Inhaled Formoterol-Fluticasone Single Inhaler Therapy in Asthma: Real-World Efficacy, Budget Impact, and Potential to Improve Adherence

Asthma is the commonest chronic disease affecting airways in humans and has an increasing global disease burden. Inhaled corticosteroids (ICS) are the first-line therapeutic option for asthma, and addition of a long-acting beta 2-agonist (LABA) has been shown to improve asthma control. A combination of the two agents in a single inhaler is beneficial with regard to ease of administration and patient compliance. Various ICS-LABA formulations are available across various countries in the world, one among them being formoterol-fluticasone. Both formoterol and fluticasone have pharmacologic peculiarities which places the combination in a uniquely advantageous position when it comes to asthma therapy. The present review focuses on some of the, hitherto, less explored aspects of this combination inhaler such as real-world efficacy, impact on budget allocation, results of switch-over therapy, and potential to improve adherence to asthma treatment. It also provides practical recommendations on positioning it in real-world asthma management

Efficacy of Omalizumab Therapy in an Asthmatic with Low IgE

Asthma is one of the most common respiratory diseases encountered in clinical practice. Although the vast majority of asthmatics can be adequately controlled with inhaled steroids and other preventer medications, a small proportion remain uncontrolled. Anti-IgE treatment with omalizumab has been proposed in patients as a preferred approach in step 5 asthma therapy according to GINA guidelines. Although therapy with this molecule is approved for patients with atopic asthma and pretreatment serum IgE levels of 30-1500 only, there have been a few reports of its efficacy in subjects outside this reference IgE range. We report the case of a middle-aged lady with severe corticosteroid-dependent asthma and low serum IgE levels who was successfully treated with 9 months of omalizumab therapy. She gained good asthma control and was tapered off steroid use by the fifth month of therapy with omalizumab. The case report stresses the need for further investigation into expanding the spectrum of omalizumab usage in asthma beyond the current IgE suitability range

Economic impacts on West Virginia from projected future coal production and implications for policymakers

Multiple economic and geologic factors are driving fundamental changes in the nation’s energy system, weakening coal’s dominance as a fuel for electricity generation, with significant implications for places like West Virginia that are heavily dependent on coal for economic activity. Some of these factors include low natural gas prices, rising labor costs and declining productivity, economic competition with other coal mining regions, environmental regulations to reduce pollution and safeguard public health, state energy efficiency and renewable electricity standards, falling costs of renewable energy resources like wind and solar, and the likely prospect of future limits on greenhouse gas emissions. This analysis uses an input–output model to examine the effects on West Virginia’s economy from these multiple factors by exploring a range of scenarios for coal production through 2020. In addition to changes in the coal industry, hypothetical investments in additional sectors of the economy are considered as a way to gauge potential alternative economic opportunities. This paper offers recommendations to policymakers for alternative economic development strategies needed to create new jobs and diversify the state’s economy, and highlights the importance of transition assistance at the federal level