elliott G, Gibson R, Ramsey B, McCarthy M, Larson L, Ricker D, Robbins M, Aitken M, Emerson J, Aronoff S, Moffett K, Biller J, Splaingard M, Sullivan B, Pritchard P, Adair S, Holzwarth P, Dopico G, Meyer K, Green C, Rock M. Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function. J Pediatr 2016; 169:116-21.e2. [PMID: 26388208 DOI: 10.1016/j.jpeds.2015.08.042] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 07/15/2015] [Accepted: 08/20/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV1 %pred) variability as potential predictors of future FEV1 %pred decline in patients with cystic fibrosis. STUDY DESIGN We included 13,827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV1 %pred to best follow-up FEV1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV1 %pred. RESULTS All 5 measures of FEV1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV1 %pred in the baseline period. The contribution to explanatory power (R(2)) was substantial and exceeded the total contribution of all other factors excluding the FEV1 %pred rate of decline. Adding the other variability measures provided minimal additional value. CONCLUSIONS Median deviation from the best FEV1 %pred is a simple metric that markedly improves prediction of FEV1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.
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Tashkin D, Chipps B, Brown R, Uryniak T, Trudo F. Responder Analysis Evaluating the Long-term Treatment of Budesonide/Formoterol Pressurized Metered-Dose Inhaler (BUD/FM pMDI) in Patients With Moderate to Severe Asthma With Versus Without Fixed Airflow Obstruction (FAO). Chest 2013. [DOI: 10.1378/chest.1704580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Chipps B, Tashkin DP, Brown R, Uryniak T, Trudo F. Long-term Effects of Budesonide/Formoterol Pressurized Metered-Dose Inhaler (BUD/FM pMDI) in African-American Patients With Moderate to Severe Asthma: Responder Analysis in Patients With Versus Without Fixed Airflow Obstruction (FAO). Chest 2013. [DOI: 10.1378/chest.1703057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Tashkin D, Chipps B, Uryniak T, Trudo F, Zangrilli J. Asthma Control and Study Withdrawal in Patients With Versus Without Fixed Airflow Obstruction (2 Criteria): Post Hoc Analysis of a Budesonide/Formoterol Pressurized Metered-Dose Inhaler Study in Patients With Moderate to Severe Asthma. Chest 2012. [DOI: 10.1378/chest.1371955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Chipps B, Tashkin D, Uryniak T, Trudo F, Zangrilli J. Post Hoc Analysis of a Budesonide/Formoterol Pressurized Metered-Dose Inhaler (BUD/FM pMDI) Study: Asthma Control and Study Withdrawal in Patients With Mild to Moderate Asthma With Versus Without Fixed Airflow Obstruction Defined Using 2 Different Criteria. Chest 2012. [DOI: 10.1378/chest.1386417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Dhand R, Dolovich M, Chipps B, R. Myers T, Restrepo R, Rosen Farrar J. The Role of Nebulized Therapy in the Management of COPD: Evidence and Recommendations. COPD 2012; 9:58-72. [DOI: 10.3109/15412555.2011.630047] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Luskin A, Yegin A, Chipps B, Rasouliyan L, Miller D, Haselkorn T. Association Between Severity of Asthma Exacerbations and Asthma-Related Quality of Life in Patients With Severe or Difficult-to-Treat Asthm. Chest 2011. [DOI: 10.1378/chest.1118241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Zeiger RS, Mellon M, Chipps B, Murphy KR, Schatz M, Kosinski M, Lampl K, Ramachandran S. Test for Respiratory and Asthma Control in Kids (TRACK): clinically meaningful changes in score. J Allergy Clin Immunol 2011; 128:983-8. [PMID: 21906790 DOI: 10.1016/j.jaci.2011.08.