Asthma Programme

 Programme Director:  Professor Richard Beasley

Global burden of asthma report

The MRINZ was commissioned by the United States National Heart, Lung and Blood Institute and World Health Organisation’s Global Initiative for Asthma Programme, to research and draft the Global Burden of Asthma Report. This detailed report reviews the global burden of asthma in terms of prevalence, morbidity, mortality and economic cost. It provides an evidence-based summary of the burden of asthma, details the barriers to improving asthma outcomes and makes recommendations regarding public health and regulatory initiatives. It has become a major reference and advocacy document worldwide.

The International Study of Asthma and Allergies in Childhood

The International Study of Asthma and Allergies in Childhood (ISAAC) programme is the largest asthma epidemiology project ever undertaken. Phase I reported the prevalence of the symptoms of asthma, allergic rhinitis and atopic eczema in children for 106 centres in 56 countries . This was the first time that the prevalence of asthma and related allergic disorders was measured in a standardised manner globally. Phase II involved a detailed immunological, genetic and physiological investigation of the causes of asthma and atopy in over 40 countries worldwide, providing unique individual data from populations with a wide range of lifestyles and environmental exposures. Phase III examines trends in the prevalence of asthma and allergic diseases in children worldwide. The MRINZ has had a crucial leadership role in both Phase I and Phase III of ISAAC.

The randomised placebo-controlled trial of buproprion in Māori;

This study was the first randomised double-blind placebo-controlled study of a pharmacological agent in a Māori; population. It investigated the efficacy and safety of the smoking cessation medication buproprion over a six month period. It showed that subjects taking buproprion were over twice as likely to stop smoking as those on placebo. This study is of major public health relevance to New Zealand, due to the very high rates of smoking in Māori; and its associated disease burden. This research programme, which involved a major collaboration with P3 Research and Māori; researchers, represents an ideal model for medical research in the Māori; community.

Inhaled corticosteroid dose-response studies

Inhaled corticosteroids represent the most important ‘preventive’ drug therapy in asthma. However, uncertainty has existed regarding the doses that should be taken by patients. To better understand this issue we have undertaken a series of systematic reviews and meta-analyses of studies which have investigated the dose response relationship of inhaled corticosteroids. These analyses have demonstrated that most of the therapeutic benefit of inhaled corticosteroids are achieved at considerably lower doses than those currently used in New Zealand and internationally. These findings have contributed to a better understanding of the use of this important therapy in asthma, and have led to modifications in the doses recommended in national and international guidelines.

The addition of long-acting beta-agonist therapy to inhaled corticosteroids in asthma

One of the therapeutic dilemmas in asthma is deciding in a patient with unstable asthma at what dose of inhaled corticosteroids a long-acting beta-agonist should be added. By undertaking a systematic review and meta-analysis of clinical trials it was possible to answer this question and determine the preferred dose level. This study has contributed to a revision of the recommendations of the use of long-acting beta-agonist therapy in asthma.

Duration of action of combination ICS/LABA therapy in asthma

The prolonged duration of bronchodilator action of the new long-acting beta-agonist drugs salmeterol and formoterol have led to their use twice daily in the treatment of asthma. While it had been well established that the duration of bronchodilator action is at least 12 hours, it was uncertain as to whether their effects may extend out to 24 hours, thereby allowing once daily use. In a series of studies in adults and children, the duration of the bronchodilator effect of both salmeterol and formoterol was examined over a 24 hour period in the inpatient facility at Bowen Hospital. These studies identified that a single evening administration of either salmeterol or formoterol resulted in a duration of bronchodilation of at least 24 hours, suggesting that once daily use may be a reasonable option in patients with stable asthma.

Your Guide to Asthma

“Your Guide to Asthma” was published in partnership with the Royal Society of Medicine. It provides a source of independent professional advice and information to help people improve their understanding of asthma and reduce the effect of asthma on their lives. It represented the first in a series of books published by the Royal Society of Medicine for lay people on common medical conditions.

The use of isotonic nebulised magnesium sulphate as an adjuvant

Intravenous magnesium has been shown to cause significant bronchodilation in the treatment of severe asthma, however its effect by the nebulised route was uncertain. In this study, which was published in The Lancet, the efficacy of isotonic magnesium sulphate as an adjuvant to nebulised salbutamol in severe asthma was assessed. Subjects with severe exacerbations of asthma presenting to the Emergency Departments at Wellington Hospital and Auckland Hospital were studied. The use of isotonic magnesium as an adjuvant to nebulised salbutamol resulted in a greater improvement in lung function and reduced the requirement for hospital admission. These findings are of considerable clinical importance and are now the focus of a major research effort internationally.

