Advances in pediatric asthma in 2012: moving toward asthma preventionStanley J Szefler
Division of Pediatric Clinical Pharmacology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA
J Allergy Clin Immunol 131:36-46. 2013
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- New insights into asthma pathogenesis and treatment
Stanley J Szefler
Helen Wohlberg and Herman Lambert Chair in Pharmacokinetics, Divisions of Pediatric Clinical Pharmacology and Allergy and Immunology, Department of Pediatrics, National Jewish Health, University of Colorado School of Medicine, Denver, CO 80206, USA
Curr Opin Immunol 23:801-7. 2011
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- Key observations from the NHLBI Asthma Clinical Research Network
Stanley J Szefler
Department of Pediatrics, National Jewish Health and University of Colorado Denver, School of Medicine, Denver, Colorado 80206, USA
Thorax 67:450-5. 2012
..This review highlights the major research observations from the ACRN that have impacted the current management of asthma...
- Advances in pediatric asthma in 2011: moving forward
Stanley J Szefler
Division of Pediatric Clinical Pharmacology and Allergy and Immunology, Department of Pediatrics, National Jewish Health, University of Colorado School of Medicine, Denver, Colo 80206, USA
J Allergy Clin Immunol 129:60-8. 2012
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Lessons learned from variation in response to therapy in clinical trialsStanley J Szefler
Division of Pediatric Clinical Pharmacology, Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA
J Allergy Clin Immunol 125:285-92; quiz 293-4. 2010
..This information now assists the clinician in personalizing asthma treatment at the time of initiating long-term control therapy...
- Achieving asthma control in the inner city: do the National Institutes of Health Asthma Guidelines really work?
Stanley J Szefler
Divisions of Pediatric Clinical Pharmacology and Allergy and Immunology, Department of Pediatrics, National Jewish Health, University of Colorado Denver School of Medicine, Denver, Colo, USA
J Allergy Clin Immunol 125:521-6; quiz 527-8. 2010
..Based on the observations from the Asthma Control Evaluation study, we were impressed that a systematic guidelines-based approach improved asthma control significantly over the course of the 1-year treatment period...
- Advances in pediatric asthma in 2010: addressing the major issues
Stanley J Szefler
Division of Pediatric Clinical Pharmacology, Department of Pediatrics, National Jewish Health, Denver, Colo 80206, USA
J Allergy Clin Immunol 127:102-15. 2011
..Perhaps new directions in personalized medicine and improved health care access and communication will help maintain steady progress in alleviating the burden of this disease in children, especially young children...
- Advancing asthma care: the glass is only half full!
Stanley J Szefler
Department of Pediatrics, National Jewish Health, University of Colorado School of Medicine, Denver, CO 80206, USA
J Allergy Clin Immunol 128:485-94. 2011
..These advances should prompt the evolution of new strategies and new treatments to further reduce disease burden. It now becomes imperative to continue a focus on ways to further reduce the burden of asthma and prevent its onset...
- Advances in pediatric asthma in 2009: gaining control of childhood asthma
Stanley J Szefler
Divisions of Pediatric Clinical Pharmacology and Allergy and Immunology, Department of Pediatrics, National Jewish Health, 1400 Jackson St, Rm J304, Molly Blank Building, Denver, CO 80206, USA
J Allergy Clin Immunol 125:69-78. 2010
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- Episodic use of an inhaled corticosteroid or leukotriene receptor antagonist in preschool children with moderate-to-severe intermittent wheezing
Leonard B Bacharier
Department of Pediatrics, Washington University and St Louis Children s Hospital, St Louis, MO 63110, USA
J Allergy Clin Immunol 122:1127-1135.e8. 2008
..Acute wheezing illnesses in preschoolers require better management strategies to reduce morbidity...
- Factors associated with asthma exacerbations during a long-term clinical trial of controller medications in children
Ronina A Covar
Department of Pediatrics, National Jewish Medical and Research Center and University of Colorado Health Sciences Center, Denver, CO 80206, USA
J Allergy Clin Immunol 122:741-747.e4. 2008
..Asthma exacerbations are a common cause of critical illness in children...
