Bjermer, Leif

Chisholm, Alison

Popov, Todor A

Price, David

Allergy Asthma and Immunology Research

English

PubMed

Cigarette smoking among asthma patients is associated with worsening symptoms and accelerated decline in lung function. Smoking asthma is also characterized by increased levels of neutrophils and macrophages, and greater small airway remodeling, resulting in increased airflow obstruction and impaired response to corticosteroid therapy. As a result, smokers are typically excluded from asthma randomized controlled trials (RCTs). The strict inclusion/exclusion criteria used by asthma RCTs limits the extent to which their findings can be extrapolated to the routine care asthma population and to reflect the likely effectiveness of therapies in subgroups of particular clinical interest, such as smoking asthmatics. The inclusion of smokers in observational asthma studies and pragmatic trials in asthma provides a way of assessing the relative effectiveness of different treatment options for the management of this interesting clinical subgroup. Exploratory studies of possible treatment options for smoking asthma suggest potential utility in: prescribing higher-dose ICS; targeting the small airways of the lungs with extra-fine particle ICS formulations; targeting leukotreines, and possibly also combinations of these options. However, further studies are required. With the paucity of RCT data available, complementary streams of evidence (those from RCTs, pragmatic trials and observational studies) need to be combined to help guide judicious prescribing decisions in smokers with asthma

Lund University Publications

Integrating evidence for managing asthma in patients who smoke.

David Price

Leif Bjermer

Todor A. Popov

Alison Chisholm

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Integrating Evidence for Managing Asthma in Patients Who Smoke

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Achieving asthma control in practice: understanding the reasons for poor control.

Airway epithelial changes in smokers but not in ex-smokers with asthma. Am J Respir Crit Care Med

Care Research Database (GB). Optimum Patient Care Research Database [Internet]. Cambridge: Optimum Patient Care Research Database;

Clinical pharmacology of eicosanoids, nicotine induced changes in man.

Clinical Practice Research Datalink(GB). Clinical Practice Research Datalink [Internet]. London: Clinical Practice Research Datalink;

Effect of montelukast for treatment of asthma in cigarette smokers.

Effects of HFA- and CFC-beclomethasone dipropionate on the bronchial response to methacholine (MCh) in mild asthma. Respir Med

Effects of smoking cessation on lung function and airway inflammation in smokers with asthma.

Efficacy of low and high dose inhaled corticosteroid in smokers versus non-smokers with mild asthma.

Exhaled 8-isoprostane as an in vivo biomarker of lung oxidative stress in patients with COPD and healthy smokers.

Fluticasone/ Salmeterol combination confers benefits in people with asthma who smoke.

Global Initiative for Asthma (US). GINA Report, Global Strategy for Asthma Management and Prevention [Internet]. [place unknown]: Global Initiative for Asthma;

Glucocorticoid receptor recruitment of histone deacetylase 2 inhibits interleukin-1beta-induced histone H4 acetylation on lysines 8 and 12.

How do corticosteroids work in asthma?

How representative are clinical study patients with asthma or COPD for a larger “real life” population of patients with obstructive lung disease? Respir Med

Immunologic aspects of chronic obstructive pulmonary disease.

Impaired inhibition by dexamethasone of cytokine release by alveolar macrophages from patients with chronic obstructive pulmonary disease.

Increased 8-isoprostane, a marker of oxidative stress, in exhaled condensate of asthma patients.

Inflammatory mediators in blood and urine. Paediatr Respir Rev 2000;1:259-65.Price et al. Allergy Asthma Immunol Res.

Inflammatory stimuli inhibit glucocorticoid-dependent transactivation in human pulmonary epithelial cells: rescue by long-acting beta2-adrenoceptor agonists.

Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma.

Influence of particle size and patient dosing technique on lung deposition of HFA-beclomethasone from a metered dose inhaler.

Leukotriene E(4) in urine in patients with asthma and COPD--the effect of smoking habit.

Lung deposition of formoterol HFA (Atimos/Forair) in healthy volunteers, asthmatic and COPD patients.

New Treatment for smoking asthmatics. KAPARDKAAACI & West Pacific Allergy Symposium Joint International Congress;

Particle size of inhaled corticosteroids: does it matter?

Pharmacological characterization of leukotriene receptors.

PJ; Languedoc-Roussillon Teaching General Practitioners Group. How representative are clinical study patients with allergic rhinitis in primary care?

Real-life asthma impairment: SABA use depends on smoking phenotype.

Real-life effectiveness of extrafine beclometasone dipropionate/formoterol in adults with persistent asthma according to smoking status.

Remodeling in asthma and chronic obstructive lung disease.

Research in Real Life Limited (GB). Research in Real Life [Internet]. Cambridge: Research in Real Life Limited;

Role of neutrophils in persistent airway obstruction due to refractory asthma.

The functional consequences of airway remodeling in asthma. Monaldi Arch Chest Dis

The role of small airways in obstructive airway diseases.

The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control.

Update on glucocorticoid action and resistance.

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Integrating evidence for managing asthma in patients who smoke

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