Distinguishing Type-2 Asthma
|
|
- Elmer Fox
- 5 years ago
- Views:
Transcription
1 UPDATE ON ASTHMA THERAPY: MATCHING PHENOTYPE TO TREATMENT Sally E. Wenzel, MD Professor of Medicine University of Pittsburgh Asthma Subsection Chief of Allergy Distinguishing Type-2 Asthma Asthma Blood eos Periostin FeNO Type-2 inflammation No/less Type-2 inflammation
2 Blockade of IL-4/-13 receptor decreased allergen induced exacerbation Wenzel, Lancet, October Placebo inhaled Pitrakinra nhaled 9 8 % f 7 Screening Day 27 Screening Day 27 Allergen Hours Mean ± SEM (n = 14 placebo, 15 AEROVANT) Allergen Hours Similar efficacy of Anti-IL-13 antibodies, with no effect on sputum eos Gauverau Am J Resp Crit Care Med 211 Suggests early onset allergic asthma should respond to IL-4/13 targeted therapy Anti-IL-5 did not impact allergen induced responses Leckie NEJM 2 3 What are the best biomarkers? Is there gold standard and how do you define? Previous studies defined gold standard as lung/sputum eosinophils but no proof that best defines a Type-2 phenotype Is it more important to use biomarkers to predict response to treatments, either non-specific (CSs) or targeted biologics Likely to have modest to good predictability Blood (sputum) eos, FeNO and serum periostin Not likely to be helpful Atopy/specific IgE
3 Predicting lung eosinophils In moderate to severe asthma, serum periostin related to lung eosinophils Jia JACI 212 In relation to FeNO, blood eosinophils or IgE periostin best predicted lung eos But not better than FeNO in predicting response to anti-il- 13 Corren NEJM 211 Cannot be used <18 years old Sputum eosinophils predict response to inhaled CS No response Good response Patients from ACRN clinical trials with at least 3 sputum samples Divided into those with eosinophils on 2 or 3, eosinophils on at least 1 or no eosinophils ever (about 3% in each) Not yet clear whether blood eos can be substituted McGrath AJRCCM 212
4 Type-2 targeted therapies: Anti-IL pts with moderate to severe asthma on mid to high dose ICS±LABA randomized to Rx with anti-il-13 vs placebo Anti-IL-13 modestly effective in improving FEV1 in all comers Dividing pts into serum periostin Hi/Lo (Th2-Hi/Lo) identified responder population FeNO worked similarly well Corren, et al N Engl J Med 211 Blockade of IL-13 also decreased Fe NO confirming bioresponse marker inos 13 kd -actin 42 kd CON IL-13 CON IL-13 CON IL-13 Normal Mild-Mod Severe inos/ -actin* P<.5 N=15 Control IL-13 1 ng/ml Chibana, K Clin Exp Allergy 28
5 Current targeted Rxs (anti-ige) may be more efficacious in Type-2 Hi Lo Th2 Hi Lo Th2 Hi Lo Th2 Hi Hanania, AJRCCM May 213 Does broader blockade of Type 2 cytokines further improve outcomes?
6 Blockade of both IL-4/13: Targeted Hi Eos subgroup (>3/ul) Screening/ run in period Treatment period Post treatment period Background therapy stable phase Background therapy withdrawal phase monotherapy Fluticasone/salmeterol DPI: 25/5 µg BID 5/5 µg BID MDI: 23/42 µg BID 46/42 µg BID Fluticasone 25 µg BID 5 µg BID 22 µg BID 44 µg BID 1 µg BID 25 µg BID 11 µg BID 22 µg BID 5 µg BID 1 µg BID 44 µg BID 11 µg BID µg BID 5 µg BID µg BID 44 µg BID µg BID µg BID Fluticasone/salmeterol 25/5 µg BID 5/5 µg BID 23/42 µg BID 46/42 µg BID SC = subcutaneous; BID = twice daily dosing; DPI = dry powder inhalation; MDI = metered dose inhalation Wenzel S, et al. N Engl J Med. 213;368: IL4R inhibition decreased time to 1 st exacerbation Cumulative Exacerbation Rate (%) Stable ICS/LABA LABA discontinuation ICS Taper or placebo monotherapy Number at Risk Week Placebo Placebo Hazard ratio.1 (95% CI.3,.34) P <.1 Wenzel S, et al. N Engl J Med. 213;368:
7 Improves lung function Mean Change from Baseline (± SE).3. Stable ICS/LABA LABA discontinuation ICS Taper or placebo monotherapy P <.1 P <.1 Placebo No. subjects Week Placebo Wenzel S, et al. N Engl J Med. 213;368: And Asthma Control Mean Change from Baseline (± SE) Stable ICS/LABA LABA discontinuation ICS Taper or placebo monotherapy Week No. subjects Placebo Wenzel S, et al. N Engl J Med. 213;368: Placebo P P = = <.1.1.1
8 Clinical Response correlates with biologic response Mean Percent Change from Baseline (± SE) Stable ICS/LABA LABA discontinuation ICS Taper or placebo monotherapy Correlation of FeNO with FEV 1 at Week 12: r =.48 P =.9 Placebo P <.1 P <.1 4 Week 8 12 No. subjects Placebo also impacted upper airway: SNOT-22 SNOT22 subscales Total change from placebo (MCS -8.99)
9 Phase 2b: What will define Type-2 asthma and how well will it respond? Multinational, randomized, placebo-controlled study in patients with uncontrolled asthma despite background therapy with medium- to high-dose ICS and LABA Patients stratified by blood eosinophil (Eos) count Hi Eos defined as >3/ul, Lo Eos all others n = 15 3 mg q2w with loading dose (6 mg) n = 15 3 mg q4w with loading dose (6 mg) Screening period (14 21 days) Randomization (1:1:1:1:1) was used as add-on therapy to ICS and LABA n = 15 2 mg q2w with loading dose (4 mg) n = 15 2 mg q4w with loading dose (4 mg) n = 15 Placebo 24-week treatment period q2w, every 2 weeks; q4w, every 4 weeks. Study Endpoints Primary endpoint: Change from baseline in FEV 1 (L) at Week 12 in the high Eos (HEos) population Secondary endpoints included: Change from baseline in FEV 1 (L and %) at Week 12 Annualized rate of severe exacerbation* during treatment period Safety and tolerability data Secondary outcomes reported for: HEos, defined as 3 cells/µl Low Eos (LEos), defined as < 3 cells/µl Overall *A severe exacerbation event during the study defined as deterioration of asthma requiring use of systemic corticosteroids for 3 days or hospitalization or emergency room visit because of asthma, requiring systemic corticosteroids.