Response profiles to fluticasone and montelukast in mild-to-moderate persistent childhood asthmaRobert S Zeiger
Department of Pediatrics, University of California San Diego, San Diego, CA 92111, USA
J Allergy Clin Immunol 117:45-52. 2006
..Outcome data are needed to base recommendations for controller asthma medication use in school-aged children...
- Characterization of within-subject responses to fluticasone and montelukast in childhood asthma
Stanley J Szefler
Department of Pediatrics, National Jewish Medical and Research Medical Center and University of Colorado Health Sciences Center, Denver, CO 80206, USA
J Allergy Clin Immunol 115:233-42. 2005
..Responses to inhaled corticosteroids (ICSs) and leukotriene receptor antagonists (LTRAs) vary among asthmatic patients...
- Azithromycin or montelukast as inhaled corticosteroid-sparing agents in moderate-to-severe childhood asthma study
Robert C Strunk
Department of Pediatrics, Washington University and St Louis Children s Hospital, St Louis, MO 63110, USA
J Allergy Clin Immunol 122:1138-1144.e4. 2008
..Clinical trials in children with moderate-to-severe persistent asthma are limited...
- Impulse oscillometry versus spirometry in a long-term study of controller therapy for pediatric asthma
Gary L Larsen
Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA
J Allergy Clin Immunol 123:861-7.e1. 2009
..Determination of the benefits and limitations of specific physiologic tests has not been well studied in long-term clinical pediatric trials...
- Signs and symptoms that precede wheezing in children with a pattern of moderate-to-severe intermittent wheezing
Katherine Rivera-Spoljaric
Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110 1077, USA
J Pediatr 154:877-81.e4. 2009
..To examine parent-reported signs and symptoms as antecedents of wheezing in preschool children with previous moderate to severe wheezing episodes, and to determine the predictive capacity of these symptom patterns for wheezing events...
- Safety and application of induced sputum analysis in childhood asthma
Ronina A Covar
Ira J and Jacqueline Neimark Laboratory of Clinical Pharmacology, National Jewish Medical and Research Center, Denver, CO 80206, USA
J Allergy Clin Immunol 114:575-82. 2004
..The Childhood Asthma Management Program (CAMP) study was designed to evaluate the long-term effects of budesonide and nedocromil compared with placebo in children with mild to moderate asthma across 8 centers...
- Urinary leukotriene E4/exhaled nitric oxide ratio and montelukast response in childhood asthma
Nathan Rabinovitch
Department of Pediatrics, National Jewish Health and the University of Colorado Denver School of Medicine, Denver, Colo 80206, USA
J Allergy Clin Immunol 126:545-51.e1-4. 2010
..A subset of children with asthma respond better to leukotriene receptor antagonists than to inhaled corticosteroids. Information is needed to identify children with these preferential responses...
- Asthma outcomes: biomarkers
Stanley J Szefler
National Jewish Health, Denver, Colorado, USA
J Allergy Clin Immunol 129:S9-23. 2012
..Measurement of biomarkers has been incorporated within clinical research studies of asthma to characterize the population and associate the disease with environmental and therapeutic effects...
- Growth of preschool children at high risk for asthma 2 years after discontinuation of fluticasone
Theresa W Guilbert
Department of Pediatrics, University of Wisconsin Madison, Wis 53716, USA
J Allergy Clin Immunol 128:956-63.e1-7. 2011
..The effect on linear growth of daily long-term inhaled corticosteroid therapy in preschool-aged children with recurrent wheezing is controversial...
- Progression of asthma measured by lung function in the childhood asthma management program
Ronina A Covar
Ira J. and Jacqueline Neimark Laboratory of Clinical Pharmacology, National Jewish Medical and Research Center, Denver, Colorado 80206, USA
Am J Respir Crit Care Med 170:234-41. 2004
..The course and mechanisms of lung function reduction or slow lung growth velocity in children with asthma must be defined...
