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The reduced odds of exacerbations with SiT compared with higher dose ICS should be viewed in the context of the possible impact of LABA withdrawal during study run-in.

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The SINA was initially based on two existing international guidelines, the Global Initiative for Asthma (GINA) and the National Asthma Education and Prevention Program (NAEPP).

If this happens, a screen in the inhaler should stop the pieces of capsule from reaching your mouth as you inhale the medication.

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Given the open-label nature of the study design there was consequently the potential for bias, as investigators had the option to increase asthma medication and consequently increase the apparent exacerbation rate.

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Leukotrienes are powerful immune system factors that, in excess, produce a battery of damaging chemicals that can cause inflammation and spasms in the airways of people with asthma.

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As further support, a recent study has reported that the use of a combination inhaler (BDP and albuterol) for maintenance and as-needed reliever therapy, in patients with mild persistent asthma, is as effective as standard ICS fixed-dosing for controlling morning PEF30.

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Most but not all patients with COPD are either current or ex-smokers with at least 10 pack-year smoking history (pack-years is calculated by multiplying the number of cigarettes smoked per day by the years smoked divided by 20).

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In particular, these studies have eventually to resolve the question on the therapeutic value of a once-daily combination relative to a combination with twice-daily LABA dosing.

This patient did not take extra inhalations for relief, although symptom scores and PEF values in his diary clearly indicated that an exacerbation was imminent.

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Inhaled corticosteroids are the preferred long-term control therapy.

Results should be taken together with other tests to determine the need for medication or oxygen therapy.

Patients with asthma who smoke should be provided with information about smoking cessation and encouraged to participate in classes to change socialization patterns.

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