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Search Results: 1 - 10 of 229654 matches for " L tvall JO "
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The safety of long-acting 2-agonists in the treatment of stable chronic obstructive pulmonary disease
Decramer ML, Hanania NA, L tvall JO, Yawn BP
International Journal of Chronic Obstructive Pulmonary Disease , 2013, DOI: http://dx.doi.org/10.2147/COPD.S39018
Abstract: afety of long-acting 2-agonists in the treatment of stable chronic obstructive pulmonary disease Review (1485) Total Article Views Authors: Decramer ML, Hanania NA, L tvall JO, Yawn BP Published Date January 2013 Volume 2013:8 Pages 53 - 64 DOI: http://dx.doi.org/10.2147/COPD.S39018 Received: 10 October 2012 Accepted: 26 November 2012 Published: 25 January 2013 Marc L Decramer,1 Nicola A Hanania,2 Jan O L tvall,3 Barbara P Yawn4 1Respiratory Division, University Hospital, KU Leuven, Belgium; 2Section of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA; 3Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden; 4Department of Research, Olmsted Medical Center, Rochester, MN, USA Background: Inhaled long-acting bronchodilators are the mainstay of pharmacotherapy for chronic obstructive pulmonary disease (COPD). Both the twice-daily long-acting 2-adrenoceptor agonists (LABAs) salmeterol and formoterol and the once-daily LABA indacaterol are indicated for use in COPD. This review examines current evidence for the safety of LABAs in COPD, focusing on their effect on exacerbations and deaths. Methods: We searched PubMed for placebo-controlled studies evaluating long-term (≥24 weeks) use of formoterol, salmeterol, or indacaterol in patients with stable COPD, published between January 1990 and September 2012. We summarized data relating to exacerbations and adverse events, particularly events related to COPD. Results: From 20 studies examined (8774 LABA-treated patients), there was no evidence of an association between LABA treatment and increased exacerbations, COPD-related adverse events, or deaths. Where analyzed as an efficacy outcome, LABA treatment was generally associated with significant or numerical reductions in COPD exacerbations compared with placebo. Incidences of COPD-related adverse events were similar for active and placebo treatments. The incidence of adverse events typically associated with the 2-agonist drug class such as skeletal muscle tremors and palpitations was low (often <1% of patients), and there were no reports of increased incidence of cardiac arrhythmias. The systemic effects of 2-adrenoceptor stimulation, such as high glucose and potassium levels, were considered minor. Conclusion: Current evidence from clinical studies of the safety and tolerability profile of LABAs supports their long-term use in COPD.
The safety of long-acting ß2-agonists in the treatment of stable chronic obstructive pulmonary disease
Decramer ML,Hanania NA,Lötvall JO,Yawn BP
International Journal of COPD , 2013,
Abstract: Marc L Decramer,1 Nicola A Hanania,2 Jan O L tvall,3 Barbara P Yawn41Respiratory Division, University Hospital, KU Leuven, Belgium; 2Section of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA; 3Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden; 4Department of Research, Olmsted Medical Center, Rochester, MN, USABackground: Inhaled long-acting bronchodilators are the mainstay of pharmacotherapy for chronic obstructive pulmonary disease (COPD). Both the twice-daily long-acting 2-adrenoceptor agonists (LABAs) salmeterol and formoterol and the once-daily LABA indacaterol are indicated for use in COPD. This review examines current evidence for the safety of LABAs in COPD, focusing on their effect on exacerbations and deaths.Methods: We searched PubMed for placebo-controlled studies evaluating long-term (≥24 weeks) use of formoterol, salmeterol, or indacaterol in patients with stable COPD, published between January 1990 and September 2012. We summarized data relating to exacerbations and adverse events, particularly events related to COPD.Results: From 20 studies examined (8774 LABA-treated patients), there was no evidence of an association between LABA treatment and increased exacerbations, COPD-related adverse events, or deaths. Where analyzed as an efficacy outcome, LABA treatment was generally associated with significant or numerical reductions in COPD exacerbations compared with placebo. Incidences of COPD-related adverse events were similar for active and placebo treatments. The incidence of adverse events typically associated with the 2-agonist drug class such as skeletal muscle tremors and palpitations was low (often <1% of patients), and there were no reports of increased incidence of cardiac arrhythmias. The systemic effects of 2-adrenoceptor stimulation, such as high glucose and potassium levels, were considered minor.Conclusion: Current evidence from clinical studies of the safety and tolerability profile of LABAs supports their long-term use in COPD.Keywords: LABA, formoterol, salmeterol, indacaterol, bronchodilator, COPD