10 Baseline Demographics and Clinical Characteristics: Overall Population Placebo (n = 158) 2 mg q4w (n = 154) 3 mg q4w (n = 157) 2 mg q2w (n = 15) 3 mg q2w (n = 157) Mean age, years Male, % BMI > 3 kg/m 2,% Baseline FEV 1, L Baseline FEV 1, % predicted Mean asthma exacerbations in past year High dose ICS/LABA use, % Atopic medical history, % Atopic dermatitis Allergic rhinitis Nasal polyposis ACQ5 score Mean FeNO, ppb BMI, body mass index; FeNO, fractional exhaled nitric oxide; ppb, parts per billion. Baseline Blood Eosinophil Counts Placebo 2 mg q4w 3 mg q4w 2 mg q2w 3 mg q2w Baseline Eosinophil counts (cells/µl) Mean (SD) n Mean (SD) n Mean (SD) n Mean (SD) n Mean (SD) n Overall population 34 (3) (76) (27) (35) (25) 157 HEos population 56 (34) 68 7 (112) (28) (41) (27) 64 LEos population 17 (7) 9 17 (7) (8) (6) (7) 93 SD, standard deviation
11 Primary Endpoint: Absolute Change in FEV1 In HEos Population Placebo (n = 62) Dup 2q4w (n = 62) Dup 3q4w (n = 66) Dup 2q2w (n = 65) Dup 3q2w (n = 64) HEos population FEV 1 liter change.5 LS mean change (± SE) *** ** * Week 8 12 Statistically significant improvement in FEV 1 at Week 12 in patients with HEos versus placebo at all doses explored except 2 mg q4w ; *P <.5, **P <.1, ***P <.1 vs placebo; Dup, dupilumab; LS, least squares; SE, standard error BUT FEV1 improves in those with <3 eos/ul too Placebo Dup 2q4w Dup 3q4w Dup 2q2w Dup 3q2w LS mean % change (± SE) LS mean % change (± SE) HEos population Week Overall population *** ** * Week *** *** ** * LS mean % change (± SE) LEos population Week ** * In the overall population, significant improvement was observed for all dupilumab dose regimens versus placebo In the LEos population, significant improvement was observed for the q2w regimens versus placebo, but not for the q4w regimens ; *P <.5, **P <.1, ***P <.1 vs placebo; Dup, dupilumab; LS, least squares; SE, standard error
12 And, no difference in effect on exacerbations Adjusted annualized severe exacerbation rate - estimate (95% CI) HEos population * Placebo 2 mg (N = 68) q4w (N = 59) 74% 26% 64% 75% 3 mg q4w (N = 66) * 2 mg q2w (N = 64) * 3 mg q2w (N = 64) Adjusted annualized severe exacerbation rate - estimate (95% CI) LEos population 46% 51% 68% 62% Placebo (N = 9) 2 mg q4w 3 mg q4w 2 mg q2w 3 mg q2w (N = 91) (N = 91) (N = 84) (N = 92) ** * Adjusted annualized severe exacerbation rate - estimate (95% CI) Placebo (N = 158) Overall population 57% 38% 67% 68% ** 2 mg q4w (N = 15) 3 mg q4w (N = 157) ** *** 2 mg q2w (N = 148) 3 mg q2w (N = 156) In the HEos and overall populations, significant decreases in severe asthma exacerbation rates were observed for all dupilumab regimens versus placebo, except the 3 mg q4w In the LEos population, significant decreases in severe asthma exacerbation rates were observed for the dupilumab q2w regimens versus placebo However, BETTER response seen in those with higher blood eos Anti-IL-5 approaches: Directly targeting eosinophils Haldar P et al. N Engl J Med 29;36: Anti IL-5 not effective in unselected pts Flood-Paige 27 Targeted Anti-IL-5 approach to eosinophilic asthma led to 4% reduction in asthma exacerbations Eosinophils nearly gone in blood Is there phenotype that responds best?
13 Mepolizumab consistently effective in 3 large trials of eosinophilic patients Targeted patients with blood eosinophils >~28/ml Reductions in exacerbations of 4-5% Recent studies show some impact on FEV1/ACQ as well Responses improve with increasing eosinophils Similar data with benralizumab Castro Lancet Res Med 214 Ortega HG et al. N Engl J Med 214;371: Will anti-il-5 approach do best in Adult onset Eosinophilic asthma? Wu, JACI 214 BAL Eosinophil %
14 Anti-IL-5 Receptor antibody approach (benralizumab) NCT (CP22) Eosinophilic phenotype: ELEN Index positive and/or Fe NO 5 ppb Non-eosinophilic phenotype: ELEN Index negative and Fe NO <5 ppb ELEN Index: mathematical algorithm to predict elevated sputum eosinophils 1 Primary endpoint: AER Secondary endpoints: FEV 1, ACQ-6 27 Demographics: High % of patients with nasal polyps Eosinophilic Non-eosinophilic Placebo Benralizumab Placebo Benralizumab n=8 2 mg n=81 2 mg n=81 1 mg n=82 n=142 1 mg n=14 Age, years 45.6 (11.7) 47.1 (12.8) 46.6 (13.2) 47.8 (12.9) 5. (12.3) 5. (11.5) Female, n (%) 53 (66.3) 58 (71.6) 48 (59.3) 6 (73.2) 1 (7.4) 98 (7.) White, n (%) 53 (66.3) 59 (72.8) 5 (61.7) 62 (75.6) 16 (74.6) 99 (7.7) BMI, kg/m (6.) 29.2 (6.5) 28. (5.2) 28. (6.1) 29.6 (5.) 29.5 (6.) ACQ-6 score 2.7 (1.) 2.6 (1.) 2.5 (.9) 2.5 (1.) 2.5 (.8) 2.6 (.8) Nasal polyps, n (%) 15 (18.8) 13 (16.) 21 (25.9) 17 (2.7) 12 (8.5) 12 (8.6) Exacerbations in past year 2.2 (.5) 2.3 (.7) 2.5 (.7) 2.3 (.6) 2.2 (.5) 2.3 (.7) FE NO, ppb 37.9 (31.9) 39.5 (32.7) 4.8 (31.) 37.8 (31.7) 2.7 (13.9) 2.2 (12.1) FEV 1, % predicted 65. (15.3) 65.1 (15.2) 64.8 (14.8) 66.1 (15.9) 69.1 (14.5) 66.8 (15.1) FEV 1 reversibility, % 18.3 (15.1) 18.7 (22.) 19.8 (2.3) 18. (13.3) 12.8 (13.) 15.3 (15.3) Blood eosinophil count, 1 3 /µl.53 (.3).53 (.33).54 (.28).56 (.36).16 (.9).19 (.12) Baseline ICS dose (fluticasone equivalent), µg *Data are expressed as mean (standard deviation) unless otherwise specified. ACQ-6; Asthma Control Questionnaire-6; BMI, body mass index; FE NO, fractional exhaled nitric oxide; FEV 1, forced expiratory volume in 1 second; ICS, inhaled corticosteroids; mitt, modified intent-to-treat; ppb, parts per billion 28 Castro, Lancet Resp Med 214