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 07/28/2011] [Accepted: 08/01/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Test for Respiratory and Asthma Control in Kids (TRACK) is the first validated questionnaire to assess respiratory and asthma control exclusively in young children. OBJECTIVE We sought to determine the minimally important difference (MID) for interpreting meaningful changes in individual patients' TRACK scores. METHODS In this prospective, nonrandomized, longitudinal study conducted at 20 US pediatric sites, TRACK was administered at 2 separate clinic visits (4-6 weeks apart) to caregivers of children aged less than 5 years with symptoms consistent with asthma. Anchor-based methods were used to determine the MID from mean score differences between patients based on multiple criteria measures: physician guidelines-based respiratory control rating, physician-recommended changes to therapy, episodes of symptoms lasting more than 24 hours in the past 3 months, oral corticosteroid use for respiratory tract illnesses in the past year, physician-assessed change in control status at follow-up, and caregiver-reported change in respiratory status. The MID also was determined from distribution-based methods. RESULTS TRACK scores were assessed at baseline (426 caregivers) and follow-up (396 caregivers). Mean differences in TRACK scores between patients differing on criteria measures ranged from 3.4 to 16.4 points (mean, 11.1 points). Distribution-based techniques confirmed these findings. Based on logistic regression analyses, scoring 10 or more points less than 80 on TRACK was associated with an approximately 2-fold increased odds of having uncontrolled asthma or respiratory symptoms. CONCLUSION Changes in TRACK scores of 10 or more points represent clinically meaningful changes in respiratory control status in individual young children with respiratory symptoms consistent with asthma and should alert health care providers to re-evaluate asthma management.
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Chipps B. Treatment of acute asthma. J Asthma 2011; 48:751; author reply 752. [PMID: 21591839 DOI: 10.3109/02770903.2011.580810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chipps B, Spector S, Farrar J, Carr W, Meltzer E, Storms W, Kaliner M, Luskin A, Bukstein D, Oppenheimer J, Smart B, Derebery J, Harder J, Dykewicz M, Benninger M. Differences in recommendations between the Allergic Rhinitis and its Impact on Asthma Update 2010 and US Rhinitis Practice Parameters. J Allergy Clin Immunol 2011; 127:1640-1.e1; author reply 1643-5. [PMID: 21481444 DOI: 10.1016/j.jaci.2011.01.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 01/14/2011] [Accepted: 01/28/2011] [Indexed: 01/29/2023]
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Chipps B, Zeiger RS, Murphy K, Mellon M, Schatz M, Kosinski M, Lampl K, Ramachandran S. Longitudinal validation of the Test for Respiratory and Asthma Control in Kids in pediatric practices. Pediatrics 2011; 127:e737-47. [PMID: 21339276 DOI: 10.1542/peds.2010-1465] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The 5-item, caregiver-completed Test for Respiratory and Asthma Control in Kids (TRACK) was developed and validated primarily in asthma-specialist practices to monitor respiratory control in preschool-aged children. This longitudinal study in children treated by pediatricians evaluated the responsiveness of TRACK to changes in respiratory- and asthma-control status over time and further assessed TRACK's reliability and validity. PATIENTS AND METHODS Caregivers of children younger than 5 years with symptoms consistent with asthma within the past year (N = 438) completed TRACK at 2 clinic visits separated by 4 to 6 weeks. Physicians were blinded to caregiver assessment, completed a guidelines-based respiratory-control survey at both visits, and were asked whether the visit resulted in a change in therapy. Responsiveness of TRACK to change in respiratory-control status over time was evaluated; reliability and discriminant validity were assessed. RESULTS Mean changes in TRACK scores from the initial to follow-up visits differed in the expected direction in subsets of children whose clinical status improved, remained unchanged, or worsened based on physicians' and caregivers' assessments (P < .001). Mean TRACK scores also differed significantly (P < .001) across patient subsets, with lower scores (indicating poorer control) in children classified as very poorly controlled, in those who required a step-up in therapy, and in those who had 4 or more episodes or attacks of wheezing, coughing, or shortness of breath per week in the past 3 months. CONCLUSIONS The present study extends the validity and reliability of TRACK by demonstrating its responsiveness to change in respiratory-control status over time in preschool-aged children with symptoms consistent with asthma.