Asthma Programme

 Programme Director:  Professor Richard Beasley

Global burden of asthma report

The MRINZ was commissioned by the United States National Heart, Lung and Blood Institute and World Health Organisation’s Global Initiative for Asthma Programme, to research and draft the Global Burden of Asthma Report. This detailed report reviews the global burden of asthma in terms of prevalence, morbidity, mortality and economic cost. It provides an evidence-based summary of the burden of asthma, details the barriers to improving asthma outcomes and makes recommendations regarding public health and regulatory initiatives. It has become a major reference and advocacy document worldwide.

The International Study of Asthma and Allergies in Childhood

The International Study of Asthma and Allergies in Childhood (ISAAC) programme is the largest asthma epidemiology project ever undertaken. Phase I reported the prevalence of the symptoms of asthma, allergic rhinitis and atopic eczema in children for 106 centres in 56 countries . This was the first time that the prevalence of asthma and related allergic disorders was measured in a standardised manner globally. Phase II involved a detailed immunological, genetic and physiological investigation of the causes of asthma and atopy in over 40 countries worldwide, providing unique individual data from populations with a wide range of lifestyles and environmental exposures. Phase III examines trends in the prevalence of asthma and allergic diseases in children worldwide. The MRINZ has had a crucial leadership role in both Phase I and Phase III of ISAAC.

The randomised placebo-controlled trial of buproprion in Māori;

This study was the first randomised double-blind placebo-controlled study of a pharmacological agent in a Māori; population. It investigated the efficacy and safety of the smoking cessation medication buproprion over a six month period. It showed that subjects taking buproprion were over twice as likely to stop smoking as those on placebo. This study is of major public health relevance to New Zealand, due to the very high rates of smoking in Māori; and its associated disease burden. This research programme, which involved a major collaboration with P3 Research and Māori; researchers, represents an ideal model for medical research in the Māori; community.

Inhaled corticosteroid dose-response studies

Inhaled corticosteroids represent the most important ‘preventive’ drug therapy in asthma. However, uncertainty has existed regarding the doses that should be taken by patients. To better understand this issue we have undertaken a series of systematic reviews and meta-analyses of studies which have investigated the dose response relationship of inhaled corticosteroids. These analyses have demonstrated that most of the therapeutic benefit of inhaled corticosteroids are achieved at considerably lower doses than those currently used in New Zealand and internationally. These findings have contributed to a better understanding of the use of this important therapy in asthma, and have led to modifications in the doses recommended in national and international guidelines.

The addition of long-acting beta-agonist therapy to inhaled corticosteroids in asthma

One of the therapeutic dilemmas in asthma is deciding in a patient with unstable asthma at what dose of inhaled corticosteroids a long-acting beta-agonist should be added. By undertaking a systematic review and meta-analysis of clinical trials it was possible to answer this question and determine the preferred dose level. This study has contributed to a revision of the recommendations of the use of long-acting beta-agonist therapy in asthma.

Duration of action of combination ICS/LABA therapy in asthma

The prolonged duration of bronchodilator action of the new long-acting beta-agonist drugs salmeterol and formoterol have led to their use twice daily in the treatment of asthma. While it had been well established that the duration of bronchodilator action is at least 12 hours, it was uncertain as to whether their effects may extend out to 24 hours, thereby allowing once daily use. In a series of studies in adults and children, the duration of the bronchodilator effect of both salmeterol and formoterol was examined over a 24 hour period in the inpatient facility at Bowen Hospital. These studies identified that a single evening administration of either salmeterol or formoterol resulted in a duration of bronchodilation of at least 24 hours, suggesting that once daily use may be a reasonable option in patients with stable asthma.

Your Guide to Asthma

“Your Guide to Asthma” was published in partnership with the Royal Society of Medicine. It provides a source of independent professional advice and information to help people improve their understanding of asthma and reduce the effect of asthma on their lives. It represented the first in a series of books published by the Royal Society of Medicine for lay people on common medical conditions.

The use of isotonic nebulised magnesium sulphate as an adjuvant

Intravenous magnesium has been shown to cause significant bronchodilation in the treatment of severe asthma, however its effect by the nebulised route was uncertain. In this study, which was published in The Lancet, the efficacy of isotonic magnesium sulphate as an adjuvant to nebulised salbutamol in severe asthma was assessed. Subjects with severe exacerbations of asthma presenting to the Emergency Departments at Wellington Hospital and Auckland Hospital were studied. The use of isotonic magnesium as an adjuvant to nebulised salbutamol resulted in a greater improvement in lung function and reduced the requirement for hospital admission. These findings are of considerable clinical importance and are now the focus of a major research effort internationally.