15 Only reduced exacerbations in Hi-Eos Benralizumab 1 mg significantly reduced AER relative to placebo - In eosinophilic subjects - In subjects with baseline blood eosinophils 3 and 4 cells/µl *Statistically significant (p<.169). Data are expressed as mean (8% confidence interval). AER, annual exacerbation rate; AERR, annual exacerbation rate reduction; mitt, modified intent-to-treat; RR, rate reduction 29 While some FEV1 improvement in low eos, greater in those with Hi eos In subgroups with blood eosinophil counts 2, 3 and 4 cells/μl, all doses of benralizumab showed significant improvements in FEV 1 vs placebo *Statistically significant (p<.169). FEV 1, forced expiratory volume in 1 second; mitt, modified intent-to-treat 3
16 Anti-IL-5 as CS sparing agent in VSA Investigational Product SC every 4 weeks Primary Efficacy Endpoint assessed at week 24 (Exit Visit) Visit 1 Visit 2 Week Visit OCS Optimisation Phase Induction Phase OCS Reduction Phase Maintenance Phase 8 to 3 weeks Mepolizumab 1mg SC Placebo SC Bel E, et al, N Engl J Med Sept 214 Baseline Characteristics Characteristic Placebo N=66 Mepolizumab N=69 Age (yr), mean (range) 49.9 (28 7) 49.8 (16 74) Female, n (%) 3 (45) 44 (64) BMI (kg/m 2 ) 29.5 (6.) 27.8 (5.9) Duration of asthma, yr 2.1 (14.4) 17.4 (11.8) Screening OCS dose (mg) median Optimized OCS dose (mg), median Duration of OCS 5 years at baseline, (%) 31 (47) 34 (49) Percent reversibility FEV (18.1) 27.3 (17.4) ACQ score 2. (1.2) 2.2 (1.3) SGRQ score 45 (18) 5 (18) Blood eosinophil count (cells/µl), geometric mean (SD on log e scale) 23 (1,1) 25 (1,245)
17 4% of patients able to decrease OCS by >75% % study population % Reduction Strata 4% vs 18% OR= 2.39 (95% CI, ) P=.8 BUT, 3-4% with no/minimal reduction despite starting eosinophilia Other: no decrease in OCS dose, or lack of control during weeks 2 24 or withdrawal from treatment Improvement in asthma control despite reduction in corticosteroids Mean ACQ-5 Score p=.4
18 Will there be phenotypic differences in IL-4/13 vs IL-5 responders? Anti-IL-4/13 effective in allergen challenge Anti-IL-5 no effect Sources differ: IL-4 more likely from Th2 cells More mature Th2 cells produce IL-5 Upadhaya J Immunol 211 IL-5/-13 produced by ILC2 cells, lesser amounts of IL-4 IL-4/13 approaches MAY be better in early onset allergic, IL-5 in late onset, neither (or combined) in complicated Type-2 In CS dependent asthma, IL-4/13 efficacy not yet confirmed (de Boever JACI 214), while anti-il-5 effective What about non-type-2 approaches? Overview IL-17A IL-17F IL-17A/F heterodimer IL-17C IL-25 (IL-17E) IL-17B IL-17D Ligands Source of Ligand Receptors T H 17 cells CD8+ T cells γδ T cells NK cells Epithelial cells (trachea, colon, skin) T cells Intraepithelial lymphocytes Cells of the GI tract and uterus Unknown Unknown Note: IL-17 ligands are expressed as dimers NKT cells LTi cells Neutrophils Eosinophils Basophils Mast cells Alveolar MФs IL-17RA IL-17RC IL-17RA IL-17RE IL-17RA IL-17RB IL-17RB Unknown 1. Gaffen SL. Nat Rev Immunol. 29;9: Chang SH, et al. Cell Res. 27;17: Garley M, et al. Adv Med Sci. 28;53: Pappu R, et al. Immunology. 211;134: Ramirez-Carrozzi V, et al. Nat Immunol. 211;12: Song X, et al. Nat Immunol.. 211;12: Moseley TA, et al. Cytokine Growth Factor Rev. 23;14: Ge D, et al. Int Arch Med. 28;1: Lee J, et al. J Biol Chem. 21;276:
19 Brodalumab Is an Anti IL-17RA mab That Blocks the Activities of IL-17A, IL-17F, IL-17A/F, and IL-25 Overview IL-17A IL-17A/F IL-25 (IL-17E) IL-17A/F IL-17F IL-17A IL-17F IL-25 IL-17C Brodalumab Brodalumab? Brodalumab IL-17RB IL-17RA IL-17RC IL-17RA IL-17RE IL-17RA Brodalumab is a human IgG2 antibody It binds to IL-17RA (K D =239 pm) to block IL-17A, IL-17F, IL-17A/F, and IL-25 activities 1. Toy D, et al. J Immunol. 26;177: Wright JF, et al. J Immunol. 28;181: Rickel EA, et al. J Immunol. 28;181: Chang SH, et al. Cell Res. 27;17: Claudio E, et al. J Immunol. 29;182: Kuestner RE, et al. J Immunol. 27;179: Ramirez-Carrozzi V, et al. Nat Immunol. 211;12: Amgen data on file. Primary Endpoint: Overall Population ACQ Change From Baseline Line Graph of ACQ Change From Baseline LOCF Phase 2: Efficacy Mean (SE) BL Study Week N=76 N=73 N=74 N=76 N=76 N=76 N=76 N=76 N=74 N=73 N=73 N=73 N=73 N=73 N=73 N=73 N=76 N=74 N=74 N=74 N=75 N=75 N=75 N=75 N=76 N=74 N=74 N=74 N=74 N=74 N=74 N=74 Placebo AMG mg Q2W AMG mg Q2W AMG mg Q2W Although identified responder group related to high reversibility, 2 nd larger study targeting high reversibility subgroup completely negative
20 Bronchial Thermoplasty: More likely to be efficacious in Type-2 Lo asthma? Castro, M AJRCCM 21; 181: No studies of BT to date have tried to identify responder group Data slowly emerging on reduction in airway smooth muscle although without control groups No evidence for reduction in inflammatory markers Should do better in those with less overall inflammation Conclusions Multiple drugs in development have clinically and biologically meaningful effects in Type-2 Hi asthma Which Type-2 subphenotype will respond best to which biologic still unclear Considerable progress likely to be made with use of biomarkers New approaches for Type-2 Lo asthma remain elusive
Severe Asthma(s): Can THEY be prevented or reversed?
