The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Nov 2013
Randomized Controlled Trial Clinical TrialPredictors of response to tiotropium versus salmeterol in asthmatic adults.
Tiotropium has activity as an asthma controller. However, predictors of a positive response to tiotropium have not been described. ⋯ Although these results require confirmation, predictors of a positive clinical response to tiotropium include a positive response to albuterol and airway obstruction, factors that could help identify appropriate patients for this therapy.
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J. Allergy Clin. Immunol. · Oct 2013
Randomized Controlled TrialPharmacodynamic modeling of cough responses to capsaicin inhalation calls into question the utility of the C5 end point.
Inhaled capsaicin elicits cough reproducibly in human subjects and is widely used in the study of cough and antitussive therapies. However, the traditional end points C2 and C5 (the concentrations of capsaicin inducing at least 2 or 5 coughs, respectively) display extensive overlap between health and disease and therefore might not best reflect clinically relevant mechanisms. ⋯ Nonlinear mixed-effects modeling demonstrates that maximal capsaicin cough responses better discriminate health from disease and predict spontaneous cough frequency and therefore provide important insights into the mechanisms underlying CC.
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J. Allergy Clin. Immunol. · Sep 2013
Randomized Controlled TrialDose-ranging study of lebrikizumab in asthmatic patients not receiving inhaled steroids.
Asthma is a disease with marked heterogeneity in its clinical course and response to treatment. IL-13 is central to type 2 inflammation, which contributes to many key features of asthma. Lebrikizumab is an anti-IL-13 mAb previously reported to significantly improve lung function in patients with inadequately controlled asthma despite inhaled corticosteroid therapy, especially in periostin-high patients. ⋯ Blocking IL-13, a single cytokine, in this population of asthmatic patients is insufficient to improve lung function. There is evidence that IL-13 blockade may improve disease control, as measured by prevention of protocol-defined treatment failure in these patients.
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J. Allergy Clin. Immunol. · Jul 2013
Randomized Controlled TrialOmalizumab in patients with symptomatic chronic idiopathic/spontaneous urticaria despite standard combination therapy.
Patients with chronic idiopathic urticaria/chronic spontaneous urticaria (CIU/CSU) often continue to experience symptoms despite receiving standard-of-care therapy with H1-antihistamines along with 1 or more add-on therapies. ⋯ Omalizumab was well tolerated and reduced the signs and symptoms of CIU/CSU in patients who remained symptomatic despite the use of H₁-antihistamines (up to 4 times the approved dose) plus H₂-antihistamines, leukotriene receptor antagonists, or both.
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J. Allergy Clin. Immunol. · Mar 2013
Randomized Controlled TrialThe novel TLR-9 agonist QbG10 shows clinical efficacy in persistent allergic asthma.
Allergen-specific TH2 responses contribute to the development of allergic asthma. Their increase may be due to a reduced early exposure to environmental pathogens, which induces a TH1 response, and thereby suppresses the allergic TH2 response. QbG10 (bacteriophage Qbeta-derived virus-like particle with CpG-motif G10 inside), a novel Toll-like receptor 9 agonist packaged into virus-like particles, was designed to stimulate the immune system toward a TH1-mediated protective response. ⋯ Treatment with QbG10 may contribute to continued asthma control during steroid reduction in patients on moderate or high-dose inhaled steroids.