Asthma Programme

 Programme Director:  Professor Richard Beasley

Global burden of asthma report

The MRINZ was commissioned by the United States National Heart, Lung and Blood Institute and World Health Organisation’s Global Initiative for Asthma Programme, to research and draft the Global Burden of Asthma Report. This detailed report reviews the global burden of asthma in terms of prevalence, morbidity, mortality and economic cost. It provides an evidence-based summary of the burden of asthma, details the barriers to improving asthma outcomes and makes recommendations regarding public health and regulatory initiatives. It has become a major reference and advocacy document worldwide.

The International Study of Asthma and Allergies in Childhood

The International Study of Asthma and Allergies in Childhood (ISAAC) programme is the largest asthma epidemiology project ever undertaken. Phase I reported the prevalence of the symptoms of asthma, allergic rhinitis and atopic eczema in children for 106 centres in 56 countries . This was the first time that the prevalence of asthma and related allergic disorders was measured in a standardised manner globally. Phase II involved a detailed immunological, genetic and physiological investigation of the causes of asthma and atopy in over 40 countries worldwide, providing unique individual data from populations with a wide range of lifestyles and environmental exposures. Phase III examines trends in the prevalence of asthma and allergic diseases in children worldwide. The MRINZ has had a crucial leadership role in both Phase I and Phase III of ISAAC.

The randomised placebo-controlled trial of buproprion in Māori;

This study was the first randomised double-blind placebo-controlled study of a pharmacological agent in a Māori; population. It investigated the efficacy and safety of the smoking cessation medication buproprion over a six month period. It showed that subjects taking buproprion were over twice as likely to stop smoking as those on placebo. This study is of major public health relevance to New Zealand, due to the very high rates of smoking in Māori; and its associated disease burden. This research programme, which involved a major collaboration with P3 Research and Māori; researchers, represents an ideal model for medical research in the Māori; community.

Inhaled corticosteroid dose-response studies

Inhaled corticosteroids represent the most important ‘preventive’ drug therapy in asthma. However, uncertainty has existed regarding the doses that should be taken by patients. To better understand this issue we have undertaken a series of systematic reviews and meta-analyses of studies which have investigated the dose response relationship of inhaled corticosteroids. These analyses have demonstrated that most of the therapeutic benefit of inhaled corticosteroids are achieved at considerably lower doses than those currently used in New Zealand and internationally. These findings have contributed to a better understanding of the use of this important therapy in asthma, and have led to modifications in the doses recommended in national and international guidelines.

The addition of long-acting beta-agonist therapy to inhaled corticosteroids in asthma

One of the therapeutic dilemmas in asthma is deciding in a patient with unstable asthma at what dose of inhaled corticosteroids a long-acting beta-agonist should be added. By undertaking a systematic review and meta-analysis of clinical trials it was possible to answer this question and determine the preferred dose level. This study has contributed to a revision of the recommendations of the use of long-acting beta-agonist therapy in asthma.

Duration of action of combination ICS/LABA therapy in asthma

The prolonged duration of bronchodilator action of the new long-acting beta-agonist drugs salmeterol and formoterol have led to their use twice daily in the treatment of asthma. While it had been well established that the duration of bronchodilator action is at least 12 hours, it was uncertain as to whether their effects may extend out to 24 hours, thereby allowing once daily use. In a series of studies in adults and children, the duration of the bronchodilator effect of both salmeterol and formoterol was examined over a 24 hour period in the inpatient facility at Bowen Hospital. These studies identified that a single evening administration of either salmeterol or formoterol resulted in a duration of bronchodilation of at least 24 hours, suggesting that once daily use may be a reasonable option in patients with stable asthma.

Your Guide to Asthma

“Your Guide to Asthma” was published in partnership with the Royal Society of Medicine. It provides a source of independent professional advice and information to help people improve their understanding of asthma and reduce the effect of asthma on their lives. It represented the first in a series of books published by the Royal Society of Medicine for lay people on common medical conditions.

The use of isotonic nebulised magnesium sulphate as an adjuvant

Intravenous magnesium has been shown to cause significant bronchodilation in the treatment of severe asthma, however its effect by the nebulised route was uncertain. In this study, which was published in The Lancet, the efficacy of isotonic magnesium sulphate as an adjuvant to nebulised salbutamol in severe asthma was assessed. Subjects with severe exacerbations of asthma presenting to the Emergency Departments at Wellington Hospital and Auckland Hospital were studied. The use of isotonic magnesium as an adjuvant to nebulised salbutamol resulted in a greater improvement in lung function and reduced the requirement for hospital admission. These findings are of considerable clinical importance and are now the focus of a major research effort internationally.
 
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