- N Engl J Med 2022; 386:2139-2140
Since the initial guidelines of the National Asthma Education and Prevention Program (NAEPP) were published in 1991,1 short-acting β2-agonists (SABAs) have been recommended as the preferred rescue therapy for patients with asthma of any severity. In the 2020 NAEPP update,2 for the first time,...
- N Engl J Med 2022; 386:2071-2083
Among patients with moderate-to-severe asthma who were receiving a range of inhaled glucocorticoid maintenance therapies, the risk of severe asthma exacerbation was significantly lower with as-needed use of a fixed-dose combination of 180 μg of albuterol and 160 μg of budesonide than with albuterol alone.
- N Engl J Med 2022; 386:1505-1518
Although reliever-triggered inhaled glucocorticoid therapy can reduce asthma exacerbations, this approach has not been well studied in Black and Latinx populations, who bear disproportionate asthma morbidity and mortality. In a pragmatic trial involving Black and Latinx patients, the asthma exacerbation rate was lower with reliever-triggered inhaled glucocorticoid use than with...
- N Engl J Med 2022; 386:1574-1575
Although asthma disproportionately affects Black and Latinx patients, they are underrepresented in studies of therapy, which makes it difficult to determine whether the results may be applied to them. Since race is not a biologic but a social construct, health disparities among persons with asthma are not a result of...
- N Engl J Med 2022; 386:157-171
Patients with severe asthma are at increased risk for a decreased quality of life, fixed airway obstruction, hospitalization, and death. Biologics may be required to reduce the disease burden. This review discusses the mechanisms, efficacy, and safety of biologics for severe asthma.
- N Engl J Med 2021; 385:2297-2298
Asthma is the most common chronic respiratory disease in children1 and the most racially and ethnically disparate of all health conditions.2 In the United States, the lifetime prevalence of childhood asthma is highest among Puerto Ricans (23.6%), intermediate among Blacks (18.1%), and lowest among Whites (9.5%)...
- N Engl J Med 2021; 385:2230-2240
In this randomized, controlled, phase 3 trial involving children between the ages of 6 and 11 years with uncontrolled moderate-to-severe asthma, those who received the monoclonal antibody dupilumab had fewer asthma exacerbations and better lung function and asthma control than those who received placebo.
- N Engl J Med 2021; 385:1656-1668
Many patients with moderate-to-severe type 2 asthma have poor disease control despite the use of currently available biologic therapies. In this randomized trial, the monoclonal antibody itepekimab against interleukin-33 improved asthma control in patients with moderate-to-severe asthma.
- N Engl J Med 2021; 385:1669-1679
Although interleukin-23 has been implicated in the pathogenesis of asthma, in this randomized, controlled trial involving adults with severe asthma, inhibition of interleukin-23 signaling with the monoclonal antibody risankizumab resulted in worse asthma outcomes than placebo.
- N Engl J Med 2021; 385:1714-1717
Basic science has enriched our understanding of the pathophysiology of severe asthma. Clinical translation of these discoveries has resulted in biologic therapies that target key components of asthma-related disease pathways. For example, identification and validation of biomarkers such as elevated blood eosinophil counts made it possible to implement tailored biologic...
- N Engl J Med 2021; 385:967-969
A subtype of structural racism, environmental racism includes the use of racist practices in determining which communities receive health-protective, and which health-harming, infrastructure. What can physicians do about this underlying and often missed diagnosis?
- N Engl J Med 2021; 384:1800-1809
Tezepelumab is a monoclonal antibody that blocks thymic stromal lymphopoietin, an epithelial-cell–derived cytokine implicated in the pathogenesis of asthma. This randomized, placebo-controlled clinical trial showed a reduction in the annualized rate of asthma exacerbations among patients with severe, uncontrolled asthma treated with tezepelumab.
- N Engl J Med 2021; 384:563-574
A 70-year-old woman was evaluated because of increasing dyspnea on exertion and abnormal findings on chest imaging. Eleven years before this evaluation, mild mosaic attenuation at the lung bases was identified incidentally. Three years later, dyspnea on exertion developed and pulmonary function worsened. Diagnostic tests were performed.
- N Engl J Med 2020; 382:1472-1475
A mouse model of airway contraction in asthma, together with analyses of the human lung, indicates that maresin conjugates, a family of lipid mediators, play a role in the resolution of inflammation. Might these lipids represent a pharmacologic target in the treatment of inflammatory disorders?
- N Engl J Med 2020; 382:574-575
Asthma is a major cause of illness and health care costs: in 2016, almost 200,000 Americans were admitted to the hospital for an asthma attack, and 40% of them were children (https://www.cdc.gov/asthma/healthcare-use/healthcare-use-2016.htm ). It therefore makes sense to consider asthma prevention a major public health priority. In most cases...
- N Engl J Med 2020; 382:525-533
In a previously published controlled trial, maternal administration of vitamin D during pregnancy was found to protect against wheeze in the offspring at the age of 3 years. In this follow-up study involving the same children at the age of 6 years, that supplementation no longer had a protective effect.
- N Engl J Med 2019; 381:1227-1239
Whether an increase in the dose of inhaled glucocorticoids or the addition of long-acting beta-agonists will lead to better outcomes in black children with moderate asthma is not known. Surprisingly, the data showed that increased doses of an inhaled glucocorticoid were as effective as addition of a LABA.
- N Engl J Med 2019; 381:1046-1057
This article addresses the potential mechanistic links between hypertension and asthma as well as the influence of coexisting conditions. An approach to the treatment of hypertension in adult patients with asthma is outlined.
- N Engl J Med 2019; 381:882-884
A recent study of Charcot–Leyden crystals, which are typically present in the airway mucus of persons with asthma and of persons with chronic rhinosinusitis with nasal polyps, indicates that they are immunogenic and that their dissolution — with the use of a nanobody — represents an experimental approach to treatment...