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Unusual Cause of Recurrent Wheezing in an Infant (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_5741; He was managed as asthma with bronchodilators and nebulized budesonide with minimal improvement...He was started on pulse steroids, thrice weekly Azithromycin, and airway clearance with significant improvement in symptoms and frequency of exacerbations.DiscussionBO is a rare cause of chronic obstructive lung disease occurring after a severe insult to the lower airway tracts...PIBO has high morbidity and patients with recurrent exacerbation requiring frequent hospitalizations, so early diagnosis is crucial. In conclusion, pediatric patients who fail to respond to conventional treatment for recurrent wheezing warrant further evaluation for other etiologies.
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Predicting Pharmacokinetics from Three Marketed Dry Powder Inhalers (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_4985; In the present work, we link real-world emulative in vitro measurements of inhaler performance with numerical models of lung deposition and pharmacokinetics for budesonide (BUD) delivered from three marketed dry powder inhalers (DPIs) to illustrate how such a process can inform device/formulation design.MethodsThree DPIs with equivalent 200 µg BUD label claims were obtained for testing, including Pulmicort® Turbuhaler®, Budelin® Novolizer®, and Easyhaler® Budesonide...Pharmacokinetic profiles predicted here were in good agreement with in vivo data from the literature.ConclusionsCoupling emulative in vitro experimentation with the modeling of regional lung deposition, ASL, and drug disposition allows for predictions of systemic drug exposure. The present method may prove useful in drug development.
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Chronic Beta Agonist and Corticosteroid Exposures Cause Distinct and Overlapping Changes to Macrophage Immunometabolism (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_4914; Budesonide exposure increases mTOR activity, salvages LPS-induced glycolysis, and rescues bacterial killing despite suppressed HIF1α and CREB activity in the setting of prolonged beta agonist exposure. These studies indicate a complex metabolic crosstalk in immune effector cells that is impacted by common medications, and suggest that immunometabolism may be a consideration when prescribing these agents.
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Preventer Therapy for Mild Asthma: A Qualitative Study of Patients' Treatment Experiences (PENNSYLVANIA CONVENTION CENTER, Room 204 A-B (200 Level)) - Mar 15, 2020 - Abstract #ATS2020ATS_4710; Findings showed that, overall, patients perceived similar symptom frequency and lower treatment burden with as-needed budesonide-formoterol but had more concern about reliever effectiveness. Shared decision-making and good doctor-patient communication are recommended to increase patient inclusion in treatment choices for mild asthma.
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Microrna Correlates of Asthma Symptoms Changes During Daily Inhaled Corticosteroid Treatment (PENNSYLVANIA CONVENTION CENTER, Room 113 A (100 Level)) - Mar 15, 2020 - Abstract #ATS2020ATS_4283; Here we investigate asthma-related symptoms, within the framework of the Global Initiative for Asthma (GINA) symptom control score, following 2 months of daily treatment with inhaled budesonide (a corticosteroid) or placebo in the Childhood Asthma Management Program (CAMP).METHODS...These and related targets have been associated with lung function traits and the asthmatic airway, and may point to specific mechanisms underwriting asthma symptoms.Funding. NIH supported: R01 HL129935, R01 HL127332, R01 NR013391, R01 HL139496.
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CEBPD Influences the Airway Smooth Muscle Transcriptomic Response to TNFα and Budesonide Exposure (PENNSYLVANIA CONVENTION CENTER, Room 118 A (100 Level)) - Mar 15, 2020 - Abstract #ATS2020ATS_2642; Enriched ontological categories related to these genes included smooth muscle contraction and nitric oxide stimulated guanylate cyclase. CEBPD knockdown changed gene expression in response to glucocorticoid exposure: 42% (194/470) of genes that were differentially expressed in budesonide vs.
