Allergy and asthma proceedings :
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Allergy Asthma Proc · Nov 2004
Practice Guideline GuidelineOptimizing childhood asthma management: the role of national institutes of health-sponsored study groups.
Advances in the National Institutes of Health (NIH)-sponsored guidelines for asthma management result in part from how these guidelines serve as a target for improvement. Taking this perspective, we can ask what features of the guidelines are of central importance but are inadequately understood? What features are difficult to implement and would benefit from a major advance in our approach? One effort to further such advancements also comes from the NIH through their support of childhood asthma study groups that aim to improve childhood asthma management. ⋯ The main objective of this article is to provide some insight to these NIH-supported childhood asthma study groups and their recently completed or ongoing studies. This should provide an understanding of the strengths of these initiatives, their contribution to the evidence basis that is a cornerstone of optimal management, and the current main themes in these efforts to improve and advance childhood asthma management.
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Allergy Asthma Proc · Nov 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialPairwise comparison of levalbuterol versus racemic albuterol in the treatment of moderate-to-severe asthma.
The object of this study is a post hoc pairwise comparison of levalbuterol versus racemic albuterol for asthma in a multicenter, double-blind, randomized, placebo-controlled clinical trial. The participants are patients > or =12 years of age (n = 362) with FEV1 45-70% of predicted. The patients received nebulized levalbuterol (0.63 or 1.25 mg), racemic albuterol (1.25 or 2.5 mg), or placebo t.i.d. for 4 weeks. ⋯ Active treatment groups demonstrated significant improvements compared with the placebo group (p < 0.05), except for AUC FEV1 in the racemic albuterol 1.25-mg group at week 4. Levalbuterol in the absence of the (S)-isomer provided greater bronchodilation than the same quantity of (R)-albuterol delivered as the racemate. These data suggest that (S)-albuterol may compromise the efficacy of (R)-albuterol.