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Aldo Lorenzetti M.D, Internal Medicine & Hepatology, Milano - SIMEDET Delegate
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Pulmonary #rehabilitation as a mechanism to reduce hospitalizations for acute #exacerbations of chronic obstructive pulmonary disease: A systematic review and meta-analysis

http://journal.publications.chestnet.org/mobile/article.aspx?articleid=2544494

Conclusions Although results from RCTs suggested that pulmonary rehabilitation reduces subsequent admissions, pooled results from the cohort studies did not, likely reflecting the heterogeneous nature of individuals included in observational research and the varying standard of pulmonary rehabilitation programmes.
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Association of Inhaled Corticosteroids and Long-Acting β-Agonists as Controller and Quick Relief Therapy With #Exacerbations and Symptom Control in Persistent #Asthma

https://jamanetwork.com/journals/jama/article-abstract/2675737

The analyses included 16 randomized clinical trials (N = 22 748 patients), 15 of which evaluated SMART as a combination therapy with budesonide and formoterol in a dry-powder inhaler. Among patients aged 12 years or older (n = 22 524; mean age, 42 years; 14 634 65% were female), SMART was associated with a reduced risk of asthma exacerbations compared with the same dose of inhaled corticosteroids and LABA as the controller therapy (RR, 0.68 95% CI, 0.58 to 0.80; RD, −6.4% 95% CI, −10.2% to −2.6%) and a higher dose of inhaled corticosteroids and LABA as the controller therapy (RR, 0.77 95% CI, 0.60 to 0.98; RD, −2.8% 95% CI, −5.2% to −0.3%). Similar results were seen when SMART was compared with inhaled corticosteroids alone as the controller therapy. Among patients aged 4 to 11 years (n = 341; median age, 8 range, 4-11 years; 69 31% were female), SMART was associated with a reduced risk of asthma exacerbations compared with a higher dose of inhaled corticosteroids as the controller therapy (RR, 0.55 95% CI, 0.32 to 0.94; RD, −12.0% 95% CI, −22.5% to −1.5%) or the same dose of inhaled corticosteroids and LABA as the controller therapy (RR, 0.38 95% CI, 0.23 to 0.63; RD, −23.2% 95% CI, −33.6% to −12.1%).

Conclusions and Relevance In this meta-analysis of patients with persistent asthma, the use of single maintenance and reliever therapy compared with inhaled corticosteroids as the controller therapy (with or without a long-acting β-agonist) and short-acting β-agonists as the relief therapy was associated with a lower risk of asthma exacerbations. Evidence for patients aged 4 to 11 years was limited