Welcome to Clinical and Translational Allergy
Jan Ltvall, Victoria Cardona
Clinical and Translational Allergy , 2011, DOI: 10.1186/2045-7022-1-1
Abstract: The aim of CTA is to provide a platform for the dissemination of original allergy-immunology research, exciting reviews as well as EAACI-developed position papers. Today, at the launch of the journal, one position paper and three exciting reviews are published, and several recently submitted original research papers are under consideration. Firstly, a very long-term effort in developing an EAACI position paper on diagnostic tools in rhinology is published in CTA [1]. This publication has taken several years to develop, and is the most comprehensive publication on the topic to date. Three review articles are discussing different interesting aspects and theories in allergy. One, by Woo and Bahna [2], discusses the different types of reactions that can be induced by shellfish ingestion, and the clinical misinterpretations that can evolve. Another review article, by Chaudhary and Marr [3], considers the impact that Aspergillus Fumigatus can have on respiratory disease. Lastly, an overview article by Mattila and colleagues [4], examines the role of respiratory and conjunctival epithelium in airway allergic disease. These fundamentally different topics not only contribute to the literature, but also illustrate the width of topics that CTA will publish. Beyond clinical experimental research and epidemiology, CTA will certainly also accept any studies using animal models of any allergic process, and immunological research related to allergic disease.The field of allergy concerns the most common group of diseases globally. Allergic diseases have grown rapidly in prevalence in the industrialized world, and are now rapidly growing in developing countries. It is considered that diseases of the immune system, such as allergic diseases, are best explained through a clear grasp of normal immune mechanisms and the ways by which these processes become dysfunctional. This is one of the explanations of selecting the name of the journal, including the key word "translational", since it
Comparing the effects of two inhaled glucocorticoids on allergen-induced bronchoconstriction and markers of systemic effects, a randomised cross-over double-blind study
Jan Ltvall, Mona Palmqvist, Peter Arvidsson
Clinical and Translational Allergy , 2011, DOI: 10.1186/2045-7022-1-12
Abstract: Twelve patients with documented early and late asthmatic responses (EAR and LAR) to inhaled allergen at a screening visit were randomized in a double-blind fashion to treatment with mometasone (200 μg × 2 or 400 μg × 2), budesonide (400 μg × 2) or placebo in a double-blind crossover fashion for a period of seven days. Challenge with the total allergen dose causing both an EAR and LAR was given on the last day of treatment taken in the morning. Lung function was assessed using FEV1, and systemic glucocorticoid activity was quantified using 24 h urinary cortisol.Mometasone and budesonide attenuate both EAR and LAR to allergen to a similar degree. No significant dose-related effects on the lung function parameters were observed. Both treatments reduced the relative amount of sputum eosinophils (%) after allergen. At the dose of 800 μg daily, mometasone reduced 24 h urinary cortisol by approximately 35%. Both drugs were well tolerated.Mometasone and budesonide are equieffective in reducing early and late asthmatic responses induced by inhaled allergen challenge. Mometasone 800 μg given for seven days partially affects the HPA axis.Asthmatic patients with allergies often develop early (EAR) and in some patients also a late asthmatic response (LAR) when a relevant allergen is inhaled [1-3]. Allergen exposure can also increase non-specific bronchial hyperresponsiveness to stimuli such as methacholine or histamine [4]. The LAR and the bronchial hyperresponsiveness are often associated with increase of eosinophils in the blood, and influx of eosinophils into the airways [3,5].The anti-inflammatory effects of inhaled glucocorticoids in asthma are well documented [1,6,7], shown by attenuation of the EAR, LAR and allergen-induced sputum eosinophils. Glucocorticoids are also more effective than anti-leukotrienes in attenuating the LARs and improve the bronchial hyperresponsiveness in mild asthmatic patients [8]. Mometasone and budesonide are corticosteroids that have been shown
Inhaled steroid/long-acting β2 agonist combination products provide 24 hours improvement in lung function in adult asthmatic patients
Jan Ltvall, Stephen Langley, Ashley Woodcock
