Author:

Tania Gesheff, RN, MSN

Authors:

Rosemary Young, APRN

Kevin Murphy, MD

Jennifer Banfield, APRN, FNP

Author:

Gabriel Ortiz, MPAS, PA-C, DFAAPA

Recent Respiratory News

• Recent Publications of Interest

The American Thoracic Society 2013 International Conference to be held in Philadelphia on May 17-22 will present a broad range of allergy, asthma, and immunology topics. Topics covered will include a pro-con debate on controversies in the evaluation and management of CTD-ILD, the role of obesity and adipokines in lung diseases, the role of immune modulation in the pathogenesis of IPF, and the genetics of childhood asthma. The press release is available at:
http://www.thoracic.org/media/press-releases/resources/
Allergy%20Asthma%20and%20Immunology%20Highlights%20at%20ATS%202013%20final.pdf

The 2013 annual AAAAI meeting was held in the first quarter of 2013. Multiple presentations focused on asthma, including the 3 reports highlighted below.

• Results from a cohort study of children and teens living in Fresno California, a city with unusually high asthma prevalence and heavy air pollution, tied together 3 elements previously know to affect asthma risk: environmental exposures, epigenetics in regulatory T Cells, and excessive immune activity measured as high IgE levels. The press release is available at: http://www.medpagetoday.com/MeetingCoverage/AAAAI/37518?utm_source=ats-confreporter&utm_medium=email&utm_content=mpt&utm_campaign=02|26|2013&userid
• Results from a Norwegian Mother and Child Cohort study showed that children of mothers who consumed milk and yogurt fortified with probiotic bacteria had a reduced risk of atopic dermatitis at 6 months and a reduced risk of rhinoconjunctivitis at ages 18 to 36 months. The press release is available at: http://www.medpagetoday.com/MeetingCoverage/AAAAI/37521?utm_source=ats-confreporter&utm_medium=email&utm_content=mpt&utm_campaign=02|26|2013&userid
• Results of a phase 3 trial conducted in 323 patients demonstrated that treatment with 150 or 300 mg of omalizumab (Xolair) every 4 weeks significantly reduced itch severity scores relative to placebo at 12 weeks in patients with chronic idiopathic uticaria that did not respond to antihistamines. The press release is available at: http://www.medpagetoday.com/MeetingCoverage/AAAAI/37508?utm_source=ats-confreporter&utm_medium=email&utm_content=mpt&utm_campaign=02|28|2013&userid The full paper also has been published in the March issue of the New England Journal of Medicine. The abstract is available at : http://www.ncbi.nlm.nih.gov/pubmed/23432142

A review article sets out to answer the question "In adults with COPD, how effective are combined inhaled corticosteroid (ICS) plus long-acting β₂-agonist (LABA) preparations compared with LABAs alone?" by reviewing studies that compared combined ICS plus LABA inhalers with the same LABA alone in adults with stable COPD. The abstract of this review is available at: http://www.ncbi.nlm.nih.gov/pubmed/23420259

In an observational multicenter study, the clinical phenotypes of emphysema, chronic bronchitis, or COPD-asthma were evaluated in 331 COPD patients. Clinical characteristics of patients within these phenotypes were analyzed. The abstract of this publication is available at: http://www.ncbi.nlm.nih.gov/pubmed/23419828

• Flu Vaccine Update

No substantive changes have been made to the CDC influenza vaccine recommendations for the 2012-2013 influenza season.The first quadrivalent influenza vaccine (FluMist Quadrivalent), containing 2 influenza A strains and 2 influenza B strains, which was approved by the US FDA in February 2012, is not available for the 2012-13 flu season.

The US FDA recently approved the first trivalent influenza vaccine made without eggs or the influenza virus. Additional information is available in the press release: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm335891.htm

Additional information about the 2012-13 influenza season can be found on the CDC website: http://www.cdc.gov/flu/about/season/flu-season-2012-2013.htm#recommendations.

• Latest COPD, Asthma, and Allergy Guidelines Updates

The Global Initiative for Chronic Obstructive Lung Disease international guidelines were recently updated in February 2013. The guidelines are available at: http://www.goldcopd.org/

New recommendations in the 2013 update:

• Inclusion of the validated Clinical COPD questionnaire to assess symptoms in patients with COPD
• Caution is recommended when using tiotropium delivered via the Respimat, due to potential increase in mortality (awaiting further studies on delivery devices and doses)
• Palliative care as an important component in the management of patients with advanced COPD and identification of resources
• Use of combination inhaled corticosteroid plus long-acting β₂-agonist or long-acting anticholinergic for patients with many symptoms and a high risk of exacerbations (Group D)

The National Asthma Education and Prevention Program (NAEPP) and the NHLBI of the NIH publish US guidelines for the diagnosis and management of asthma, which were last updated in 2007. More information is available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.

Current guidelines for the diagnosis and management of food allergy in the United States were published by the National Institute of Allergy and Infectious Diseases (NIAID) in December 2010. More information is available at: http://www.niaid.nih.gov/topics/foodallergy/clinical/pages/default.aspx.