- Systemic effect comparisons of six inhaled corticosteroid preparations
Richard J Martin
National Jewish Medical and Research Center, Denver, Colorado 80206, USA
Am J Respir Crit Care Med 165:1377-83. 2002
..This study represents the first step in evaluation of ICS efficacy based on equisystemic (cortisol suppression) effects of a given ICS, rather than doses judged arbitrarily to be comparable on a microgram basis...
- Long-term budesonide or nedocromil treatment, once discontinued, does not alter the course of mild to moderate asthma in children and adolescents
Robert C Strunk
Department of Pediatrics, Washington University School of Medicine, St Louis Children s Hospital, St Louis, MO 63110, USA
J Pediatr 154:682-7. 2009
..To determine whether long-term, continuous use of inhaled anti-inflammatory medications affects asthma outcomes in children with mild to moderate asthma after use is discontinued...
- The Predicting Response to Inhaled Corticosteroid Efficacy (PRICE) trial
Richard J Martin
National Jewish Medical and Research Center, Denver, CO 80206, USA
J Allergy Clin Immunol 119:73-80. 2007
..Although guidelines recommend anti-inflammatory therapy for persistent asthma, recent studies suggest that 25% to 35% of patients with asthma may not improve lung function with inhaled corticosteroids...
- Most nocturnal asthma symptoms occur outside of exacerbations and associate with morbidity
Caroline C Horner
Department of Pediatrics, Washington University School of Medicine and St Louis Children s Hospital, St Louis, MO 63110, USA
J Allergy Clin Immunol 128:977-82.e1-2. 2011
..Although nocturnal awakenings help categorize asthma severity and control, their clinical significance has not been thoroughly studied...
- Airway tissue mast cells in persistent asthma: predictor of treatment failure when patients discontinue inhaled corticosteroids
Monica Kraft
National Jewish Medical and Research Center, Denver, CO 80206, USA
Chest 124:42-50. 2003
..To determine if persistent airway tissue mast cells are associated with treatment failure when patients discontinue inhaled corticosteroids (ICS)...
- Management of asthma based on exhaled nitric oxide in addition to guideline-based treatment for inner-city adolescents and young adults: a randomised controlled trial
Stanley J Szefler
National Jewish Health, Denver, CO, USA
Lancet 372:1065-72. 2008
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- Predictors of remitting, periodic, and persistent childhood asthma
Ronina A Covar
National Jewish Health, Denver, CO 80206, USA
J Allergy Clin Immunol 125:359-366.e3. 2010
..The course of mild to moderate persistent asthma in children is not clearly established...
- Patient characteristics associated with improved outcomes with use of an inhaled corticosteroid in preschool children at risk for asthma
Leonard B Bacharier
Department of Pediatrics, Washington University School of Medicine and St Louis Children s Hospital, St Louis, MO 63017, USA
J Allergy Clin Immunol 123:1077-82, 1082.e1-5. 2009
..However, determination of baseline features associated with ICS responsiveness may identify children most likely to benefit from ICS treatment...
- Effect of montelukast on peripheral airflow obstruction in children with asthma
Joseph D Spahn
Division of Clinical Pharmacology, Department of Pediatrics, National Jewish Medical and Research Center, University of Colorado Health Sciences Center, Denver 80206, USA
Ann Allergy Asthma Immunol 96:541-9. 2006
..Montelukast is a widely used controller agent in childhood asthma. It is modestly effective in reducing symptoms, decreasing the need for rescue albuterol, and improving forced expiratory volume in 1 second (FEV1)...
- Mild to moderate asthma affects lung growth in children and adolescents
Robert C Strunk
Division of Allergy and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110, USA
J Allergy Clin Immunol 118:1040-7. 2006
..The effect of childhood asthma on lung growth is unclear...
