Medscape InDiscussion: Moderate to Severe Asthma Medscape

Drs Wechsler, Bacharier, and Phipatanakul discuss moderate to severe childhood asthma.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969691). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources:
Precision Interventions for Severe and/or Exacerbation-Prone Asthma (PrecISE) Network https://preciseasthma.org/preciseweb/
Inhaled Corticosteroid Therapy in Children: An Assessment of the Potential for Side Effects https://www.ncbi.nlm.nih.gov/pmc/articles/PMC475319/pdf/thorax00304-0005.pdf
Inhaled Corticosteroids in Children: Effects on Bone Mineral Density and Growth https://linkinghub.elsevier.com/retrieve/pii/S2213-2600(14)70024-4
Aerochamber https://aerochamber.com/
Pulmonary Function Testing https://emedicine.medscape.com/article/303239-overview
Using Impulse Oscillometry in Clinical Practice https://www.medscape.com/viewarticle/862265
Global Initiative for Asthma Guidelines https://ginasthma.org/
National Asthma Education Prevention Program Guidelines https://www.nhlbi.nih.gov/health-topics/asthma-management-guidelines-2020-updates
Omalizumab Prescribing Information https://www.gene.com/download/pdf/xolair_prescribing.pdf
Mepolizumab Prescribing Information https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Nucala/pdf/NUCALA-PI-PIL-IFU-COMBINED.PDF
Benralizumab Prescribing Information https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/3647bed4-ce91-4fe7-9bc5-32dbee73f80a/3647bed4-ce91-4fe7-9bc5-32dbee73f80a_viewable_rendition__v.pdf
Dupilumab in Children With Uncontrolled Moderate-to-Severe Asthma https://www.nejm.org/doi/10.1056/NEJMoa2106567
Dupilumab Prescribing Information https://www.regeneron.com/downloads/dupixent_fpi.pdf
Tezepelumab Prescribing Information https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/e306dc06-d580-4457-b15f-9f28545ad63a/e306dc06-d580-4457-b15f-9f28545ad63a_viewable_rendition__v.pdf
Preventing Asthma in High Risk Kids (PARK) With Omalizumab: Design, Rationale, Methods, Lessons Learned and Adaptation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887056/

What are the social and environmental determinants of asthma? Drs Wechsler, Cardet, and Kraft have a wide-ranging discussion about the science, publications, and their experience as clinicians.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969690). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Asthma https://emedicine.medscape.com/article/296301-overview
The School Inner-City Asthma Intervention Study: Design, Rationale, Methods, and Lessons Learned https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5557648/
2020 Focused Updates to the Asthma Management Guidelines: A Report From the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group https://www.jacionline.org/article/S0091-6749(20)31404-4/fulltext
Allergic and Environmental Asthma https://emedicine.medscape.com/article/137501-overview
Comparing Asthma Treatments: A Study Focusing on African-American, Hispanic, and Latino Adults -- The PREPARE Study for PeRson EmPowered Asthma Relief https://www.pcori.org/research-results/2016/comparing-asthma-treatments-study-focusing-african-american-hispanic-and-latino-adults-prepare-study-person-empowered-asthma-relief
Percentage of People With Asthma Who Smoke https://www.cdc.gov/asthma/asthma_stats/people_who_smoke.htm
Associations Between Historical Residential Redlining and Current Age-Adjusted Rates of Emergency Department Visits Due to Asthma Across Eight Cities in California: An Ecological Study https://linkinghub.elsevier.com/retrieve/pii/S2542-5196(19)30241-4
Socioeconomic Status and Asthma Control in African American Youth in SAGE II https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257058/
Combatting the Health Consequences of Poverty and Stress https://www.hsph.harvard.edu/news/magazine/fall09wrights/
Designing Clinical Trials to Address the Needs of Childhood and Adult Asthma: The National Heart, Lung, and Blood Institute's AsthmaNet https://www.jacionline.org/article/S0091-6749(13)01638-2/fulltext
AsthmaNet Best African American Response to Asthma Drugs (BARD) https://biolincc.nhlbi.nih.gov/studies/asthmanet_bard/
Smoking Affects Response to Inhaled Corticosteroids or Leukotriene Receptor Antagonists in Asthma https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1899291/
Primary Adherence to Controller Medications for Asthma Is Poor https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342835/
Asthma and African Americans https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid

