Treatment of asthma in young children: evidence-based recommendations

Juan Carlos Ivancevich Friday, 04 March 2016 15:57
 
 
 
Jose A. Castro-Rodriguez Email authorAdnan Custovic and Francine M. Ducharme

Abstract

In the present review, we focus on evidence-based data for the use of inhaled corticosteroids (ICS), leukotriene receptor antagonist (LTRA), long-acting beta2-agonits (LABA) and oral corticosteroids (OCS), with a special emphasis on well-performed randomized clinical trials (RCTs) and meta-analyses of such trials for the chronic management of asthma/wheeze in infants and preschoolers. Results: Seven meta-analyses and 14 RCTs were reviewed. Daily ICS should be the preferred drug for infants/preschoolers with recurrent wheezing, especially in asthmatics. For those with moderate or severe episodes of EVW, the use of high intermittent ICS doses significantly reduce the use of OCS. There is no evidence of effect of intermittent ICS at low-moderate dose in preschoolers with mild EVW episodes. In preschoolers with asthma, there were no significant differences between daily vs. intermittent ICS in terms of asthma exacerbations with insufficient power to conclude to equivalence; however, for other asthma control outcomes, daily ICS works significantly better than intermittent ICS for older children. Daily ICS is superior to daily or intermittent LRTA for reducing symptoms, preventing exacerbations, and improving lung function. No RCTs testing combination therapy with ICS and LABA (or LTRA) were published in infant/preschoolers. Parent-initiation of OCS at the first sign of symptoms is not effective in children with recurrent wheezing episode. In terms of ICS safety, growth suppression is dose and molecule-dependent but it’s effect is not cumulative beyond the first year of therapy and may be associated with some catch-up growth while on or off therapy. Linear growth must be monitored as individual susceptibility to ICS drugs may vary considerably.

Join WAO at Interasma for the COSA Symposium

Juan Carlos Ivancevich Wednesday, 02 March 2016 13:32

Join WAO at Interasma for the COSA Symposium: Approaches to Severe Asthma. WAO experts will present on severe asthma during Interasma’s World Congress on Asthma (WCA) in Madrid, Spain, on 14 March 2016 from 16:30 to 18:00.

Prof Lanny Rosenwasser will speak on “Cytokine Families and Receptors as Treatment Targets in Severe Asthma”. Prof Ignacio Ansotegui will speak on “Small Airways in Asthma”, and Prof Mario Sánchez-Borges will speak on “Acute Asthma Induced by Mite-Contaminated Foods.”

Upcoming Symposia

INTERASMA'S WORLD CONGRESS ON ASTHMA 2016 - MADRID, SPAIN

World Allergy Organization COSA Symposium: Approaches to Severe Asthma
Monday, 14 March 2016
16:30 to 18:00

Chairpersons:
G Walter Canonica, University of Genoa
Sergio Bonini, Second University of Naples

Cytokine Families and Receptors as Treatment Targets in Severe Asthma
Lanny Rosenwasser, Children’s Mercy Hospital

Small Airways in Asthma
Ignacio Ansotegui, Hospital Quirón Bizkaia

Acute Asthma Induced by Mite-Contamined Foods
Mario Sanchez-Borges, Centro Médico Docente – La Trinidad

http://www.wca-2016.com/

 

GINA will be present in the WCA 2016

Juan Carlos Ivancevich Thursday, 18 February 2016 19:30

XXIII World Congress of Asthma
March 12 – 15, 2016
Madrid Spain

 

Madrid is hosting the World Congress of Asthma, organized by the Global Asthma Association / Interasma from March 12 to 15, 2016, at Melia Castilla hotel.
 
The World Congress on Asthma (WCA 2016) will review the key findings from recent research on both adult and pediatric Asthma and how knowledge translation methods have evolved to better integrate research findings into care.
 
The origins and determinants of asthma, triggers and inducers, the new insight gained on the role of allergy, environmental and biodiversity changes, respiratory infections and various aspects of assessment of the disease are among the topics that will be covered through keynote lectures, debates, symposia and workshops by world experts, who will also be looking into the role of phenotyping/endotyping asthma, particularly when severe, and new therapeutic current and future advances.
 
GINA will be present in the WCA 2016 with an important and interesting Plenary Session on Sunday March 13, 03:00 pm as part of the excellent Scientific Program.


 
GINA GUIDELINES 2014-2015
 
Chairs:
Mark Levy, G. Walter Canonica
 
Mark Levy: “Lesson from a teenage asthma death – the case of Tamara Mills”
Louis Philippe-Boulet: “Adult asthma and ACOS”
Alvaró Cruz: “Exacerbations/Dissemination and implementation”
 
Take this excellent opportunity to hear and ask the GINA experts live and direct.
 