Respiratory Research , 2006, DOI: 10.1186/1465-9921-7-110
Abstract: The purpose of these studies was to evaluate and compare the duration of bronchodilation of both combination products up to 24 hours after a single dose.Two randomised, double blind, placebo-controlled, crossover studies were performed. Study A was conducted in 33 asthmatic adults receiving 400–1200 mcg of budesonide or equivalent. Serial forced expiratory volume in one second (FEV1) was measured over 24 hours to determine the duration of effect of both SFC (50/100 mcg) and FBC (4.5/160 mcg). Study B was conducted in 75 asthmatic adults receiving 800–1200 mcg of budesonide or equivalent and comprised a 4 week run-in of 400 mcg bd Becotide? followed by 4 weeks treatment with either SFC 50/100 mcg bd or FBC 4.5/160 mcg bd taken in a cross-over manner. Serial 24-hour FEV1 was measured after the first dose and the last dose after each 4-weeks treatment period to determine the offset of action of each treatment.In study A, a single inhalation of SFC and FBC produced a sustained bronchodilation at 16 hours with an adjusted mean increase in FEV1 from pre-dose of 0.22 L (95% CI 0.19, 0.35 L) for SFC and 0.25 L (95% CI 0.21, 0.37 L) for FBC, which was significantly greater than placebo for both treatments (-0.05 L; p < 0.001). In study B, the slope of decline in FEV1 from 2–24 hours post dose was -16.0 ml/hr for SFC and -14.2 ml/hr for FBC. The weighted mean AUC over 24 hours was 0.21 Lxmin and 0.22 Lxmin and mean change from pre-dose FEV1 at 12 hours was 0.21 L for SFC and 0.20 L for FBC respectivelyBoth SFC and FBC produced a similar sustained bronchodilator effect which was prolonged beyond 12 hours post dose and was clearly measurable at 24 h.The benefit of adding a long-acting β2-agonist (LABA) to inhaled corticosteroid therapy (ICS) in the treatment of asthma is well-established [1-3]. Two such combinations, salmeterol xinafoate and fluticasone propionate (SFC, Seretide?) and formoterol and budesonide (FBC, Symbicort?) are widely used and have been shown to be effectiv
Reviewer acknowledgement 2012
Ltvall Jan,Panettieri Reynold A
Respiratory Research , 2013, DOI: 10.1186/1465-9921-14-12
Abstract: Contributing reviewers The editors of Respiratory Research would like to thank all of our reviewers who have contributed to the journal in Volume 13 (2012).
The Influence of Personality Traits on Reported Adherence to Medication in Individuals with Chronic Disease: An Epidemiological Study in West Sweden
Malin Axelsson,Eva Brink,Jesper Lundgren,Jan Ltvall
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0018241
Abstract: Limited research exists exploring the influence of personality on adherence behaviour. Since non-adherence is a major obstacle in treating prevalent chronic diseases the aim was to determine whether personality traits are related to reported adherence to medication in individuals with chronic disease.
Motivational foci and asthma medication tactics directed towards a functional day
Malin Axelsson, Jan Ltvall, Jesper Lundgren, Eva Brink
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-809
Abstract: This was a qualitative study; data collection and analysis procedures were conducted according to Grounded Theory methodology. Eighteen persons, aged 22 with asthma and regular asthma medication treatment, were interviewed.The emerged theoretical model illustrated that adherence to asthma medication was motivated by three foci, all directed towards a desired outcome in terms of a functional day as desired by the patient. A promotive focus was associated with the ambition to achieve a positive asthma outcome by being adherent either to the received prescription or to a self-adjusted dosage. A preventive focus was intended to ensure avoidance of a negative asthma outcome either by sticking to the prescription or by preventively overusing the medication. A permissive focus was associated with unstructured adherence behaviour in which medication intake was primarily triggered by asthma symptoms.As all participants had consciously adopted functioning medication tactics that directed them towards the desired goal of a functional day. In an effort to bridge the gap between a patient- and a medical adherence perspective, patients need support in defining their desired functionality and guidance in developing a person-based medication tactic.A novel trend direction in health care has been established in recent years. It is seen in the transition from disease-oriented care [1] to a more patient-centred approach [2], which is intended to result in a shared decision about treatment between the patient and the caregiver [1]. It has been argued that a patient-centred approach is crucial for encouraging adherence to treatment [3]. With reference to asthma medication treatment, several studies have reported figures showing lower adherence than prescribed [4-8]. From a medical perspective, deviating from a medication prescription could seem rather irrational, because it could constitute the missing link between a prescribed treatment and an efficacious outcome [9]. Inadequate adhere