Drs Wechsler and Jackson discuss their partnerships with nurses, asthma educators, psychologists, speech therapists, and other specialists when diagnosing and treating patients with severe asthma.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969689). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Asthma https://emedicine.medscape.com/article/296301-overview
Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma https://jamanetwork.com/journals/jama/fullarticle/2598265
Churg-Strauss Disease https://emedicine.medscape.com/article/1178795-overview
Aspergillosis https://emedicine.medscape.com/article/296052-overview
Chronic Obstructive Pulmonary Disease (COPD) https://emedicine.medscape.com/article/297664-overview
Pulmonary Function Testing https://emedicine.medscape.com/article/303239-overview#a9
Esophageal Manometry https://emedicine.medscape.com/article/1891791-overview
Obstructive Sleep Apnea (OSA) https://emedicine.medscape.com/article/295807-overview
Granulomatosis With Polyangiitis (GPA, formerly Wegener Granulomatosis) https://emedicine.medscape.com/article/332622-overview
Anti-IL–5 Therapy in Patients With Severe Eosinophilic Asthma https://www.medscape.com/viewarticle/900560
Strongyloidiasis Infection FAQs https://www.cdc.gov/parasites/strongyloides/gen_info/faqs.html

Drs Wechsler and Akuthota discuss novel therapies in severe asthma treatment, including precision medicine, biomarkers, and new biologic agents.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969688). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Omalizumab https://reference.medscape.com/drug/xolair-omalizumab-343444
Mepolizumab https://reference.medscape.com/drug/nucala-mepolizumab-1000034
Bronchial Thermoplasty https://emedicine.medscape.com/article/2094272-overview
Eosinophilic Asthma and Sputum Eosinophilia https://www.webmd.com/asthma/eosinophilic-asthma-defined
Role of T2 Inflammation Biomarkers in Severe Asthma https://reference.medscape.com/medline/abstract/26574724
Cluster Analysis of Inflammatory Biomarker Expression in the International Severe Asthma Registry https://linkinghub.elsevier.com/retrieve/pii/S2213-2198(21)00311-1
Dupilumab Prescribing Information https://www.regeneron.com/downloads/dupixent_fpi.pdf
FDA Approves Cinqair to Treat Severe Asthma https://www.fda.gov/news-events/press-announcements/fda-approves-cinqair-treat-severe-asthma
Benralizumab https://reference.medscape.com/drug/fasenra-benralizumab-1000213
Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss Syndrome) https://emedicine.medscape.com/article/333492-overview
Hypereosinophilic Syndrome https://emedicine.medscape.com/article/202030-overview
Anti-IL-5 Therapy in Patients With Severe Eosinophilic Asthma – Clinical Efficacy and Possible Criteria for Treatment Response https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-018-0689-2
Mepolizumab for Severe Eosinophilic Asthma (DREAM): A Multicentre, Double-blind, Placebo-Controlled Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60988-X/fulltext
Allergic and Environmental Asthma https://emedicine.medscape.com/article/137501-overview
FDA Approves Maintenance Treatment for Severe Asthma https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-maintenance-treatment-severe-asthma
Tezepelumab in Adults and Adolescents With Severe, Uncontrolled Asthma https://www.nejm.org/doi/full/10.1056/NEJMoa2034975
Efficacy and Safety of Itepekimab in Patients With Moderate-to-Severe Asthma https://www.nejm.org/doi/10.1056/NEJMoa2024257
The Targeted Eosinophil-Lowering Effects of Dexpramipexole in Clinical Studies https://www.sciencedirect.com/science/article/abs/pii/S107997961630328X
CRTH2 Antagonists in Asthma: Current Perspectives https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733922
Precision Interventions for Severe and/or Exacerbation-Prone Asthma Network (PrecISE) https://preciseasthma.org/preciseweb/
A Study of GSK3511294 (Depemokimab) Compared With Mepolizumab or Benralizumab in Participants With Severe Asthma With an Eosinophilic Phenotype https://clinicaltrials.gov/ct2/show/NCT04718389