Severe Asthma(s): Can THEY be prevented or reversed? Sally Wenzel, MD Professor of Medicine UPMC Chair in Translational Airway Biology Disclosures Sally Wenzel, M.D. Grant/Research Support: Boehringer-Ingelheim,
More informationBiologic Therapy in the Management of Asthma. Nabeel Farooqui, MD
Biologic Therapy in the Management of Asthma Nabeel Farooqui, MD None Disclosures Objectives Define severe asthma phenotypes and endotypes Describe the role of biologics in asthma management Review pivotal
More informationAsthma Hetereogeneity, Phenotypes and Endotypes Choosing the Right Biologic for your Patient
Asthma Hetereogeneity, Phenotypes and Endotypes Choosing the Right Biologic for your Patient Mario Castro MD, MPH Asthma & Airway Translational Research Unit Washington University School of Medicine St.
More informationBiologics in asthma Are we turning the corner? Roland Buhl Pulmonary Department Mainz University Hospital
Biologics in asthma Are we turning the corner? Roland Buhl Pulmonary Department Mainz University Hospital Biologics in asthma - are we turning the corner? Allergic asthma anti - IgE Allergic airway inflammation
More informationBiologics in Asthma: Present and Future
Biologics in Asthma: Present and Future Flavia Hoyte, MD Associate Professor of Medicine Fellowship Training Program Director Division of Allergy and Immunology National Jewish Health and University of
More informationSevere Asthma & Exacerbations: Dawn of a New Era?
Severe Asthma & Exacerbations: Dawn of a New Era? Christophe von Garnier Department of Pulmonary Medicine Syndromes, Phenotypes & Endotypes Asthma Syndrome Variable symptoms, expiratory airflow limitation,
More informationDisclosures. Learning Objective. Biological therapies. Biologics with action against 11/30/2011. Biologic Asthma Therapies and Individualized Medicine
Biologic Asthma Therapies and Individualized Medicine Mark S. Dykewicz, MD Director, Allergy & Immunology Fellowship Program Director Wake Forest University School of Medicine Winston-Salem, North Carolina
More informationDo We Need Biologics in Pediatric Asthma Management?
Do We Need Biologics in Pediatric Asthma Management? Ting Fan LEUNG, MBChB, MD, FRCPCH, FAAAAI Professor and Chairman Department of Paediatrics The Chinese University of Hong Kong Asthma and Allergy by
More informationSearching for Targets to Control Asthma
Searching for Targets to Control Asthma Timothy Craig Distinguished Educator Professor Medicine and Pediatrics Penn State University Hershey, PA, USA Inflammation and Remodeling in Asthma The most important
More informationDelivering in Respiratory ATS Analyst Briefing
Delivering in Respiratory ATS Analyst Briefing James Ward-Lilley, VP of RIA Therapy Area AstraZeneca Bing Yao, SVP & Head RIA imed MedImmune 20 May 2014 San Diego Cautionary statement regarding forward-looking
More informationDifferent kinds of asthma, different kinds of therapies
Different kinds of asthma, different kinds of therapies Friday 10 th November 2017 XXXIII Congresso Sezione SIAAIC Toscana Professor Neil Barnes Medical Head Global Respiratory Franchise, GSK Brentford,
More informationPrecision Asthma Therapy: Picking the Right Biologic for the Right Patient. The Asthma Umbrella. Asthma. Late onset. Early onset.
recision Asthma Therapy: icking the Right Biologic for the Right atient The Asthma Umbrella Asthma arly onset Late onset Symptoms xacerbations FV1 T H 2 inflammation No or less T H 2 inflammation henotype
More informationTraiter l asthme sévère par le phénotype. Dr. Alain Michils CUB-Hôpital Erasme
Traiter l asthme sévère par le phénotype Dr. Alain Michils CUB-Hôpital Erasme Darwin 25 mars 2017 Step 5 treatment (GINA 2016) STEP 5 STEP 4 PREFERRED CONTROLLER CHOICE STEP 1 STEP 2 Low dose ICS STEP
More informationCurrent Asthma Therapy: Little Need to Phenotype. Phenotypes of Severe Asthma. Cellular Phenotypes 12/7/2012
Subbasement Membrane Thickness(µm) 12/7/212 Current Asthma Therapy: Little Need to Phenotype Phenotypes of Severe Asthma Most mild and to some degree moderate asthmatics respond well to currently available
More informationPhenotypes of asthma; implications for treatment. Medical Grand Rounds Feb 2018 Jim Martin MD DSc
Phenotypes of asthma; implications for treatment Medical Grand Rounds Feb 2018 Jim Martin MD DSc No conflicts to declare Objectives To understand the varied clinical forms of asthma To understand the pathobiologic
More informationSEVERE ASTHMA - EVIDENCE TABLES APPENDIX 1
Section 2: Biomarkers Biomarkers to predict response to biologic therapies and macrolides Summary of randomized controlled trials Cut-offs Cut-off selection Study Design N Drug Predictive ability to identify
More informationABCs of Immune Modifiers. Relevant Disclosures
ABCs of Immune Modifiers Dennis K. Ledford, MD Ellsworth and Simmons Professor of Allergy/Immunology University of South Florida Morsani College of Medicine Tampa, FL USA Relevant Disclosures Research
More informationUsing Patient Characteristics to Individualize and Improve Asthma Care
Using Patient Characteristics to Individualize and Improve Asthma Care Leonard B. Bacharier, M.D. Associate Professor of Pediatrics Clinical Director, Division of Allergy, Immunology, & Pulmonary Medicine
More informationBiologicals in the management of bronchial asthma. Deepa Shrestha
Biologicals in the management of bronchial asthma Deepa Shrestha Overview of the seminar Burden of asthma and need of biologicals Immunology of asthma Possible targeted therapy Available biologicals used
More informationTreatment of Severe Asthma: Biologics to Bronchial Thermoplasty. Disclosures
Treatment of Severe Asthma: Biologics to Bronchial Thermoplasty Monica Kraft, M.D. Robert and Irene Flinn Professor of Medicine Chair, Department of Medicine Deputy Director, Asthma and Airway Disease
More informationPediatric Asthma: Pharmacotherapy. Joseph Spahn, MD Children s Hospital Colorado & University of Colorado Medical School Aurora, Colorado
Pediatric Asthma: Pharmacotherapy Joseph Spahn, MD Children s Hospital Colorado & University of Colorado Medical School Aurora, Colorado Pediatric Asthma: Pharmacotherapy Disclosures/Conflicts of Interest:
More informationJamie Lee Memorial Lecture ( ) Targets and Outcomes: Mepolizumab, Benralizumab, Reslizumab
Jamie Lee Memorial Lecture (1958-2017) Targets and Outcomes: Mepolizumab, Benralizumab, Reslizumab Larry Borish, M.D. Professor of Medicine and Microbiology University of Virginia Conflict of Interest
More informationCigna Drug and Biologic Coverage Policy
Cigna Drug and Biologic Coverage Policy Subject Interleukin (IL)-5 Antagonists: Mepolizumab and Reslizumab Table of Contents Coverage Policy... 1 General Background... 3 Coding/Billing Information... 5
More information-agonist therapy could improve the lives of patients with uncontrolled persistent asthma compared with standard therapy alone.
Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β 2 agonist: a randomised double-blind placebo-controlled
More informationStudy Investigators/Centers: GSK sponsored studies MEA112997, MEA115588, and MEA and a proof of concept investigator sponsored study CRT110184
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationAsthma and Its Many Unmet Needs: Directions for Novel Therapeutic Approaches
Asthma and Its Many Unmet Needs: Directions for Novel Therapeutic Approaches William W. Busse,, M.D. University of Wisconsin School of Medicine and Public Health Madison, WI, USA Disclosure Slide Employment
More informationNew Therapies for Asthma
New Therapies for Asthma Tracy Bridges, MD Speaker Disclosure: Dr. Bridges participates in speaker bureaus for Teva, Genetech & Astra Zeneca. Objectives: Discuss the use of LAMA s for Asthma Detail the
More informationEFFECTIVE ASTHMA MANAGEMENT IN PRIMARY CARE Severity Assessment, Guidelines, and New Therapeutic Options
Educational Objectives EFFECTIVE ASTHMA MANAGEMENT IN PRIMARY CARE Bradley E. Chipps, MD, FAAP, FACAAI, FAAAAI, FCCP President-Elect, American College of Allergy, Asthma & Immunology Medical Director,
More informationImmunomodulators: Anti-IgE mab. Thomas B. Casale, MD Professor of Medicine Chief, Allergy/Immunology Creighton University Omaha, NE
Immunomodulators: Anti-IgE mab Thomas B. Casale, MD Professor of Medicine Chief, Allergy/Immunology Creighton University Omaha, NE Objectives To explain the rationale behind IgE blockade To discuss which
More informationAsthma Phenotypes, Heterogeneity and Severity: The Basis of Asthma Management
Asthma Phenotypes, Heterogeneity and Severity: The Basis of Asthma Management Eugene R. Bleecker, MD Professor and Director, Center for Genomics & Personalized Medicine Research Professor, Translational
More informationLearning the Asthma Guidelines by Case Studies
Learning the Asthma Guidelines by Case Studies Timothy Craig, DO Professor of Medicine and Pediatrics Distinguished Educator Penn State University Hershey Medical Center Objectives 1. Learn the Asthma
More informationIdentifying Biologic Targets to Attenuate or Eliminate Asthma Exacerbations
Identifying Biologic Targets to Attenuate or Eliminate Exacerbations exacerbations are a major cause of disease morbidity and costs. For both children and adults, viral respiratory infections are the major
More informationClinical Implications of Asthma Phenotypes. Michael Schatz, MD, MS Department of Allergy
Clinical Implications of Asthma Phenotypes Michael Schatz, MD, MS Department of Allergy Definition of Phenotype The observable properties of an organism that are produced by the interaction of the genotype
More informationAsthma and obesity, implications for airway inflammation and Bronchial Hyperresponsiveness
Asthma and obesity, implications for airway inflammation and Bronchial Hyperresponsiveness Fernando Holguin MD MPH Asthma Institute University of Pittsburgh Obesity Trends* Among U.S. Adults BRFSS, 1990,
More informationDifficult Asthma Assessment: A systematic approach
Difficult Asthma Assessment: A systematic approach Dr Naghmeh Radhakrishna Respiratory, Sleep & Allergy Physician Allergy, Asthma & Clinical Immunology Service The Alfred Hospital Melbourne, Australia
More informationSEVERE ASTHMA NUCALA 100MG SUBCUTANEOUS INJECTION THE FIRST TARGETED ANTI IL-5 ADD-ON TREATMENT FOR ADULTS WITH SEVERE REFRACTORY EOSINOPHILIC ASTHMA
SEVERE ASTHMA NUCALA 100MG SUBCUTANEOUS INJECTION THE FIRST TARGETED ANTI ADD-ON TREATMENT FOR ADULTS WITH SEVERE REFRACTORY EOSINOPHILIC ASTHMA FIND OUT MORE VISIT - WWW.NUCALA.CO.UK Vial not actual size
More informationAddressing Unmet Medical Needs in Severe Asthma: Where Do We Stand?
Addressing Unmet Medical Needs in Severe Asthma: Where Do We Stand? An Expert Consensus Presented by: Michael Blaiss, MD, FACAAI Mario Castro, MD, MPH Provided by the American College of Allergy, Asthma
More information10/24/2016. Precision Management of Severe Asthma How, When and Where. The Goals of Today s Presentation
1/24/216 Precision Management of Severe Asthma How, When and Where. Reynold A. Panettieri, Jr., MD Vice Chancellor for Clinical & Translational Science Director, Rutgers Institute for Translational and
More informationAsthma Upate 2018: What s New Since the 2007 Asthma Guidelines of NAEPP?