For more information on the Congress's full schedule can be found at www.wca-2016.com.
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World Congress of Asthma 2016. Madrid, March 12-15. General Information.

Juan Carlos Ivancevich Thursday, 11 February 2016 14:35

Congress Venue


Meliá Castilla

Calle del Capitán Haya, 43

Madrid 28020 

Spain

Climate and Dress Code


Madrid and its metropolitan area has a Mediterranean climate with continental influences, with mild cool winters and hot summers. The average temperature in March it varies from +8oC (46oF) to +20oC (60oF). The Spanish capital is in the center of the Iberian Peninsula, 622 meters above sea level. The dress code will be informal throughout the Congress.

Currency


The local currency is the Euro (EUR).

Exhibition


The WCA 2016 Congress in Madrid will include an exhibition that will be open from 12-15 March.
For more information regarding the exhibition and other sponsorship opportunities, please visit the Congress website or contact This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Language


The official language of the Congress is English.

 

Local Time


The time zone in Madrid is Central European Time (CEST / GMT +1) .

Visa


Participants are advised to make their own arrangements with respect to entering Spain.
If you need a letter of invitation, contact This email address is being protected from spambots. You need JavaScript enabled to view it.  after your registration fee is settled.
Please apply for a visa within a reasonable time prior to making your bookings.

Travel and Health Insurance


It is strongly recommended that all participants purchase adequate coverage for health, travel and private liability insurance before departing from their home countries. The Organizers will not accept responsibility for personal injury, loss or damage to private, personal property of participants, accompanying persons and exhibitors.

http://www.wca-2016.com/

The following new article has just been published in Asthma Research and Practice

Juan Carlos Ivancevich Tuesday, 09 February 2016 20:52

Research   

Once-daily fluticasone furoate/vilanterol versus twice daily combination therapies in asthma–mixed treatment comparisons of clinical efficacy

Svedsater H, Stynes G, Wex J, Frith L, Leather D, Castelnuovo E, Detry M, Berry S

Asthma Research and Practice 2016, 2 :4 (8 February 2016)

Abstract | Full Text | PDF

WCA 2016 - Venue and General Information

Juan Carlos Ivancevich Wednesday, 03 February 2016 14:54

Congress Venue


Meliá Castilla

Calle del Capitán Haya, 43

Madrid 28020 

Spain

 

Climate and Dress Code


Madrid and its metropolitan area has a Mediterranean climate with continental influences, with mild cool winters and hot summers. The average temperature in March it varies from +8oC (46oF) to +20oC (60oF). The Spanish capital is in the center of the Iberian Peninsula, 622 meters above sea level. The dress code will be informal throughout the Congress.

Currency


The local currency is the Euro (EUR).

Exhibition


The WCA 2016 Congress in Madrid will include an exhibition that will be open from 12-15 March.
For more information regarding the exhibition and other sponsorship opportunities, please visit the Congress website or contact This email address is being protected from spambots. You need JavaScript enabled to view it.

Language


The official language of the Congress is English.

Local Time


The time zone in Madrid is Central European Time (CEST / GMT +1) .

Visa


Participants are advised to make their own arrangements with respect to entering Spain.
If you need a letter of invitation, contact This email address is being protected from spambots. You need JavaScript enabled to view it.  after your registration fee is settled.
Please apply for a visa within a reasonable time prior to making your bookings.

Travel and Health Insurance


It is strongly recommended that all participants purchase adequate coverage for health, travel and private liability insurance before departing from their home countries. The Organizers will not accept responsibility for personal injury, loss or damage to private, personal property of participants, accompanying persons and exhibitors.

Asthma in the elderly patient

Juan Carlos Ivancevich Wednesday, 03 February 2016 13:26
Louis-Philippe Boulet
 

DOI: 10.1186/s40733-015-0015-1

Abstract

Asthma affects a significant proportion of elderly patients, but unfortunately, it is responsible for a high asthma-related morbidity and mortality in this population. This may be related not only to the development of a more severe asthma phenotype compared to younger patients, with more marked airway obstruction and a more neutrophilic type of airway inflammation, but also to the presence of many co-morbid conditions. Furthermore, in older patients, asthma is often under-diagnosed, undertreated and poorly managed. Unfortunately, elderly patients have usually been excluded of clinical trials on asthma and there is an urgent need to perform more research on the optimal management of asthma in this population.

Table of Contents

World Congress of Astma, Madrid March 12-15, 2016: Scientific Program Committee´s Message

Juan Carlos Ivancevich Friday, 29 January 2016 13:42

Significant achievements have been accomplished in the last few years to better understanding what is asthma, how it should be assessed in regard to control and severity and what is its optimal therapy. Unfortunately these improvements in our understanding of the disease have not always translated into better asthma management.