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Eid NS, Noonan MJ, Chipps B, Parasuraman B, Miller CJ, O'Brien CD. Once- vs twice-daily budesonide/formoterol in 6- to 15-year-old patients with stable asthma. Pediatrics 2010; 126:e565-75. [PMID: 20713475 DOI: 10.1542/peds.2009-2970] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess efficacy/tolerability of once-daily budesonide/formoterol pressurized metered-dose inhaler (pMDI) versus budesonide pMDI (primary) and twice-daily budesonide/formoterol (secondary) in children/adolescents with asthma stabilized with twice-daily budesonide/formoterol. METHODS This 12-week multicenter, double-blind randomized controlled study (www.clinicaltrials.gov identifier NCT00646321) included 521 patients aged 6 to 15 years with mild/moderate persistent asthma. Patients stabilized during a 4- to 5-week run-in with twice-daily budesonide/formoterol pMDI 40/4.5 microgx2 inhalations (160/18 microg daily) received twice-daily budesonide/formoterol pMDI 40/4.5 microgx2 inhalations (160/18 microg daily), once-daily budesonide/formoterol pMDI 80/4.5 microgx2 inhalations (160/9 microg daily; evening), or once-daily budesonide pMDI 80 microgx2 inhalations (160 microg daily; evening). RESULTS Once- or twice-daily budesonide/formoterol was more effective than budesonide for evening peak expiratory flow (primary variable) at the end of the 24-hour once-daily dosing interval (P<or=.027). Twice-daily budesonide/formoterol demonstrated better efficacy versus once-daily treatments for evening predose forced expiratory volume in 1 second (P<or=.011), versus budesonide for daytime/nighttime rescue medication (P<or=.023), and versus once-daily budesonide/formoterol for daytime rescue medication (last 12 hours of once-daily dosing) (P=.032). There were no significant between-group differences for daytime/nighttime asthma symptoms, nighttime awakenings attributed to asthma, or health-related quality of life. Fewer patients experienced asthma worsening (predefined criteria) with twice-daily budesonide/formoterol (8.2%) versus once-daily budesonide (15.5%) (P=.036) or once-daily budesonide/formoterol (19.6%) (P=.002). All treatments were well tolerated. CONCLUSIONS Once-daily budesonide/formoterol demonstrated significantly better efficacy than once-daily budesonide for most pulmonary-function variables. Twice-daily budesonide/formoterol (160/18 microg daily) maintenance therapy was generally more effective than stepping down to once-daily dosing (160/9 microg daily). Treatments were well tolerated, and there was no evident safety benefit for once- versus twice-daily dosing.
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Blaiss M, Fairchild CJ, Darter A, LaForce C, Tort MJ, Darter A, Storms W, Tort MJ, Granet DB, Amin D, Tort MJ, Meltzer E, Fairchild CJ, Kircik L, Chipps B, Mellon M, Murphy K, Zeiger RS, Schatz M, Kosinski M, Lampl K, Ramachandran S, Mellon M, Zeiger RS, Chipps B, Murphy KR, Schatz M, Kosinski M, Lampl K, Ramachandran S, Nelson H, LaForce C, Bonuccelli C, Radner F, Ottosson A, Carroll KJ, Andersson TLG, LaForce C, Nelson H, Bonuccelli C, Radner F, Andersson TLG, Yu GP, Nadeau KC, Berk DR, de Saint Basile G, Lambert N, Knapnougel P, Roberts J, Steihm RE, Lewis DB, Umetsu DT, Puck JM, Cowan MJ, Baker JW, Paul M. Research abstracts presented at the Western Society of Allergy, Asthma, and Immunology Meeting, January 24‐28, 2010. Allergy Asthma Proc 2010. [DOI: 10.2500/108854110791063952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Chipps B, Kianifard F, Fernandez Viduarre C, Massanari M. EFFECT OF OMALIZUMAB ON PERIPHERAL BLOOD EOSINOPHILS IN CHILDREN WITH MODERATE-SEVERE PERSISTENT ALLERGIC ASTHMA. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.35s] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Kaliner MA, Storms W, Tilles S, Spector S, Tan R, LaForce C, Lanier BQ, Chipps B. Comparison of olopatadine 0.6% nasal spray versus fluticasone propionate 50 microg in the treatment of seasonal allergic rhinitis. Allergy Asthma Proc 2009; 30:255-62. [PMID: 19549426 DOI: 10.2500/aap.2009.30.3232] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The efficacy of nasal antihistamines (NAHs) for allergic rhinitis (AR) is comparable with or better than second-generation oral antihistamines, with faster onset of action and greater effect on congestion. Limited data suggest that NAHs may be equivalent to intranasal corticosteroids at reducing the full range of nasal seasonal AR (SAR) symptoms, including congestion. The efficacy of olopatadine 0.6% nasal spray (2 sprays/nostril b.i.d.) for symptoms of SAR was compared with fluticasone 50 microg nasal spray (2 sprays/nostril q.d.) in a double-blind, randomized, parallel-group, 2-week noninferiority trial. A total of 130 symptomatic patients were randomized to treatment and they recorded nasal and ocular allergy symptom scores b.i.d. (morning and evening) in a diary. Both treatments reduced reflective and instantaneous assessments of nasal and ocular symptoms from baseline throughout the 2-week study period (p < 0.05). The reflective total nasal symptom score (the primary efficacy variable) decreased by an average of -45.4% for patients treated with olopatadine 0.6% and by -47.4% for those treated with fluticasone; statistical significance favoring olopatadine was demonstrated at day 1. No significant between-treatment differences were determined for the average 2-week percent changes from baseline for congestion, runny nose, sneezing, itchy nose, and ocular symptoms, although olopatadine had a faster onset of action for reducing all symptoms. Both treatments were safe and well tolerated. Olopatadine and fluticasone nasal sprays both reduced nasal and ocular SAR symptoms with no significant between-treatment differences except for a faster and greater onset of action with olopatadine.
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Murphy KR, Zeiger RS, Kosinski M, Chipps B, Mellon M, Schatz M, Lampl K, Hanlon JT, Ramachandran S. Test for respiratory and asthma control in kids (TRACK): a caregiver-completed questionnaire for preschool-aged children. J Allergy Clin Immunol 2009; 123:833-9.e9. [PMID: 19348922 DOI: 10.1016/j.jaci.2009.01.058] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 01/23/2009] [Accepted: 01/26/2009] [Indexed: 11/18/2022]
Abstract
BACKGROUND A validated questionnaire is needed to monitor respiratory control in preschool-aged children. OBJECTIVE We sought to develop and validate a caregiver-completed questionnaire that measures respiratory control in young children. METHODS A 33-item questionnaire that included asthma impairment and risk items was administered to 486 caregivers of children aged younger than 5 years with a current, recent, or past history of respiratory symptoms. Stepwise regression was used to select a subset of items with the greatest discriminant validity in relation to guidelines-defined asthma control in a random two-thirds development sample. Reliability, validity, and ability to screen for respiratory control problems were tested in development and validation samples (remaining one-third sample). RESULTS The content of the 5 items selected, the Test for Respiratory and Asthma Control in Kids (TRACK), included frequency of respiratory symptoms (wheeze, cough, shortness of breath), activity limitation, and nighttime awakenings in the past 4 weeks; rescue medication use in the past 3 months; and oral corticosteroid use in the previous year. Reliability was greater than 0.70 in both samples. ANOVA showed that mean scores differed significantly (P < .001) in the expected direction across both samples for 3 levels of guidelines-based respiratory control, physician-recommended change in therapy, and symptom status. In the development and validation samples, screening analyses revealed areas under the receiver operating characteristic curve of 0.88 and 0.82, respectively; control status was correctly classified in 81% and 78% of cases. CONCLUSION TRACK is a valid, easy-to-administer, caregiver-completed questionnaire of respiratory control in preschool-aged children with symptoms consistent with asthma.
