Salmeterol/fluticasone propionate vs. double dose fluticasone propionate on lung function and asthma control in children.

There is a large body of data to support the use of an inhaled corticosteroid (ICS) plus a long-acting beta(2)-agonist vs. increasing the dose of ICS in adults, but less data in children. This double-blind, parallel group, non-inferiority study compared lung function and asthma control, based on Global Initiative for Asthma guidelines, in children receiving either salmeterol/fluticasone propionate (SFC) 50/100 microg bd (n = 160) or fluticasone propionate (FP) 200 microg bd (n = 161) for 12 wks. Change from baseline in mean morning peak expiratory flow increased following both treatments, but was significantly greater in the SFC group compared with FP [Adjusted mean change (s.e.) (l/min): SFC: 26.9 (2.13), FP: 19.3 (2.12); treatment difference: 7.6 (3.01); 95% CI: 1.7, 13.5; p = 0.012)]. Asthma control improved over time in both groups. Mean pre-bronchodilator maximal-expiratory flow at 50% vital capacity and percentage rescue-free days showed significantly greater improvements in the SFC group compared with FP. All other efficacy indices showed comparable improvements in each group. Treatment with SFC 50/100 microg bd compared with twice the steroid dose of FP (200 microg bd), was at least as effective in improving individual clinical outcomes and overall asthma control, in asthmatic children previously uncontrolled on low doses of ICS.

[Fifty percent of pollinosis patients sensitive to birch pollen demonstrate bronchoconstriction during bronchial provocation test with the allergen]. / Polowa chorych na pylkowice, uczulonych na pylek brzozy, reaguje skurczem oskrzeli w trakcie oskrzelowego testu prowokacyjnego z alergenem.

UNLABELLED: Birch pollens are known as seasonal asthma precipitants. Our earlier studies evidenced a very high frequency of positive results bronchial allergen challenges in pollinosis patients sensitive to grass pollen. The aim of the study was to evaluate how often the bronchial challenge with birch pollen allergen causes bronchoconstriction. MATERIAL AND METHODS: Studies were performed outside of pollen season on 30 patients sensitive to birch pollen allergen. Before the allergen challenges bronchial provocation tests with methacholine were performed in all subjects. RESULTS: About 13% of examined group had bronchial hyperreactivity (PC20FEV1Mch < 8 mg/ml) and 50% demonstrated bronchoconstriction after birch pollen allergen inhalation. CONCLUSIONS: About 13 percent of patients sensitive to birch pollen demonstrated nonspecific hyperrectivity out of pollen season. Bronchial birch allergen challenge tests are positive in about half of birch sensitive patients with pollinosis.

[The estimation of treatment of Hymenoptera venoms allergy in children]. / Ocena sposobów immunoterapil dzieci uczulonych na jady owadów blonkoskrzydlych.

Specific immunotherapy in patients hypersensitive to Hymenoptera venom is effective method of preventing from severe adverse events after wasp or honey bee sting. In children very often the conventional method was used. In this method injections of vaccines in rising doses was repeated in intervals of 7 days during 3 or 4 months. After obtaining the dose of 100 microg/ml the maintenance therapy is continued during 3-5 years with prolongation of time between vaccine injection to 4-5 weeks. In this paper the "rush" method of immunotherapy was described. Using this method the maintenance dose of vaccine can obtained after 5 days therapy using 3 to 5 concentrations of vaccines during one day. The preliminary effects in 10 children showed that it is safe method and except one children who have the local manifestation of oedema did not observed adverse effects. The efficacy of sting immunotherapy was documented by presentation the 31 cases of children treated by conventional method. The immunotherapy in a short time after "rush" method in our opinion make progress in this treatment.

[Seasonal changes in serum level of eosinophil-derived neurotoxin, interleukin-18, and interferon-gamma in pollinosis patients]. / Sezonowe zmiany stezenia neurotoksyny eozynofilowej, interleukiny 18 i interferonu gamma w surowicy chorych na pylkowice.

UNLABELLED: Pollinosis is the most common disease in the world in people touched by atopy. The aim of the study was to evaluate seasonal changes in serum levels of EDN, IL-18, and IFN-gamma. MATERIAL AND METHODS: Studies were carried out on a group of 30 patients suffering from pollinosis, sensitive to pollen of Ryegrass engl. Twenty healthy subject were considered as a control group. Blood samples were collected in June and December. The concentrations of above mentioned substances were evaluated using ELISA method. RESULT AND CONCLUSION: In pollen season the significant increase in concentration of EDN, and IL-18, and no changes in serum concentration of IFN-gamma were found.

[Seasonal changes in bronchial reactivity in pollinosis patients]. / Sezonowe zmiany reaktywnosci oskrzeli u chorych na pylkowice.

THE AIM OF THE STUDY: To evaluate seasonal changes in bronchial hyperreactivity (BHR) in patients suffering from pollinosis, sensitive to Ryegrass engl. MATERIAL AND METHODS: The studies were carried out on 26 patients and 20 healthy subjects. All the patients had a history of seasonal allergic rhinitis. The following measurements were performed outside and during the pollen season: bronchial provocation test (BPT) with metacholine and 4.5% NaCl, serum concentration of specific and total IgE. RESULTS: Outside the pollen season additionally the BPT with Ryegrass engl. allergen was performed and 88% of the pollinosis patients had positive result of the test. After 4.5% NaCl bronchial challenge positive results had 2 out of 26 patients outside the season, and 3 during the season. Bronchial hyperreactivity to metacholine (PC20 < 8 mg/ml) were observed in 4/26 (15.4%) persons outside the season and in 7 (26.9) during the season. The healthy subjects had no bronchoconstriction neither after metacholine or 4.5% NaCl. During the pollen season the increase in serum concentration of tIgE and sIgE was observed only in pollinosis patient. CONCLUSIONS: There was not found a correlation between BHR to the allergen and serum total IgE nor specific IgE concentration.

[Subclasses of immunoglobulin G in children with atopic bronchial asthma]. / Podklasy immunoglobuliny G u dzieci z atopowa astma oskrzelowa.

We examined immunoglobulin G (IgG) and its subclasses IgG1-IgG4 in the group of asthmatic children aged from 6 to 16 (n = 50) before of specific (mite) immunotherapy and in control group (n = 150) The results showed isolated decrease of IgG2 (22%) and connected with deficiency of other subclasses (16%). After immunotherapy during 3 years we showed deficiency of IgG subclasses in 60% children with asthma. In our opinion IgG should be examined before decision about immunotherapy because its deficiency in spite of good results of immunotherapy may be conductive for recurrent respiratory tract infections. In these cases immunocorrection methods should be considered.

Similar efficacy of ciclesonide once daily versus fluticasone propionate twice daily in patients with persistent asthma.

This 12-week, double-blind, parallel-group study compared the efficacy and safety of once daily ciclesonide and twice daily fluticasone propionate in patients aged 12-75 years with persistent asthma. Patients were randomized to once-daily ciclesonide 80 micro g (n = 278) or 160 micro g (n = 271), or twice daily fluticasone propionate 88 micro g (n = 259) (all ex-actuator). Significant improvements from baseline were seen in all three treatment groups for forced expiratory volume in 1 second, asthma symptom scores and rescue medication use (all p < 0.0001). Asthma exacerbation rates were low (each ciclesonide group, n = 2; fluticasone group, n = 1). Adverse event reporting indicated good tolerability. Once daily ciclesonide 80 micro g or 160 micro g showed comparable efficacy and tolerability to twice daily fluticasone propionate 88 micro g in persistent asthma.