Asthma

Questions discussed in this category

Do you generally favor nebulizers, HFAs or other devices in children aged 5 and younger with asthma?

Would you stop Dupixent in an asthma patient who has good asthma control and notes improvement in loss of smell, but shows notable eosinophil elevation after 4-5 doses of the medication?

Dupixent was started for asthma. Eosinophils rose from 880 to 1940 after 6-8 weeks of therapy.

1 Answer available

If a child 4 years of age or younger has respiratory symptoms consistent with asthma, are you diagnosing asthma or using different terminology such as bronchiolitis or reactive airway disease?

The pediatrician in my area will typically diagnose a child below age four who has coughing and wheezing with bronchiolitis, or reactive airway diseas...

1 Answer available

Should a patient on medium-dose ICS/LABA with normal PFTs, but who shows a greater than 10% decrease in FEV1 if their PFTs are done after 24 hours off their inhaler, be started on a biologic?

This suggests continuing mucosal inflammation and the possibility of progressive scarring.

2 Answers available

What factors do you consider prior to offering a trial of ICS/LABA therapy versus a methacholine challenge test in patients with suspected asthma but normal pulmonary function testing?

1 Answer available

What treatment approach do you suggests for a patient with nasal polyp disease and asthma who was improved on dupilumab, but over last 2 years has begun to have increased nasal symptoms and rising eosinophil counts?

Eosinophils increased from 0.5 to 1.3 over about 5 years

3 Answers available

Is there a specific group of children that you start on AIT for prevention of asthma?

Do you utilize a PARS or API score to help this decision?

1 Answer available

Are there concerns with combining anti-IL5 biologics (mepolizumab or benralizumab) for severe asthma with other biologics for RA?

1 Answer available

How do you factor smoking history into biologic selection for asthma since the clinical trials generally excluded these patients?

1 Answer available

Have you observed adverse mental health side effects in patients who start montelukast?

In light of the FDA warning about mental health side effects of the medication have you observed in particular any patients develop suicidal thoughts ...

6 Answers available

Which class of biologic agent do you use first in a patient with asthma who may qualify for multiple drugs?

1 Answer available

What is your preferred rescue inhaler for patients with asthma?

Do you favor albuterol PRN, albuterol/budesonide PRN, or SMART therapy with ICS/formoterol?

2 Answers available

Do you use bronchodilator response to distinguish between asthma, COPD, or asthma-COPD overlap?

Do the findings of a recent large cohort study (Beasly et al., PMID 38029294) in which bronchodilator response did not distinguish between asthma and ...

1 Answer available

Is methacholine challenge on its way out?

1 Answer available

Is there any genetic testing available for the CDHR3 receptor?

This receptor is known to cause increased susceptibility to rhinovirus infection

1 Answer available

When would you recommend prescribing an asthmatic patient budesonide/salbutamol rather than budesonide/formoterol?

6 Answers available

What is your preferred biologic in children and adolescents with T2 high asthma?

1 Answer available

Do you feel high dose Symbicort or Dulera is appropriate to use for SMART despite these doses not being studied in clinical trials?

1 Answer available

Should in-office oscillometry for lung function measurements be utilized in pediatric patients who are unable to reliably perform spirometry?

1 Answer available

What is your approach to de-escalation of asthma inhaler therapy in the setting of negative bronchoprovocation testing when patients are averse to deprescribing?

At times due to limited testing resources, inhaler therapy is started based on clinical suspicion of asthma and bronchoprovocation testing is done lat...

1 Answer available

What features on PFT or flow-volume loops do you look at to suspect small airway dysfunction?

Often distal flattening of expiratory limb or decreased Fev25-50/FVC is referred for small airway dysfunction but it is advised against using it give ...

1 Answer available

What is the rationale/evidence to support doing 4 puffs of albuterol vs. 2 puffs for a reversibility study?

3 Answers available

Which patient characteristics or scenarios drive you to choose tezepelumab over dupilumab for asthma?

3 Answers available

Are there any contraindications to starting a patient on Dupixent for prurigo nodularis if the patient is already on Xolair for asthma?

1 Answer available

Do you utilize urinary leukotrienes as a marker for initiation of montelukast?

1 Answer available

Is there a role for biologics to improve lung function in patients who have severe asthma with daily symptoms and reduced lung function but do not experience frequent exacerbations?

2 Answers available

Do you diagnose obstruction by the criteria of FEV1/FVC < 70% or < LLN?