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Miller DP, Tom G, Rasouliyan L, Chipps B. Patient-reported outcomes among omalizumab and salmeterol/fluticasone combination therapy patients. J Asthma 2009; 46:179-85. [PMID: 19253127 DOI: 10.1080/02770900802604103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Some asthma patients remain poorly controlled despite receiving care consistent with treatment guidelines. OBJECTIVE This study compared the ability to sleep, work, and participate in leisure activities among subjects with immunoglobulin E-mediated (allergic) asthma initiating omalizumab (omalizumab start group) with subjects receiving moderate-to-high doses of salmeterol/fluticasone combination therapy, who continued on salmeterol/fluticasone combination therapy for at least a year without adding omalizumab (salmeterol/fluticasone combination continuation group). METHODS Subjects completed an Internet-based screener and, if eligible, an Internet-based questionnaire. A propensity score model was utilized in the analysis. Group differences were assessed through logistic and linear regression models. Analyses were adjusted for propensity score quintile, how subjects heard about the study, and responses to retrospective single-item questions. RESULTS The analysis population included 86 omalizumab start group subjects and 436 salmeterol/fluticasone combination continuation subjects, recruited from June to November 2006. In the adjusted analyses, the omalizumab start group was more than twice as likely to have controlled asthma as measured by the Asthma Control Test (odds ratio, 2.62; p = 0.005). The omalizumab start group had significantly fewer sleep disturbances as measured by the Jenkins Sleep Evaluation Questionnaire (least-square means difference, -1.65;p = 0.004), less activity impairment as measured by the Work Productivity Activity Impairment-Asthma Scale (least-square means difference, -13.36;p < 0.001), and less difficulty in activities as measured by the Valued Life Activities Questionnaire (least-square means difference, -0.24; p < 0.001). CONCLUSION Asthma subjects who started taking omalizumab reported more improvement in asthma control, fewer sleep problems, less activity impairment, and less difficulty with activities than a similar cohort of subjects who continued taking salmeterol/fluticasone combination therapy.
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Liu AH, Zeiger R, Mahr T, Ostrom N, Chipps B. Reply. J Allergy Clin Immunol 2008. [DOI: 10.1016/j.jaci.2007.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chipps B, Buhl R, Beeh KM, Fox H, Thomas K, Reisner C. Improvement in quality of life with omalizumab in patients with severe allergic asthma. Curr Med Res Opin 2006; 22:2201-8. [PMID: 17076981 DOI: 10.1185/030079906x148643] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients with severe persistent asthma experience daily symptoms and frequent serious exacerbations that contribute to a significant impairment of health-related quality of life (QoL). METHODS A pooled analysis was completed of six controlled clinical trials that evaluated the effect of add-on omalizumab on asthma-related QoL in patients with severe persistent allergic (IgE-mediated) asthma. Asthma-related QoL was assessed at baseline and treatment endpoint using the well-validated Juniper Asthma Quality of Life Questionnaire (AQLQ). Change from baseline in AQLQ total score was compared between treatments using analysis of covariance methods. The percentage of patients who achieved a clinically meaningful (> or = 0.5-point) improvement in AQLQ total score was compared using the Mantel-Haenszel Chi-square test. RESULTS The pooled patient population comprised 2548 patients (omalizumab, n = 1342; control, n = 1206), of whom 96% had severe persistent asthma according to the GINA 2002 classification. Omalizumab produced significantly greater improvements in AQLQ total score vs the control group (mean increases of 1.01 and 0.61 points, respectively; p < 0.001). In addition, significantly more omalizumab-treated patients achieved a clinically meaningful improvement in AQLQ total score than patients in the control group (66.3% vs 52.4%; p < 0.001). CONCLUSIONS Add-on therapy with omalizumab improves QoL to a significant and clinically meaningful level in patients with severe persistent allergic asthma.