10:50-11:50am Asthma Update 2018: What s New Since the 2007 National Asthma Guidelines? SPEAKER Christopher H. Fanta, MD Disclosures The following relationships exist related to this presentation: Christopher
More informationUpdate on Biologicals for ABPA and Asthma
Update on Biologicals for ABPA and Asthma 5 th Advances Against Aspergillosis Istanbul 27 Jan 2012 Richard B. Moss MD Professor of Pediatrics Stanford University Palo Alto CA USA Disease of chronic airway
More informationExhaled Nitric Oxide: An Adjunctive Tool in the Diagnosis and Management of Asthma
Exhaled Nitric Oxide: An Adjunctive Tool in the Diagnosis and Management of Asthma Jason Debley, MD, MPH Assistant Professor, Pediatrics Division of Pulmonary Medicine University of Washington School of
More informationAsthma Update I have no professional or personal financial conflicts of interest to disclose.
Asthma Update 2018 Disclosures Jennifer W. McCallister, MD, FACP, FCCP Associate Professor Division of Pulmonary, Critical Care, and Sleep Medicine The Ohio State University Wexner Medical Center I have
More informationAsthma Update Jennifer W. McCallister, MD, FACP, FCCP
Asthma Update 2018 Jennifer W. McCallister, MD, FACP, FCCP Associate Professor Division of Pulmonary, Critical Care, and Sleep Medicine The Ohio State University Wexner Medical Center Disclosures I have
More informationAsma e BPCO: le strategie terapeutiche
Asma e BPCO: le strategie terapeutiche Dott. Marco Contoli ctm@unife.it Sezione di Medicina Interna e Cardio-Respiratoria Dipartimento di Scienze Mediche Università di Ferrara COPD Definition Chronic Obstructive
More informationThe Pharmacist s Role in Managing Severe Asthma. This activity is supported by an educational grant from Genentech. Educational Objectives
The Pharmacist s Role in Managing Severe Asthma Jennifer M. Malinowski, PharmD, RPh Assistant Dean, Academic Affairs Associate Professor, Pharmacy Practice Wilkes University School of Pharmacy Wilkes-Barre,
More informationERS Investor & Analyst Event. Munich Tuesday 9 th September 2014
ERS Investor & Analyst Event Munich Tuesday 9 th September 2014 Darrell Baker SVP, Global Head of Respiratory Agenda GSK s Respiratory Portfolio Eosinophils Research in COPD Eosinophils Clinical Experience
More informationAsthma Therapy 2017 JOSHUA S. JACOBS, M.D.
Asthma Therapy 2017 JOSHUA S. JACOBS, M.D. BACKGROUND-PREVALENCE Asthma is one of the most common chronic diseases worldwide with an estimated 300 million affected individuals Prevalence is increasing
More informationWhat s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university
What s new in COPD? Apichart Khanichap MD. Department of Medicine, Faculty of Medicine, Thammasat university Management stable COPD Relieve symptoms Improve exercise tolerance Improve health status Prevent
More informationBrooke L. Gildon, Pharm.D., BCPS, BCPPS, AE C
Brooke L. Gildon, Pharm.D., BCPS, BCPPS, AE C Associate Professor of Pharmacy Practice Southwestern Oklahoma State University College of Pharmacy Oklahoma Society of Health System Pharmacists Annual Meeting
More informationOptimal Assessment of Asthma Control in Clinical Practice: Is there a role for biomarkers?
Disclosures: Optimal Assessment of Asthma Control in Clinical Practice: Is there a role for biomarkers? Stanley Fineman, MD Past-President, American College of Allergy, Asthma & Immunology Adjunct Associate
More informationPotential new targets for drug development in severe asthma
Zhu et al. World Allergy Organization Journal (2018) 11:30 https://doi.org/10.1186/s40413-018-0208-1 REVIEW Potential new targets for drug development in severe asthma Linda Zhu 1,2, Christina E. Ciaccio
More informationTORCH: Salmeterol and Fluticasone Propionate and Survival in COPD
TORCH: and Propionate and Survival in COPD April 19, 2007 Justin Lee Pharmacy Resident University Health Network Outline Overview of COPD Pathophysiology Pharmacological Treatment Overview of the TORCH
More informationGlobal Initiative for Asthma (GINA) What s new in GINA 2017?
Global Initiative for Asthma (GINA) GINA Global Strategy for Asthma Management and Prevention Asthma-COPD overlap The word syndrome has been removed from the previous term asthma-copd overlap syndrome
More informationTreatment Responses. Ronald Dahl, Aarhus University Hospital, Denmark
Asthma and COPD: Are They a Spectrum Treatment Responses Ronald Dahl, Aarhus University Hospital, Denmark Pharmacological Treatments Bronchodilators Inhaled short-acting β -Agonist (rescue) Inhaled short-acting
More informationPolicy Effective 4/1/2018
Corporate Medical Policy Interleukin-5 Antagonists Notification File Name: Origination: Last CAP Review: Next CAP Review: Last Review: interleukin_5_antagonists 2/2016 11/2017 11/2018 2/2018 Policy Effective
More informationCOPD or not COPD, that is the question.
COPD or not COPD, that is the question. Asthma-COPD Overlap Syndrome: ACOS Do we really need this? Michelle Harkins Disclosure Slide Slide help - William Busse, MD Organizational Interests ATS, ACCP, ACP
More informationStudy No.: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives: Co-Primary Outcomes/Efficacy Variables:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationAre emerging PGD2 antagonists a promising therapy class for treating asthma?
Expert Opinion on Emerging Drugs ISSN: 1472-8214 (Print) 1744-7623 (Online) Journal homepage: http://www.tandfonline.com/loi/iemd20 Are emerging PGD2 antagonists a promising therapy class for treating
More informationChallenges in Meeting International Requirements for Clinical Bioequivalence of Inhaled Drug Products
Challenges in Meeting International Requirements for Clinical Bioequivalence of Inhaled Drug Products Tushar Shah, M.D. Sr. VP, Global Respiratory Research and Development TEVA Pharmaceuticals 1 Presentation
More informationDiagnosis and Management of Fungal Allergy Monday, 9-139
Diagnosis and Management of Fungal Allergy Monday, 9-139 13-2010 Alan P. Knutsen,, MD Director, Pediatric Allergy & Immunology Director, Jeffrey Modell Diagnostic Center for Primary Immunodeficiencies
More informationSponsor. Generic drug name. Trial indication(s) Protocol number. Protocol title. Clinical trial phase. Study Start/End Dates.
