An overview of EPR3 Asthma Guidelines: What's different?
Department of Pulmonary, Allergy, and Critical Care, Cleveland Clinic, Cleveland, Ohio 44195, USA. Allergy and Asthma Proceedings
(Impact Factor: 3.06).
11/2007; 28(6):620-7. DOI: 10.2500/aap.2007.28.3065
Updated asthma care guidelines have recently been released. This review will focus on several elements in the Expert Panel Report (EPR) 3 guidelines that reflect substantial differences compared with recommendations of the EPR2 guidelines, issued in 1997 and updated in 2002. A major difference is the emphasis on asthma control. The revised paradigm for asthma management now recommends that asthma management decisions should be initially based on categorization of asthma severity, and subsequently on assessment of asthma control. Asthma control can be assessed serially by use of validated instruments. The goal of asthma therapy is to achieve asthma control by reducing current impairment and future risk. Recommendations for asthma pharmacotherapy have also been revised since release of updated EPR2 guidelines. The revisions in asthma management proposed in these guidelines offer the potential for improved normative care outcomes in asthmatic patients in the United States.
Available from: clevelandclinicmeded.com
Available from: Nikolaos G Papadopoulos
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ABSTRACT: Exercise-induced (EI) hypersensitivity disorders are significant problems for both recreational and competitive athletes. These include EI-asthma, EI-bronchoconstriction, EI-rhinitis, EI-anaphylaxis and EI-urticaria. A group of experts from the European Academy of Allergology and Clinical Immunology and the American Academy of Allergy Asthma and Immunology met to discuss the pathogenesis of these disorders and how to diagnose and treat them, and then to develop a consensus report. Key words (exercise with asthma, bronchoconstriction, rhinitis, urticaria or anaphylaxis) were used to search Medline, the Cochrane database and related websites through February 2008 to obtain pertinent information which, along with personal reference databases and institutional experience with these disorders, were used to develop this report. The goal is to provide physicians with guidance in the diagnosis, understanding and management of EI-hypersensitivity disorders to enable their patients to safely return to exercise-related activities.
Available from: Teresa Renda
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ABSTRACT: Omalizumab is a humanized monoclonal anti-IgE antibody recently approved for the treatment of severe allergic asthma. This drug inhibits allergic responses by binding to serum IgE, thus preventing their interactions with cellular IgE receptors. Omalizumab is also capable of downregulating the expression of high-affinity IgE receptors on inflammatory cells, as well as the numbers of eosinophils in both blood and induced sputum. The clinical effects of omalizumab include relevant improvements in respiratory symptoms and quality of life, paralleled by a marked reduction of asthma exacerbations, emergency room visits, and use of systemic corticosteroids and rescue bronchodilators. Omalizumab is relatively well tolerated, and only rarely induces anaphylactic reactions. Therefore, this drug represents a valid option as add-on therapy for patients with severe persistent allergic asthma, inadequately controlled by high doses of standard inhaled treatments.
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