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Chipps B, Szefler S, Lee J, Haselkorn T, Mink D, Deniz Y, Simons F. Demographic and Clinical Characteristics of Children and Adolescents with Severe or Difficult-to-Treat Asthma. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Borish L, Chipps B, Deniz Y, Gujrathi S, Zheng B, Dolan CM. Total serum IgE levels in a large cohort of patients with severe or difficult-to-treat asthma. Ann Allergy Asthma Immunol 2005; 95:247-53. [PMID: 16200815 DOI: 10.1016/s1081-1206(10)61221-5] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Limited data are available on levels of IgE in large cohorts of patients with severe or difficult-to-treat asthma. OBJECTIVE To examine IgE levels and disease in patients from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. METHODS From January 2001 to October 2001, 4,923 patients were screened for inclusion in the study. Of these, 4,756 patients 6 years or older with severe or difficult-to-treat asthma were enrolled and completed a baseline study visit. Total serum IgE levels were measured at the baseline visit and are summarized by geometric means. RESULTS The mean total IgE level of the population is 106.6 IU/mL (95% confidence interval, 101.5-112.0 IU/mL). Children (6-12 years old) and adolescents (13-17 years old) have higher mean IgE levels than adults (> or =18 years old) (P < .001). Males have a higher mean IgE level than females (P < .001). IgE levels are higher among nonwhite patients than white patients (P < .001). Current smokers have higher IgE levels than past smokers or never smokers (P < .001). Among children, patients with severe asthma have a higher mean IgE level (280.2 IU/mL) than patients with moderate (145.8 IU/mL) or mild (137.8 IU/mL) asthma (P < .001). Among adults, patients with childhood-onset asthma have higher IgE levels (124.3 IU/mL [n = 1,348]) than patients with adult-onset asthma (65.7 IU/mL [n = 1,956]) (P < .001). CONCLUSION In patients with severe or difficult-to-treat asthma from the TENOR study, higher total IgE levels were observed in males, children, smokers, nonwhite racial/ethnic groups, and adults with childhood-onset disease. In addition, IgE levels are associated with asthma severity among younger patients.
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Chipps B, Spahn J, Sorkness C, Emmett A, Sutton L, Dorinsky PM. CLASSIFICATION OF ASTHMA SEVERITY AMONG STEROID-NAÏVE PEDIATRIC SUBJECTS PREVIOUSLY RECEIVING SHORT-ACTING BETA2-AGONISTS: DO THE GUIDELINES NEED REVISITING? Chest 2005. [DOI: 10.1378/chest.128.4_meetingabstracts.352s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Chipps B, Spahn J, Sorkness C, Sutton L, Emmett A, Dorinsky P. Variability in asthma severity in pediatric asthma patients previously receiving short-acting beta2-agonists. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ververeli K, Chipps B. Oral corticosteroid-sparing effects of inhaled corticosteroids in the treatment of persistent and acute asthma. Ann Allergy Asthma Immunol 2004; 92:512-22. [PMID: 15191019 DOI: 10.1016/s1081-1206(10)61758-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the efficacy and safety of inhaled corticosteroids (ICSs) when used to reduce daily oral corticosteroid (OCS) requirements in patients with severe persistent asthma and periodic requirements in patients with acute asthma exacerbations. DATA SOURCES Clinical studies of the OCS-sparing effects of ICSs were located by searching MEDLINE databases from 1966 onward using the terms oral, steroid, and asthma in combination with the generic names for each marketed ICS. STUDY SELECTION Studies reporting on the use of ICSs to reduce OCS requirements in patients with persistent and acute asthma are included. RESULTS Clinical study results consistently show that ICSs significantly improve asthma control and reduce OCS requirements among adults, children, and infants with persistent asthma. A dose reduction or complete discontinuation of use of OCSs is possible in most patients without loss of asthma control. ICSs also can control asthma during acute asthma exacerbations and reduce the need for short courses of OCSs. With many ICSs, the reductions in OCS use are accompanied by recovery of hypothalamic-pituitary-adrenal axis function, indicating that the safety of asthma therapy is improved when OCS requirements are decreased with ICSs. Of the available ICSs that may reduce OCS needs, budesonide appears to be the most intensively studied. CONCLUSIONS ICSs can reduce OCS requirements in adults and children with persistent asthma and during acute asthma exacerbations. The reduced systemic corticosteroid activity associated with ICS treatment improves the overall safety of asthma therapy.
