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- Systematic Review of Intermittent Inhaled Corticosteroids and of Long-acting Muscarinic Antagonists for Asthma
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- Research Protocol Sept. 16, 2016
Research Review - Draft – Mar. 22, 2017
Systematic Review of Intermittent Inhaled Corticosteroids and of Long-acting Muscarinic Antagonists for Asthma
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Purpose of the review
To assess the efficacy of intermittent inhaled corticosteroids (ICS) in different populations of patients with asthma and to assess the efficacy of added long-acting muscarinic antagonist patients with uncontrolled, persistent asthma.
- Intermittent use of ICS during an upper respiratory tract infection in children less than 5 years old with recurrent wheezing decreases asthma exacerbations.
- Intermittent ICS use in patients 12 years and older with persistent asthma may be similar to ICS controller use. Using ICS and long-acting beta-agonist (LABA) together as controller and quick relief therapy reduces exacerbations compared to using ICS alone or with LABA as a controller only.
- In patients at least 12 years old with uncontrolled, persistent asthma adding LAMA to ICS reduces exacerbations and improves lung function while adding LAMA to ICS and LABA controller improves asthma control and lung function. Adding LAMA to ICS instead of adding LABA impacts outcomes similarly.
- Future research is needed to further explore the impact of intermittent ICS dosing on asthma outcomes in addition to studies more explicitly defining asthma severity and control, including reasons for a lack of control.