Drs Michael Wechsler and Mario Castro discuss precision medicine for moderate to severe asthma and the past, present, and future of clinical trials.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969686). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Precision Interventions for Severe and/or Exacerbation-Prone Asthma Network (PrecISE) Network https://preciseasthma.org/preciseweb/
Asthma https://emedicine.medscape.com/article/296301-overview
The Many 'Buckets' of Severe Asthma: Moving Toward Personalized Managements https://www.jaci-inpractice.org/article/S2213-2198(17)30379-3/pdf
What is Fractional Exhaled Nitric Oxide (FeNO) in Pulmonary Function Testing?https://www.medscape.com/answers/303239-77907/what-is-fractional-exhaled-nitric-oxide-feno-in-pulmonary-function-testing
Periostin is a Systemic Biomarker of Eosinophilic Airway Inflammation in Asthmatic Patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3626285/
Asthma Workup Approach Considerations https://emedicine.medscape.com/article/296301-workup
PrecISE: Precision Medicine in Severe Asthma: An Adaptive Platform Trial With Biomarker Ascertainment https://www.jacionline.org/article/S0091-6749(21)00352-3/fulltext
KIT Inhibition by Imatinib in Patients with Severe Refractory Asthma https://www.nejm.org/doi/full/10.1056/NEJMoa1613125
PrecISE (Precision Interventions for Severe and/or Exacerbation-Prone Asthma) Network Study https://clinicaltrials.gov/ct2/show/NCT04129931
Designing Clinical Trials to Address the Needs Of Childhood And Adult Asthma: The National Heart, Lung, and Blood Institute's AsthmaNet https://www.jacionline.org/article/S0091-6749(13)01638-2/pdf
Severe Asthma Research Program http://www.severeasthma.org/
Airways Clinical Research Centers https://www.lung.org/research/airways-clinical-research-centers
Lung Health Cohort Study: Making History https://www.lung.org/research/lung-health-cohort-study

Listen in as Drs Michael Wechsler and Geoffrey Chupp discuss real-world examples of how they use precision medicine in their own clinics to treat moderate to severe asthma.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969685). The topics and discussions are planned, produced, and reviewed independently of the advertiser. This podcast is intended only for US healthcare professionals.
Resources
Theophylline (Rx) https://reference.medscape.com/drug/theo-24-theochron-theophylline-343447
Merged Affinity Network Association Clustering: Joint Multi-Omic/Clinical Clustering to Identify Disease Endotypes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195153/
How Is the Type 2 (T2 High) Subtype of Asthma? https://www.medscape.com/answers/137501-198413/how-is-the-type-2-t2-high-subtype-of-asthma
Targeting Interleukins to Treat Severe Asthma https://www.medscape.com/viewarticle/771133_4
Asthma Workup https://emedicine.medscape.com/article/296301-workup
ImmunoCAP for IgE-Mediated Hyperreactivity Analysis https://www.bioagilytix.com/immunocap-platform-for-immunogenicity-testing/
Bronchiectasis https://emedicine.medscape.com/article/296961-overview
T-Helper Type 2–Driven Inflammation Defines Major Subphenotypes of Asthma https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742757/
Efficacy and Safety of Tralokinumab in Patients With Severe Uncontrolled Asthma: A Randomised, Double-blind, Placebo-Controlled, Phase 2b Trial https://linkinghub.elsevier.com/retrieve/pii/S2213-2600(15)00197-6
Mepolizumab for Prednisone-Dependent Asthma With Sputum Eosinophilia https://www.nejm.org/doi/full/10.1056/nejmoa0805435
Mepolizumab and Exacerbations of Refractory Eosinophilic Asthma https://www.nejm.org/doi/full/10.1056/nejmoa0808991
Effect of Azithromycin on Asthma Exacerbations and Quality of Life in Adults With Persistent Uncontrolled Asthma (AMAZES): A Randomised, Double-blind, Placebo-Controlled Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31281-3/fulltext
A Randomized, Open-Label, Pragmatic Study to Assess Reliever-Triggered Inhaled Corticosteroid in African American/Black and Hispanic/Latinx Adults With Asthma: Design and Methods of the PREPARE Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130188/
PrecISE (Precision Interventions for Severe and/or Exacerbation-Prone Asthma) Network Study https://clinicaltrials.gov/ct2/show/NCT04129931