Sponsor Novartis Generic drug name Fluticasone propionate Trial indication(s) Moderate-severe bronchial asthma Protocol number CQAE397A2202 Protocol title A randomized open label study to assess the utility
More informationDevelopment of New Therapies for Severe Asthma
Review Allergy Asthma Immunol Res. 2017 January;9(1):3-14. https://doi.org/10.4168/aair.2017.9.1.3 pissn 2092-7355 eissn 2092-7363 Development of New Therapies for Severe Asthma Merritt L. Fajt, Sally
More informationHCT Medical Policy. Bronchial Thermoplasty. Policy # HCT113 Current Effective Date: 05/24/2016. Policy Statement. Overview
HCT Medical Policy Bronchial Thermoplasty Policy # HCT113 Current Effective Date: 05/24/2016 Medical Policies are developed by HealthyCT to assist in administering plan benefits and constitute neither
More informationΑνασκόπηση Βιβλιογραφίας στο Άσθμα: Τα 5 κορυφαία άρθρα σχετικά με τους φαινοτύπους του άσθματος του τελευταίου έτους
Ανασκόπηση Βιβλιογραφίας στο Άσθμα: Τα 5 κορυφαία άρθρα σχετικά με τους φαινοτύπους του άσθματος του τελευταίου έτους Στυλιανός Κ. Βιττωράκης MD, PhD. Πνευμονολόγος, Χανιά Ερέτρια, 16 Μαρτίου 2014 Exploring
More informationTreating the right patient with the right
Asthma Getting it Right. Diagnosis, phenotypes, guidelines Treating the right patient with the right treatment Rama Vancheeswaran, FRCP, MSc Immunology, PhD Royal Free Hospital NHS Trust (Barnet site)
More informationPhenotyping Asthma: Environmental and Occupational Asthma
Phenotyping Asthma: Environmental and Occupational Asthma / Nicholas Kenyon, MD, MAS EHS CENTER UC Davis Environmental Health Sciences Center Phenotyping Asthma: Environmental and Occupational Asthma Nicholas
More informationNovel Biologics for Asthma: Steps on the Long Road to Therapies for Uncontrolled Asthma
vel Biologics for Asthma: Steps on the Long Road to Therapies for Uncontrolled Asthma LAURA RUNKEL, PHD Associate Director, CNS, Autoimmune/Inflammation Introduction Asthma is one of the most prevalent
More informationUncontrolled Moderate-to-Severe-Asthma: Latest Data from the Floor of CHEST 2018
Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including
More informationL eosinofilo come nuovo target terapeutico. Paola Parronchi
L eosinofilo come nuovo target terapeutico Paola Parronchi XXX Congresso SIAAIC Sezione Toscana IX Congresso Sezione SIAAIC Toscana, Emilia Romagna, San Marino Firenze, 10-11 Ottobre 2014 Benign and sinister
More informationGlobal Initiative for Asthma (GINA) What s new in GINA 2016?
Global Initiative for Asthma (GINA) What s new in GINA 2016? GINA Global Strategy for Asthma Management and Prevention GINA: A Brief History Established in 1993 Collaboration between NHLBI and WHO Multiple
More informationResearch Review. Salmeterol/fluticasone propionate (Seretide ) in COPD. Extended listing for salmeterol/fluticasone propionate in COPD
Research Review Salmeterol/fluticasone propionate (Seretide ) in COPD Extended listing for salmeterol/fluticasone propionate in COPD In New Zealand, salmeterol/fluticasone propionate (SFC) (Seretide )
More informationAsma, BPCO ed Esercizio Fisico Ferrara, 6 e 7 Novembre Overlap asma BPCO. Dr. Marco Contoli
Asma, BPCO ed Esercizio Fisico Ferrara, 6 e 7 Novembre 2015 Overlap asma BPCO Dr. Marco Contoli Sezione di Medicina Interna e Cardio-Respiratoria Dipartimento di Scienze Mediche Università di Ferrara (Sept.
More informationNucala (mepolizumab) Prior Authorization Protocol
Nucala (mepolizumab) Prior Authorization Protocol Line of Business: Medicaid P&T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed through review of medical
More informationMeeting the Challenges of Asthma
Presenter Disclosure Information 11:05 11:45am Meeting the Challenge of Asthma SPEAKER Christopher Fanta, MD The following relationships exist related to this presentation: Christopher Fanta, MD: No financial
More informationProf Neil Barnes. Respiratory and General Medicine London Chest Hospital and The Royal London Hospital
Prof Neil Barnes Respiratory and General Medicine London Chest Hospital and The Royal London Hospital ASTHMA: WHEN EVERYTHING FAILS WHAT DO YOU DO? South GP CME 2013, Dunedin Saturday 17 th August 2013
More informationUsefulness of Bronchial Thermoplasty for Patients with a Deteriorating Lung Function
doi: 10.2169/internalmedicine.8965-17 http://internmed.jp CASE REPORT Usefulness of Bronchial Thermoplasty for Patients with a Deteriorating Lung Function Daisuke Minami, Chihiro Ando, Takamasa Nakasuka,
More informationIs reslizumab effective in improving quality of life and asthma control in adolescent and adult patients with poorly controlled eosinophilic asthma?
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2018 Is reslizumab effective in improving
More informationGeneral Comments to the Author: Reviewer #1 Well done!!
REVIEWERS COMMENTS General Comments to the Author: Reviewer #1 Well done!! Reviewer #2 The strengths of this guideline on severe asthma are first, that the set-up is modular with questions that are relevant
More informationControversial Issues in the Management of Childhood Asthma: Insights from NIH Asthma Network Studies
Controversial Issues in the Management of Childhood Asthma: Insights from NIH Asthma Network Studies Stanley J. Szefler, MD Helen Wohlberg and Herman Lambert Chair in Pharmacokinetics, Head, Pediatric
More informationE-1 Role of IgE and IgE receptors in allergic airway inflammation and remodeling
E-1 Role of IgE and IgE receptors in allergic airway inflammation and remodeling Ruby Pawankar, MD, Ph.D. FRCP, FAAAAI Prof. Div of Allergy, Dept of Pediatrics Nippon Medical School Tokyo, Japan pawankar.ruby@gmail.com
More informationPotential risks of ICS use
Potential risks of ICS use Randomised controlled trial Observational study Systematic review Pneumonia Tuberculosis Bone fracture Skin thinning/easy bruising Cataract Diabetes No effect on fracture risk
More information7/7/2015. Somboon Chansakulporn, MD. History of variable respiratory symptoms. 1. Documented excessive variability in PFT ( 1 test)
Definition of Asthma GINA 2010: Chronic inflammatory disorder of the airways Airway hyper-responsiveness Recurrent wheezing, breathlessness, chest tightness, coughing Variable, reversible airflow obstruction
More informationAllergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al.