The 2016 World Congress on Asthma in Madrid will review the key findings from recent research on both adult and pediatric Asthma and how knowledge translation methods have evolved to better integrate research findings into care.

The origins and determinants of Asthma, triggers and inducers, the new insight gained on the role of allergy, environmental and biodiversity changes, workplace hazards, respiratory infections andvarious aspects of assessment of the disease are among the topics that will be covered by world experts. The role of phenotyping/endotyping Asthma, particularly when severe, and new therapeutic current and future advances will be covered.

A significant part of the meeting will be devoted to practical workshops on asthma testing and treatment delivery, as we'll as the integration of practice tools into day-to-day care. Sessions will discuss how to optimize the multidisciplinary approach to asthma management.

We and the members of the scientific advisory board the impressive program of WCA-2016 will be of interest to all those involved in research and care of asthma.

             
             
G. Walter Canonica   Lawrence DuBuske   Louis-Philippe Boulet   Ralph Mösges

 

on behalf of the Scientific Programme Committee –WCA 2016 Madrid INTERASMA

WCA 2016 - Scientific Program Saturday March 12, 2016

Juan Carlos Ivancevich Wednesday, 13 January 2016 03:55
  Room A
Room B
Room C

14.30

ACOS Symposium

Chairs: Stefano Centanni, Joan Soriano 

Marc Miravitlles “ACOS-The Spanish document”
Vito Brusasco “Do we need ACOS?” 

Mar Fernandez- Nieto Eosinophilic bronchitis”

SEPAR Symposium

Chairs: Inmaculada Alfageme,  Carlos Melero

Antolín Lopez-Viña“Novedades terapeuticas de la guia española para el manejo del asma GEMA 4.0”
Eva Martinez Moragon“Asma y embarazo: dos escenarios para cuidar” 
Luis Perez de Llano“Coexistencia de asma y EPOC”
"Basic Science in Asthma & Related Disorders"

Chairs: Giovanni Passalacqua, Carlos Nunes 

David Soto “The role of stem cells in asthma: pathogenic versus therapeutic”
Alberto Papi “Virus and Asthma” 
Santiago Quirce“Neutrophilic Inflammation in Asthma”

 

 

 

 

 

 

 

 

16.00 Coffee Break

16.30

Social Aspects of Respiratory Diseases (GARD Session)

Chairs: Nikolai Khaltaev, G.Walter Canonica 

Nikolai Khaltaev “Social Predictors of Health (GARD Perspective)"
Arzu Yorgancıoğlu "Social determinants of obstructive diseases other than tobacco"

Alvaro Cruz “Do socieconomic inequalities in health have an impact on Asthma and Allergic diseases?”

Jaime Correia de Sousa “The role of primary care in dealing with social determinants”

SEAIC Symposium

Chairs: TBA

Mar Fernandez-Nieto “New developments in occupational asthma”
Irina Bobolea “Clinical Management of aspirin-exacerbated respiratory disease” 
Silvia Sanchez-Garcia“Childhood Asthma: Role of alergens”
Workshop:"Diet and Lifestyle"

Chairs: Carlo Lombardi, Ruby Pawankar 

Catherine Hawrylowicz“Vitamin D and Corticosteroid Response”
Sergio Bonini “Regulatory aspects of anti-asthmatic drugs” 
Jonathan Bernstein“Occupational Asthma”

 

 

 

18.00

Keynote Lecture


Chairs
  Joaquin Sastre, Inmaculada Alfageme, G.Walter Canonica

Kian Fan Chung
"Systems Medicine as Pathway to Precision Medicine"

 

18.30
Opening Ceremony

20.00

Poster Discussion

The geriatric asthma: pitfalls and challenges

Juan Carlos Ivancevich Thursday, 07 January 2016 05:09

Alida Benfante and Nicola Scichilone

Abstract

Historically, asthma has been envisioned as a disease of younger ages. This has led to the assumption that respiratory symptoms suggestive of asthma occurring in older ages are to be attributed to conditions other than asthma, mainly COPD. Old observational reports and new epidemiological studies confirm that asthma is as frequent in older as it is in younger populations. Nevertheless, under-recognition, misdiagnosis and under-treatment are still relevant issues. The characterization of asthma in the aged suffers from the fact that there has been very little original research in this field. Indeed, geriatric asthma is often excluded from clinical trials because of age and comorbidities. The current review paper revises the areas that need to be elucidated, and highlights the gaps in the management of this condition. It follows that a multidimensional management is advocated for elderly asthmatics to evaluate the severity and establish the complexity of the disease. We suggest that the term “geriatric” asthma should be preferred to “senile” asthma, which is confined to the age-related changes in the lung, or the more generic “asthma in the elderly”, which is only descriptive of the prevalence in specific age groups.

Download PDF

 

 

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Editor: Juan C. Ivancevich, MD

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