- Minimizing attrition in a long-term clinical trial of pediatric asthma
Bruce G Bender
Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA
Ann Allergy Asthma Immunol 91:168-76. 2003
..Despite increased attention focused on the need to prevent patient attrition in long-term clinical trials, high dropout rates have threatened the success of numerous studies...
- Relations between exhaled nitric oxide and measures of disease activity among children with mild-to-moderate asthma
Ronina A Covar
Ira J and Jacqueline Neimark Laboratory of Clinical Pharmacology and the Division of Allergy Clinical Immunology, Department of Pediatrics, Denver, Colorado, USA
J Pediatr 142:469-75. 2003
..Exhaled nitric oxide (FE(NO)) was evaluated in children with asthma after 4 to 6 years of treatment with budesonide, nedocromil, or albuterol as needed...
- Progression of asthma in childhood
Ronina A Covar
Neimark Laboratory of Clinical Pharmacology, National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206, USA
J Allergy Clin Immunol 115:700-7. 2005
..Additional efforts are necessary to understand the mechanisms involved in this phenomenon and to discover specific modalities of treatment to target the structural changes of airway remodeling...
- A trial of clarithromycin for the treatment of suboptimally controlled asthma
E Rand Sutherland
National Jewish Health, Denver, CO 80206, USA
J Allergy Clin Immunol 126:747-53. 2010
..PCR studies have demonstrated evidence of Mycoplasma pneumoniae and Chlamydophila pneumoniae in the lower airways of patients with asthma...
- Comparative study of budesonide inhalation suspension and montelukast in young children with mild persistent asthma
Stanley J Szefler
Division of Pediatric Clinical Pharmacology and Allergy Immunology, National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206, USA
J Allergy Clin Immunol 120:1043-50. 2007
..Budesonide inhalation suspension and the leukotriene receptor antagonist montelukast have demonstrated efficacy in children with mild persistent asthma, but comparative long-term studies in young children are needed...
- Significant variability in response to inhaled corticosteroids for persistent asthma
Stanley J Szefler
National Jewish Medical and Research Center, Department of Pediatrics, Denver, CO 80206, USA
J Allergy Clin Immunol 109:410-8. 2002
..It is possible that higher doses of ICSs are necessary to manage more severe patients or to achieve goals of therapy not evaluated in this study, such as prevention of asthma exacerbations...
- Fluticasone propionate plasma concentration and systemic effect: effect of delivery device and duration of administration
Glenn J Whelan
Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA
J Allergy Clin Immunol 116:525-30. 2005
..Dry powder inhalers (DPIs) generate a larger particle size compared with metered-dose inhalers (MDIs), which affects pulmonary deposition, bioavailability, and subsequent systemic effects of fluticasone propionate (fluticasone)...
- A comparison of the clinical characteristics of children and adults with severe asthma
Henry A Jenkins
Division of Clinical Pharmacology, The Ira J. and Jacqueline Neimark Laboratory of Clinical Pharmacology in Pediatrics, National Jewish Medical and Research Center and, University of Colorado Health Sciences Center, Denver, CO 80206, USA
Chest 124:1318-24. 2003
..Finally, disease severity in children and adults whose onset of asthma occurred in childhood was related to disease duration, but not in patients with onset of asthma in adulthood...
- Current concepts in asthma treatment in children
Stanley J Szefler
Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA
Curr Opin Pediatr 16:299-304. 2004
..The purpose of this review is to present current literature related to the management of childhood asthma...
- Switching from conventional to extrafine aerosol beclomethasone dipropionate therapy in children: a 6-month, open- label, randomized trial
Stanley J Szefler
National Jewish Medical and Research Center, Denver, CO 80206, USA
J Allergy Clin Immunol 110:45-50. 2002
..CONCLUSIONS: This study confirms that asthma control can be well maintained in children when switching from CFC-BDP+S to an HFA-BDP Autohaler at doses as low as 100 to 200 microg/d...