Allergy and Immunology Review Corner: Chapter 75 of Middleton s Allergy Principles and Practice, 7 th Edition, edited by N. Franklin Adkinson, et al. Chapter 75: Approach to Infants and Children with Asthma
More informationAnti-IgE Treatment In Severe Asthma. Thomas B. Casale, MD Professor of Medicine Chief, Allergy/Immunology Creighton University Omaha, NE
Anti-IgE Treatment In Severe Asthma Thomas B. Casale, MD Professor of Medicine Chief, Allergy/Immunology Creighton University Omaha, NE Relevant Disclosures Financial Relationship/Consulting Fees: Value
More informationCynthia S. Kelly, M.D. Professor of Pediatrics Eastern Virginia Medical School Division Director Allergy Children s Hospital of The King s Daughters
Cynthia S. Kelly, M.D. Professor of Pediatrics Eastern Virginia Medical School Division Director Allergy Children s Hospital of The King s Daughters Disclosures Speakers bureau of Novartis and Genentech
More informationTargeting Interleukin-5 in Patients With Severe Eosinophilic Asthma: A Clinical Review
Targeting Interleukin-5 in Patients With Severe Eosinophilic Asthma: A Clinical Review Christine Lam, PharmD, BCPS; Kunal J. Shah, PharmD; and Rupal Mansukhani, PharmD INTRODUCTION Asthma is a chronic
More informationBiologic Agents in the treatment of Severe Asthma
Biologic Agents in the treatment of Severe Asthma Daniel L Maxwell, D.O., FACOI, FAASM Clinical Assistant Professor of Medicine Michigan State University College of Osteopathic Medicine College of Human
More informationImproving Outcomes in the Management & Treatment of Asthma. April 21, Spring Managed Care Forum
Improving Outcomes in the Management & Treatment of Asthma April 21, 2016 2016 Spring Managed Care Forum David M. Mannino, M.D. Professor Department of Preventive Medicine and Environmental Health University
More informationAsthma COPD Overlap (ACO)
Asthma COPD Overlap (ACO) Dr Thomas Brown Consultant Respiratory Physician Thomas.Brown@porthosp.nhs.uk Dr Hitasha Rupani Consultant Respiratory Physician Hitasha.rupani@porthosp.nhs.uk What is Asthma
More informationMepolizumab (asthma)
IQWiG Reports Commission No. A16-33 Mepolizumab (asthma) Addendum to Commission A16-03 1 Addendum Commission:A16-33 Version: 1.0 Status: 29 June 2016 1 Translation of addendum A16-33 Mepolizumab (Asthma)
More informationClinical Benefits of FeNO Monitoring in Asthma RYAN BURTON, MS, RPFT
Clinical Benefits of FeNO Monitoring in Asthma RYAN BURTON, MS, RPFT Disclosures I am an employee of Circassia Pharmaceuticals. Objectives Nitric Oxide Inflammation in Asthma Phenotyping Personalized Medicine
More informationCOPD: From Phenotypes to Endotypes. MeiLan K Han, M.D., M.S. Associate Professor of Medicine University of Michigan, Ann Arbor, MI
COPD: From Phenotypes to Endotypes MeiLan K Han, M.D., M.S. Associate Professor of Medicine University of Michigan, Ann Arbor, MI Presenter Disclosures MeiLan K. Han Consulting Research support Novartis
More informationVitamina D: un ormone multifunzione
Vitamina D: un ormone multifunzione Introduction And Infections Diego Peroni Clinica Pediatrica Universita di Ferrara Food Allergy Asthma Conclusions diego.peroni@unife.it Holick, M. F. J. Clin. Invest.
More informationWhat s new in Asthma? Dr Alexandra Nanzer-Kelly Consultant Respiratory Physician Royal Brompton and Harefield Hospitals
What s new in Asthma? Dr Alexandra Nanzer-Kelly Consultant Respiratory Physician Royal Brompton and Harefield Hospitals Asthma is an inflammatory disease Relaxed smooth muscles Air trapped in alveoli Tightened
More informationThe FDA Critical Path Initiative
The FDA Critical Path Initiative Clinical Considerations for Demonstration of Dose-response for Inhaled Corticosteroids - Exhaled Nitric Oxide Model Badrul A. Chowdhury, MD, PhD Director Division of Pulmonary
More information#1 cause of school absenteeism in children 13 million missed days annually
Asthma Update 2013 Jennifer W. McCallister, MD, FACP, FCCP Associate Professor Pulmonary & Critical Care Medicine The Ohio State University Wexner Medical Center Disclosures None 2 Objectives Review burden
More informationAnti-IgE: beyond asthma
Anti-IgE: beyond asthma Yehia El-Gamal, MD, PhD, FAAAAI Professor of Pediatrics Pediatric Allergy and Immunology Unit Children s Hospital, Ain Shams University Member, WAO Board of Directors Disclosure
More informationAllergic Rhinitis and Its Impact on Ast. Rhinitis: A Risk Factor for Asthma? Ronald Dahl, Aarhus University Hospital, Denmark
Allergic Rhinitis and Its Impact on Ast Rhinitis: A Risk Factor for Asthma? Ronald Dahl, Aarhus University Hospital, Denmark Rhinitis and asthma SIT-SLIT Evidence A SIT-SLIT Evidence A? SIT Evidence? Rhinitis
More informationAsthma Treatment Update: 2018
Asthma Treatment Update: 2018 John B. Cox MD Clinical Professor Division of Pulmonary, Critical Care, Allergy and Sleep Medicine Medical University of South Carolina Disclosures I have no conflicts and
More information(Asthma) Diagnosis, monitoring and chronic asthma management
Dubai Standards of Care 2018 (Asthma) Diagnosis, monitoring and chronic asthma management Preface Asthma is one of the most common problem dealt with in daily practice. In Dubai, the management of chronic
More information