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Dolan CM, Fraher KE, Bleecker ER, Borish L, Chipps B, Hayden ML, Weiss S, Zheng B, Johnson C, Wenzel S. Design and baseline characteristics of the epidemiology and natural history of asthma: Outcomes and Treatment Regimens (TENOR) study: a large cohort of patients with severe or difficult-to-treat asthma. Ann Allergy Asthma Immunol 2004; 92:32-9. [PMID: 14756462 DOI: 10.1016/s1081-1206(10)61707-3] [Citation(s) in RCA: 185] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patients with severe and difficult-to-treat asthma represent a small percentage of asthma patients, yet they account for much of the morbidity, mortality, and cost of disease. The goal of The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study is to better understand the natural history of asthma in these patients. OBJECTIVE To describe the methods and baseline characteristics of the TENOR study cohort. METHODS The TENOR study is a 3-year, multicenter, observational study of patients with severe or difficult-to-treat asthma. From January through October 2001, more than 400 US pulmonologists and allergists enrolled patients. Patients 6 years or older who were considered to have severe or difficult-to-treat asthma by their physicians were eligible. Patients have been receiving care for 1 year or more, have a smoking history of 30 pack-years or less, and have current high medication or health care utilization in the past year. Data are collected semiannually. RESULTS A total of 4,756 patients enrolled and completed a baseline visit. Overall, 73% of the TENOR study patients are adults, 10% are adolescents, and 16% are children. According to physician evaluation, 48% of patients have severe asthma, 48% have moderate asthma, 3% have mild asthma, and 96% have difficult-to-treat asthma. Severe asthmatic patients have the highest health care utilization in the past 3 months (P < .001). CONCLUSIONS The TENOR study is the largest cohort of patients with severe or difficult-to-treat asthma. Although patients are equally divided into moderate or severe asthma categories, most are considered difficult-to-treat. The TENOR study highlights the lack of control in moderate-to-severe asthma and provides a unique opportunity to examine factors related to health outcomes in this understudied population.
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Chipps B, Kim K, Korenblat P, Deniz Y, Zheng B, Carroll A. Effect of omalizumab on healthcare utilization in patients with moderate to severe allergic asthma. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80461-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dolan CM, Chipps B, Zheng B, Johnson C, Tenor FT, Group S. Baseline characteristics of a large cohort of severe or difficult to treat asthma subjects from the epidemiology and natural history of asthma: Outcomes and treatment regimens (TENOR) study. J Allergy Clin Immunol 2002. [DOI: 10.1016/s0091-6749(02)81223-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Aquino SL, Schechter MS, Chiles C, Ablin DS, Chipps B, Webb WR. High-resolution inspiratory and expiratory CT in older children and adults with bronchopulmonary dysplasia. AJR Am J Roentgenol 1999; 173:963-7. [PMID: 10511158 DOI: 10.2214/ajr.173.4.10511158] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study is to correlate high-resolution inspiratory and expiratory CT findings with pulmonary function results in older children and adults who have bronchopulmonary dysplasia. SUBJECTS AND METHODS High-resolution inspiratory and expiratory CT of the thorax was performed prospectively on 26 patients (16 male, 10 female) with a clinical history of bronchopulmonary dysplasia. The median age was 10 years old (range, 5-18 years). High-resolution CT during inspiration was scored for areas of decreased density and evidence of interstitial lung disease; expiratory CT was scored for air trapping. Findings were correlated with pulmonary function measurements and clinical history. RESULTS Twenty-four (92%) of the 26 patients had abnormal CT findings. Of these 24, 22 had reticular opacities and 18 had areas of architectural distortion. Twenty patients had areas of relatively decreased density. In 24 patients, air trapping was seen on expiratory CT. Abnormal pulmonary function correlated significantly (p < .05) with abnormal decreases in density, air trapping on expiratory CT, and architectural distortion. CONCLUSION Abnormal findings on inspiratory and expiratory high-resolution CT of older children with bronchopulmonary dysplasia include scarring and air trapping with architectural distortion. The correlation between these findings and physiologic evidence of air trapping and obstructive lung disease was statistically significant.
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