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Efficacy in asthma of once-daily treatment with fluticasone furoate: a randomized, placebo-controlled trial

Abstract Background Asthma is an obstructive airway disease characterized by inflammation and bronchospasms (swelling and narrowing of the airways). Asthma is categorized as extrinsic (allergic) or intrinsic (non-allergic). According to the Centers for Disease Control (CDC) seven million children currently have asthma. There are about 10.6 million doctor visits take place annually due to asthma. Parents and caregivers need to understand signs and symptoms of asthma, potential triggers for asthma reactions and what steps to take in order to prevent exacerbations.

Methods Asthma patients maintained on ICS for 3 months with baseline morning forced expiratory volume in one second (FEV1) 50-80% of predicted normal value and FEV1 reversibility of 12% and 200 ml were eligible. The primary endpoint was mean change from baseline FEV1 at week 8 in pre-dose (morning or evening [depending on regimen], pre-rescue bronchodilator) FEV1. Results A total of 545 patients received one of five FF treatment groups and 101 patients received placebo (intent-to-treat population). Each of the five FF treatment groups produced a statistically significant improvement in pre-dose FEV1 compared with placebo (p < 0.05). FF 400 mcg once daily in the evening and FF 200 mcg twice daily produced similar placebo-adjusted improvements in evening pre-dose FEV1 at week 8 (240 ml vs. 235 ml). FF 400 mcg once daily in the morning, although effective, resulted in a smaller improvement in morning pre-dose FEV1 than FF 200 mcg twice daily at week 8 (315 ml vs. 202 ml). The incidence of oral candidiasis was low (0-4%) and UC excretion was comparable with placebo for all FF groups. Conclusions FF at total daily doses of 200 mcg or 400 mcg was significantly more effective than placebo. FF 400 mcg once daily in the evening had similar efficacy to FF 200 mcg twice daily and all FF regimens had a safety tolerability profile generally similar to placebo. This indicates that inhaled FF is an effective and well tolerated once-daily treatment for mild-to-moderate.

SUMMARY:

Asthma is an obstructive airway disease characterized by inflammation and bronchospasms (swelling and narrowing of the airways). Asthma is categorized as extrinsic (allergic) or intrinsic (non-allergic). According to the Centers for Disease Control (CDC) seven million children currently have asthma. There are about 10.6 million doctor visits take place annually due to asthma. Parents and caregivers need to understand signs and symptoms of asthma, potential triggers for asthma reactions and what steps to take in order to prevent exacerbations. Asthma patients maintained on ICS for 3 months with baseline morning forced
expiratory volume in one second (FEV1) 50-80% of predicted normal value and FEV1 reversibility of 12% and 200 ml were eligible. The primary endpoint was mean change from baseline FEV1 at week 8 in pre-dose (morning or evening [depending on regimen], pre-rescue bronchodilator) FEV.

REACTION: My reaction about this reading is that asthma is not only a minor disease that we should always be

ware of which triggers cause asthma exacerbations in your child. Viral and bacterial infections, allergens like pollen and dust mites, environmental irritants like tobacco smoke; wood smoke and fumes from chemicals or perfumes, and physical and emotional stress like running, laughing or crying may cause asthma flare-ups. this is a serious disease condition that each of us should know the proper ways of avoiding this different factors in order for us to maintain a normal circulation. The reading gives me knowledge on how to be aware and emphasizes the efficacy of treatment using fluticasone flurate daily.

For us student nurses, we could always give the best help that we can do by sharing our knowledge on how asthma will be minimized or decrease the risk of it. by giving such information through heath teachings and by sharing the knowledge of what we have.

HEALTH TEACHING! Teaching Prevention of Asthma Asthma is an obstructive airway disease characterized by inflammation and bronchospasms (swelling and narrowing of the airways). Asthma is categorized as extrinsic (allergic) or intrinsic (non-allergic). According to the Centers for Disease Control (CDC) seven million children currently have asthma. There are about 10.6 million doctor visits take place annually due to asthma. Parents and caregivers need to understand signs and symptoms of asthma, potential triggers for asthma reactions and what steps to take in order to prevent exacerbations.

Knowing Signs and Symptoms of Asthma Exacerbations Step 1 Monitor for cough, shortness of breath with mild activity and wheezing (high pitched sounds on inspiration and/or expiration). Wheezing may not be present, so parents should be alert to other more insidious symptoms. These include anxiety, restlessness and use of accessory muscles for breathing, retractions (sucking in of chest wall with inspiration), increased use of asthma medications, and decreased appetite. Step 2 Monitor peak flow. Good indicators of how well asthma is being managed are peak flow readings. If peak flow readings are 20 percent or less than a child's normal results, an asthma exacerbation is occurring. Step 3 Seek medical consultation for children when flareups are moderate to severe. Peak flow readings with a 30-percent or greater drop from a child's average readings indicate moderate or worse asthma exacerbation. Identify Triggers Step 1 Be aware of which triggers cause asthma exacerbations in your child. Viral and bacterial infections, allergens like pollen and dust mites, environmental irritants like tobacco smoke, wood smoke and fumes from chemicals or perfumes, and physical and emotional stress like running, laughing or crying may cause asthma flare-ups. Other triggers listed by the American Academy of Family Physicians include air pollution, mold, pet dancer, certain foods that contain sulfites,

aerosols, cold temperatures, heartburn, and anti-inflammatory medications like aspirin and ibuprofen. Step 2 Keep a diary of asthma exacerbations and the suspected trigger. Share this diary with your physician. Step 3 Consider allergy testing. Prevent Exacerbations Step 1 Remove or diminish asthma triggers from the child's environment. If allergens like pollen or mold are triggers, then keep asthmatic children indoors as much as possible until pollen and mold counts go down. Use air filters in the home and change heating and cooling system filters frequently. Clean out bathrooms, kitchens and basements frequently to control mold. Use air conditioning or a dehumidifier to keep humidity down below 50 percent to reduce mold. Step 2 Keep all children, especially asthmatic children, away from tobacco smoke. Do not smoke in the home or the car. Smoke particles cling to clothing, so even smoking outside will not prevent a child from being exposed to smoke unless clothing is changed prior to contact with the asthmatic child. Step 3 Vacuum and dust the house at least weekly, preferably twice a week to minimize asthma exacerbations. Keep pets out of children's rooms if pet dander is a suspected allergen. Wash bed linens weekly, preferably twice a week, in very hot water (over 130 degrees) to remove dust mites. Place allergen covers on pillows and mattresses to protect sleepers from dust mites. Place stuffed toys in airtight containers (plastic bags), and wash them whenever possible. Wash curtains and blinds frequently. Step 4 Administer medications as directed. Do not decrease medication dosages or skip taking medications because of an improvement in condition. Asthma can flare up and become uncontrollable if medications are not taken properly.