- Correlates of household smoking bans in low-income families of children with and without asthma
Frederick S Wamboldt
Division of Psychosocial Medicine, National Jewish Medical and Research Center, Denver, CO, USA
Fam Process 47:81-94. 2008
..Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures...
- Steroid therapy for asthma in children
Joseph D Spahn
Ira J and Jacqueline Neimark Laboratory of Clinical Pharmacology in Pediatrics, Division of Pediatric Clinical Pharmacology, Department of Pediatrics, National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206, USA
Curr Opin Pediatr 19:300-5. 2007
..To highlight studies that have contributed significantly to our current knowledge of inhaled glucocorticoids in childhood asthma...
- The Aerocrine exhaled nitric oxide monitoring system NIOX is cleared by the US Food and Drug Administration for monitoring therapy in asthma
Philip E Silkoff
National Jewish Medical and Research Center, Denver, Colorado, USA
J Allergy Clin Immunol 114:1241-56. 2004
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- Safety profile of budesonide inhalation suspension in the pediatric population: worldwide experience
Stanley J Szefler
National Jewish Medical and Research Center, Denver, Colorado 80206, USA
Ann Allergy Asthma Immunol 93:83-90. 2004
..To review the worldwide safety data for budesonide inhalation suspension (Pulmicort Respules) to provide a budesonide inhalation suspension pediatric tolerability profile...
- The need for pediatric studies of allergy and asthma medications
Stanley J Szefler
National Jewish Medical and Research Center, 1400 Jackson Street, Room J304, Denver, CO 80206, USA
Curr Allergy Asthma Rep 3:478-83. 2003
..In this review, we discuss the background for this effort and the continuing impact it will have on the future management of allergy and asthma in children...
- Nocturnal awakening caused by asthma in children with mild-to-moderate asthma in the childhood asthma management program
Robert C Strunk
Department of Pediatrics, Washington University School of Medicine, Division of Allergy and Pulmonary Medicine, St Louis Children's Hospital, MO 63110, USA
J Allergy Clin Immunol 110:395-403. 2002
..01). CONCLUSIONS: Nocturnal awakening occurred in one third of the children with mild-to-moderate asthma during a month of relative stability and appears to be an indicator of asthma that is becoming increasingly severe...
- Histopathology of severe childhood asthma: a case series
Henry A Jenkins
Ira J. and Jacqueline Neimark Laboratory of Clinical Pharmacology in Pediatrics, Division of Clinical Pharmacology, National Jewish Medical and Research Center, Denver, CO, USA
Chest 124:32-41. 2003
..These findings suggest the need to look beyond inflammation to fully treat severe asthma and ultimately alter its progression...
- Pediatric asthma: an approach to pharmacogenetics analysis
Stanley J Szefler
Divisions of Clinical Pharmacology and Allergy and Immunology, Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA
Chest 123:434S-8S. 2003
- Economic burden of impairment in children with severe or difficult-to-treat asthma
Stanley J Szefler
National Jewish Health, Denver, Colorado, USA
Ann Allergy Asthma Immunol 107:110-119.e1. 2011
..The cost associated with asthma impairment in children with severe asthma has not been determined...
- Medications as asthma triggers
Ronina A Covar
Department of Pediatrics, Division of Allergy Clinical Immunology, National Jewish Medical and Research Center, 1400 Jackson Street A303, Denver, CO 80206, USA
Immunol Allergy Clin North Am 25:169-90. 2005
..Fortunately, controller therapy for asthma and alternative or more selective medications for the treatment of these conditions are now available...
- Advances in pediatric and adult asthma
Stanley J Szefler
Division of Clinical Pharmacology, Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colo 80206, USA
J Allergy Clin Immunol 115:470-7. 2005
..Asthma management is likely to change in the coming years from a strategy directed to the best outcome in groups of patients to an individualized approach to assessment and management...