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Clinical, Journal: Clinical study of Chinese Medicine fumigation combined with "Zhuyuan Decoction" in the treatment of chronic rhinosinusitis (Pubmed Central) - Mar 12, 2020 In the western medicine group, the nasal spray hormone Budesonide was used, and the patients in the traditional Chinese medicine group were treated with the traditional Chinese medicine prescription"Zhuyuan soup"by combination with fumigation and oral administration...The above methods may be applied alone or in combination with Chinese and Western medicine. Further optimization and improvement of the combination of traditional Chinese and Western medicine in chronic sinusitis can help improve the clinical efficacy and satisfaction of patients, which deserves further study.
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Journal: Challenges in the use of corticosteroids in the management of autoimmune hepatitis. (Pubmed Central) - Mar 10, 2020 Recent evidence suggests that it is not always necessary to use high-dose steroids (>0.5 mg/kg/d) to attain remission; and side effects may also be minimised through more targeted therapy with the less systemically-absorbed corticosteroid, budesonide. The authors offer advice on the stratification of treatment for these patients and suggest changes to improve the services available for people with autoimmune hepatitis in the UK.
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EOSINOPHILIC ESOPHAGITIS WITH STRICTURE PRESENTING SHORTING AFTER INITIATION OF ORAL PEANUT IMMUNOTHERAPY () - Mar 8, 2020 - Abstract #CDDW2020CDDW_234; After discussion, the patient was started on oral viscous budesonide (OVB) 1mg PO BID.The patient was re-scoped 4 weeks into OVB therapy with complete resolution of the stricture with neither macroscopic nor histologic findings of EoE...Pediatric Gastroenterologists need to be increasingly aware that patients undergoing OIT are at an increasing risk of ‘developing’ or at least ‘unmasking’ EoE. More research is required to evaluate whether EoE screening, by symptom questionnaire or endoscopy is warranted prior to beginning OIT, and whether OIT is truly needed.Upper GI endoscopy showing signs of EoE and an esophageal stricture Funding Agencies CAG
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A CASE OF ADULT AUTOIMMUNE ENTEROPATHY AND PRIMARY SCLEROSING CHOLANGITIS () - Mar 8, 2020 - Abstract #CDDW2020CDDW_190; He was given budesonide with moderate improvement...Ulcerative colitis (UC) was suspected, and he was given oral 5-ASA and prednisone, with subsequent switch to vedolizumab...After dose escalation of infliximab, and further IV steroids and TPN, he was started on a trial of ustekinumab...This is the first reported case of ustekinumab being tried to control symptoms. Funding Agencies None
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Journal: Mucoadhesive Budesonide Formulation for the Treatment of Eosinophilic Esophagitis. (Pubmed Central) - Mar 4, 2020 The obtained results demonstrated that gums allowed a prolonged residence time. However, the concentration of the mucoadhesive polymer has to be rationalized appropriately to permit the syringeability of the formulation and, therefore, easy dosing by the patient/caregiver.
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Clinical, Journal: Exhaled nitric oxide predicts loss of asthma control in children after inhaled corticosteroids withdrawal. (Pubmed Central) - Mar 2, 2020 However, the concentration of the mucoadhesive polymer has to be rationalized appropriately to permit the syringeability of the formulation and, therefore, easy dosing by the patient/caregiver. Our findings suggest that eNO predicts loss of asthma control and may contribute for clinical follow up decisions during childhood asthma after ICS withdrawal.
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Retrospective data, Journal: Nebulized step-down budesonide vs. fluticasone in infantile asthma: A retrospective cohort study. (Pubmed Central) - Mar 1, 2020 The budesonide treatment group had more post-treatment symptom-free days than the fluticasone treatment group (165.56±23.15 vs. 112.21±9.45 days; P<0.0001). The step-down approach of budesonide nebulization may better support the functional and clinical outcomes with an increased number of post-treatment symptom-free days compared with fluticasone in infantile asthma (level of evidence, 3).
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Budesonide Oral Suspension Improves Histologic Features In Patients With Eosinophilic Esophagitis: Results From A Phase 3, Randomized, Double-blind, Placebo-Controlled Trial (Convention Center, 400 Level, Terrace Ballroom II) - Mar 1, 2020 - Abstract #AAAAI2020AAAAI_1659; P3 This phase 3, double-blind, multicenter, placebo-controlled trial (SHP621-301; NCT02605837) randomized patients aged 11–55 years with EoE and dysphagia to receive BOS (2.0 mg BID) or placebo for 12 weeks. Twelve weeks of BOS therapy leads to significant improvements in peak eosinophil counts and EoE HSS scores, a more robust and validated histologic assessment.