Multi-symptom asthma is closely related to nasal blockage, rhinorrhea and symptoms of chronic rhinosinusitis-evidence from the West Sweden Asthma Study
Jan Ltvall, Linda Ekerljung, Bo Lundb?ck
Respiratory Research , 2010, DOI: 10.1186/1465-9921-11-163
Abstract: This study analyzed data on asthma symptoms, rhinitis, and chronic rhinosinusitis from the 2008 West Sweden Asthma Study, which is an epidemiologically based study using the OLIN and GA2LEN respiratory and allergy focused questionnaires.Multi-symptom asthma was present in 2.1% of the general population. Subjects with multi-symptom asthma had more than double the risk of having night-time awakenings caused by asthma compared with those with fewer asthma symptoms (P < 0.001). The prevalence of allergic rhinitis was similar in the fewer- and multi-symptom asthma groups, but nasal blockage and rhinorrhea were significantly increased in those with multi- versus fewer-symptom asthma (odds ratio 2.21; 95% confidence interval 1.64-2.97, versus 1.49; 1.10-2.02, respectively). Having any, or one to four symptoms of chronic rhinosinusitis significantly increased the risk of having multi- versus fewer-symptom asthma (P < 0.01).An epidemiologically identified group of individuals with multiple asthma symptoms harbour to greater extent those with signs of severe asthma. The degree of rhinitis, described by the presence of symptoms of nasal blockage or rhinorrhea, as well as the presence of any or several signs of chronic rhinosinusitis, significantly increases the risk of having multi-symptom asthma.Asthma is a common chronic disease with a prevalence of approximately 5-10% in different populations [1-6]. We have recently shown that the prevalence of asthma in West Sweden is approximately 8.5%, based on a large epidemiological survey [6]. Importantly, our data argue that there has been no further increase in the prevalence of asthma over the last 18 years in this part of Europe, and moreover that the overall degree of airway symptoms have decreased over this period [6]. However, in the current survey we identify a large population of individuals with multiple asthma symptoms, which amounts to approximately 25% of all asthmatics, and 2% of the general population [6].Asthma is asso
Repeated allergen exposure reduce early phase airway response and leukotriene release despite upregulation of 5-lipoxygenase pathways
Zhi-Hua Cui, Madeleine R?dinger, Margareta Sj?strand, Jan Ltvall
Clinical and Translational Allergy , 2012, DOI: 10.1186/2045-7022-2-7
Abstract: A trimellitic anhydride (TMA) sensitized guinea pig model was used to investigate the effects of low dose repeated allergen exposure on cholinergic airway responsiveness, early phase airway response and plasma exudation, as well as local airway production of mast cell derived cysteinyl leukotrienes and thromboxane B2 (TXB2) after allergen challenge.Repeated low dose allergen exposure increased cholinergic airway responsiveness. In contrast, early phase airway response and plasma exudation in response to a high-dose allergen challenge were strongly attenuated after repeated low dose allergen exposure. Inhibition of the airway response was unspecific to exposed allergen and independent of histamine receptor blocking. Furthermore, a significant reduction of cysteinyl leukotrienes and TXB2 was found in the airways of animals repeatedly exposed to a low dose allergen. However, in vitro stimulation of airway tissue from animals repeatedly exposed to a low dose allergen with arachidonic acid and calcium ionophore (A23187) induced production of cysteinyl leukotrienes and TXB2, suggesting enhanced activity of 5-lipoxygenase and cyclooxygenase pathways.The inhibition of the early phase airway response, cysteinyl leukotriene and TXB2 production after repeated allergen exposure may result from unresponsive effector cells.Early phase airway response to allergen and airway plasma exudation are predominantly mediated by inflammatory mediators including histamine, cysteinyl leukotrienes (cysLTs) and thromboxane A2 (TXA2) [1-3] released from mast cells in the response to allergen challenge [4-7]. In asthmatic patients, the concentrations of cysLTs and TXA2 are increased in plasma, urine and BAL fluid during asthma exacerbation and after experimental allergen challenges [8-11]. Thus, these mediators can induce both airway constriction and airway plasma exudation in several species [3,12-14]. Production of these mediators needs the substrate arachidonic acid and enzymes such as 5-lipo
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