Add-on omalizumab in children with severe allergic asthma: a one year real life survey.

Eur Respir J. 2013 Mar 21;

Authors: Deschildre A, Marguet C, Salleron J, Pin I, Rittié JL, Derelle J, Taam RA, Fayon M, Brouard J, Dubus JC, Siret D, Pouessel G, Beghin L, Just J

Abstract
Omalizumab was shown to reduce exacerbation rate in moderate to severe allergic asthma.To evaluate omalizumab efficacy and safety in a real life setting in severe asthmatic children.104 children (6-18 y), followed-up in paediatric pulmonary tertiary care centres were included at omalizumab onset. Asthma control levels, exacerbations, inhaled corticosteroids (ICS) dose, lung function and adverse events (AEs) were evaluated over one year.Children were characterized by allergic sensitisation to ≥3 allergens (66%), high IgE levels (mean: 1125 kU·l(-1)), high rate of exacerbations (4.4/year) and health care use during the previous year, high ICS dose (mean: 703 μg equivalent fluticasone/day). Asthma control levels defined as good, partial or poor, improved from 0%, 18%, and 82% at entry to 53%, 30% and 17% at week 20, and to 67%, 25% and 8% at week 52, respectively (p<0.0001). Exacerbation and hospitalisation rates dropped by 72 and 88.5%. At 12 months, FEV1 improved by 4.9% (p=0.023), and ICS dose decreased by 30% (p<0.001). Six patients stopped omalizumab for related significantAEs.Omalizumab improved asthma control in children with severe allergic asthma and was generally well tolerated. The observed benefit was greater than that reported in clinical trials.

PMID: 23520319 [PubMed - as supplied by publisher]

The effect of a smoking ban on hospitalization rates for cardiovascular and respiratory conditions in prince edward island, Canada.

PLoS One. 2013;8(3):e56102

Authors: Gaudreau K, Sanford CJ, Cheverie C, McClure C

Abstract
BACKGROUND: This is the first study to have examined the effect of smoking bans on hospitalizations in the Atlantic Canadian socio-economic, cultural and climatic context. On June 1, 2003 Prince Edward Island (PEI) enacted a province-wide smoking ban in public places and workplaces. Changes in hospital admission rates for cardiovascular (acute myocardial infarction, angina, and stroke) and respiratory (chronic obstructive pulmonary disease and asthma) conditions were examined before and after the smoking ban.
METHODS: Crude annual and monthly admission rates for the above conditions were calculated from April 1, 1995 to December 31, 2008 in all PEI acute care hospitals. Autoregressive Integrated Moving Average time series models were used to test for changes in mean and trend of monthly admission rates for study conditions, control conditions and a control province after the comprehensive smoking ban. Age- and sex-based analyses were completed.
RESULTS: The mean rate of acute myocardial infarctions was reduced by 5.92 cases per 100,000 person-months (P = 0.04) immediately after the smoking ban. The trend of monthly angina admissions in men was reduced by -0.44 cases per 100,000 person-months (P = 0.01) in the 67 months after the smoking ban. All other cardiovascular and respiratory admission changes were non-significant.
CONCLUSIONS: A comprehensive smoking ban in PEI reduced the overall mean number of acute myocardial infarction admissions and the trend of angina hospital admissions.

PMID: 23520450 [PubMed - in process]

A quarter of incident lung cancers are slow growing or indolent, and may be overdiagnosed, suggest results from sequential low-dose computed tomography screening.

Researchers challenge the definition of a positive result in first-round lung cancer screening with low-dose computed tomography in the Annals of Internal Medicine.