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Spirometry In Classification and Management of Childhood Asthma (Convention Center, 200 Level, Hall D) - Mar 1, 2020 - Abstract #AAAAI2020AAAAI_1458; FEV1 and FEF25-75 is important tool for monitoring and assessing treatment response in asthma. Spirometry based treatment implementation leads to better asthma control, optimum dose adjustment.
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Journal: Impact of drug particle shape on permeability and cellular uptake in the lung. (Pubmed Central) - Feb 28, 2020 Therefore, highly water soluble salbutamol sulphate and poorly water soluble budesonide were compared regarding dissolution, permeation and preferential uptake by epithelial cells compared to macrophages after jet milling and spray drying...Preferential uptake by macrophages was higher for spray dried particles, suggesting that processing may improve targeted delivery. The comparison between murine cell lines and human monocyte derived macrophages primary cells showed similar trends in rate and preference of particle uptake.
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A curious case of collagenous colitis (Room SANCY) - Feb 24, 2020 - Abstract #BWG2020BWG_49; In mild disease, antidiarrheal medication may suffice. There is an important role for the use of budesonide in the induction therapy, and if necessary also in the maintenance therapy (3).
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Clinical, Journal, HEOR: A budget impact analysis of budesonide/formoterol in patients with mild asthma in Egypt. (Pubmed Central) - Feb 24, 2020 Budesonide/formoterol in mild asthma instead of salbutamol produces better patient outcomes, decreases total costs with increases in drug cost offset by reductions in non-drug costs due to fewer exacerbations. Budesonide/formoterol is a budget saving option for guideline-directed treatment, from the economic perspective of the payer and the health perspective of the patient.
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Preclinical, Journal: Ternary nanocomposite carriers based on organic clay-lipid vesicles as an effective colon-targeted drug delivery system: preparation and in vitro/in vivo characterization. (Pubmed Central) - Feb 23, 2020 Budesonide (Bud), an anti-inflammatory drug was chosen as a model drug and encapsulated into three different formulations: liposome (Bud-Lip), aminoclay-coated liposome (AC-Bud-Lip), and Eudragit S100-aminoclay double coated liposome (EAC-Bud-Lip)...Furthermore, a bio-distribution study in mice demonstrated that Eudragit S100-aminoclay dual coating led to a higher colonic distribution with a longer residence time, which correlated well with the delayed systemic drug exposure in rats. Taken together, the present study suggests that the ternary nanocomposite carrier consisting of Eudragit S100, aminoclay, and lipid vesicle might be useful as an effective colon-targeted drug delivery system.
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Preclinical, Journal: Effect of Huai Qi Huang on asthma in rats and the mechanism research (Pubmed Central) - Feb 21, 2020 Taken together, the present study suggests that the ternary nanocomposite carrier consisting of Eudragit S100, aminoclay, and lipid vesicle might be useful as an effective colon-targeted drug delivery system. HQH can reduce the airway inflammation of asthmatic rats and alleviate the symptoms of asthma, possibly by regulating the levels of related cytokines and Th1/Th2 ratio through the T-bet/GATA-3 pathway.
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Journal: Airway Smooth Muscle-Specific Transcriptomic Signatures of Glucocorticoid Exposure. (Pubmed Central) - Feb 20, 2020 In cells derived from nine donors with fatal asthma and eight donors without asthma, RNA sequencing was used to measure ASM transcriptome changes after exposure to budesonide (100 nM 24 h) or control vehicle (DMSO)...Comparison of glucocorticoid-induced changes of the non-asthma ASM transcriptome to that of 6 other cell types showed that ASM has a distinct glucocorticoid response signature that is also present in fatal asthma donor-derived ASM cells. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial License 4.0 (http://creativecommons.org/licenses/by-nc/4.0/.
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