- Managing severe asthma
Sally Wenzel
Division of Pulmonary Medicine, National Jewish Medical and Research Center, and the Department of Medicine, University of Colorado Health Sciences Center, Denver, CO 80206, USA
J Allergy Clin Immunol 117:508-11. 2006
- Advances in childhood asthma: hygiene hypothesis, natural history, and management
Andrew H Liu
National Jewish Medical and Research Center, and the University of Colorado Health Sciences Center, Denver, CO, USA
J Allergy Clin Immunol 111:S785-92. 2003
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- The natural history of asthma and early intervention
Stanley J Szefler
Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA
J Allergy Clin Immunol 109:S549-53. 2002
..The progress in defining asthma and targeting treatment toward specific pathophysiologic mechanisms should lead to better-defined optimal strategies for treating asthma in children...
- Budesonide inhalation suspension: a nebulized corticosteroid for persistent asthma
Stanley J Szefler
National Jewish Medical and Research Center, Denver, USA
J Allergy Clin Immunol 109:730-42. 2002
..This article reviews the results of these studies, as well as the pharmacokinetics, pharmacodynamics, and clinical use of budesonide inhalation suspension...
- Identifying the child in need of asthma therapy
Stanley J Szefler
Department of Pediatrics, Division of Pediatric Clinical Pharmacology, National Jewish Medical and Research Center 1400 Jackson St, Room B121, Denver, CO 80206, USA
Pediatr Clin North Am 50:577-91. 2003
..Recommendations have been made to integrate available resources in the United States to improve overall asthma outcomes for children...
- Corticosteroid therapy in asthma: predictors of responsiveness
Christopher M Mjaanes
National Jewish Medical and Research Center, 1400 Jackson Street, Office J304, Denver, CO 80209, USA
Clin Chest Med 27:119-32, vii. 2006
..Clinical factors associated with steroid insensitivity, strategies for managing patients with steroid insensitivity, and underlying molecular mechanisms responsible for variable responses to corticosteroids are described...
- Single-dose pharmacokinetics of roflumilast in children and adolescents
Kathleen A Neville
Department of Pediatrics, University of Missouri Kansas City and the Children s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64079, USA
J Clin Pharmacol 48:978-85. 2008
..1 and 0.8 microg/L per 1 microg/kg dose for adolescents and children, respectively), pharmacokinetic parameters for roflumilast and roflumilast N-oxide were not different between age groups and were similar to adults...
- Advances in pediatric asthma in 2007
Stanley J Szefler
Division of Pediatric Clinical Pharmacology, Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA
J Allergy Clin Immunol 121:614-9. 2008
..This review highlights journal articles that relate to these guideline topics...
- Asthma progression: can we and should we measure it?
Stanley J Szefler
Division of Pediatric Clinical Pharmacology and Allergy and Immunology, Department of Pediatrics, National Jewish Medical and Research Center, University of Colorado Health Sciences Center, Denver, CO 80206, USA
J Allergy Clin Immunol 121:598-600. 2008
- Advances in pediatric asthma 2006
Stanley J Szefler
Divisions of Pediatric Clinical Pharmacology, Allergy and Immunology, Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA
J Allergy Clin Immunol 119:558-62. 2007
..Application of biomarkers and genetics could be useful tools in individualizing our approach to the management of childhood asthma...
- Childhood asthma: new insights into management
Joseph D Spahn
Division of Allergy and Immunology, Department of Pediatrics, National Jewish Medical and Research Center, University of Colorado Health Sciences Center, Denver 80206, USA
J Allergy Clin Immunol 109:3-13. 2002
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- Prevalence and correlates of household exposures to tobacco smoke and pets in children with asthma
Frederick S Wamboldt
Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado 80206, USA
J Pediatr 141:109-15. 2002
..CONCLUSIONS: Smoke exposure and pet ownership are not related to one another in children with asthma and will require independent counseling strategies because they relate in different and opposite ways to socioeconomic status...
- Altering the course of asthma: Introduction
Stanley J Szefler
Department of Pediatrics, National Jewish Medical and Research Center, Denver, Colorado 80206, USA
J Allergy Clin Immunol 109:S519-20. 2002
