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EWS-ALERT
ADVAIR / SYMBICORT
Doctors tell FDA to keep Symbicort and Advair on the
market for children
December 11, 2008 An Food and Drug advisory committee
overwhelmingly (27-0) voted to continue the use of combination asthma drugs Advair
and Symbicort in children. The advisory group was asked to assess the
safety not only these combination drugs but also their components
individually. Both contain a inhaled steroid linked with a long acting albuterol like substance.
The steroid was not the focus, the albuterol like drug was the concern since heavy use is
considered dangerous by most doctors.
Asthma experts have debated the merits and problems of
asthma medications for decades with the latest report
issued earlier this year as a 1400 page analysis. The report suggested
a careful approach to classifying asthma and prescribing medications.
The new expert committee on concluded that the albuterol like substances should not be used alone, but
used with a steroid inside Advair or Symbicort, they are low risk. The
ruling was met with enthusiasm by the makers of Advair.
It should be pointed out this was an
advisory committee – not the same as the official FDA. Usually the FDA follows the advisory committee’s
suggestion.
The television and internet news reports are very
confusing and scary, with the headlines often reflecting a poor understanding
of the medical issues. Here’s the bottom line: there is no suggested
change in how we intend to utilize these medications. They save lives and
protect the lungs of children. This is an ongoing controversy.
Dr. Bob Lanier Teaches in China
Beijing November 15,
2008. Dr. Lanier was invited
to teach at the annual
Meeting of the Chinese Allergology
Society In Beijing China. This is the fourth time Dr. Lanier has
spoken at the meeting. His topic was
the classification and management of asthma.
Dr. Bob Lanier Teaches at ACAAI
Seattle November 10,
2008. Dr. Lanier spoke at the Annual American
College of Allergy Asthma and
Immunology in Seattle. His topics included
The cumulative effect of steroids in
the allergic person, the and anatomy and physiology
of the nose, and the adaptation to a more socialized system of medicine. This is the 17th year of
lectures for the ACAAI, a professional organization of university trained
allergists. He is a past president,
and the recipient of the Distinguished Service Award.
Dr. Bob Lanier
Teaches in 4
universities in Taiwan
Taipei October 18,
2008. Dr. Lanier was invited
to lecture before the faculties of 4 Taiwan Universities, and to share his
knowledge at the Federation of Asian Immunology Societies. Dr Lanier discussed the nature and
development of steroids for the nasal cavities from his research findings. This
is the second time Dr. Lanier has been invited to speak in Taiwan. Dr. Lanier has participated as a principal
investigator in over thirty protocols dealing with nasal steroids and has
authored 8 papers in this area.
Dr. Bob Lectures at European
Respiratory Society
Berlin October 4 –
6, 2008. Dr. Lanier was invited
to speak before the European Respiratory Society concerning his research in
the application monoclonal anti-IgE to children. He was joined in a panel discussion by
world experts in immunology including Steven Holgate ( England) Ulrich Wahl ( Germany) and Jean Bousquet
( France). Dr. Lanier has participated as a principal
investigator in 16 monoclonal anti-IgE trials, and has authored five papers and two textbook
chapters on the subject
Dr. Bob has Olympics insider September 2008- New York Dr. Bob Lanier is an adjunct
professor of The Peking Union Medical School in Beijing, China.
He teaches at the university twice yearly, and for 6 years has hosted in his
home senior Chinese allergists at his clinic in Fort Worth for 3-4 months. So when ESPN
news wanted an American opinion on the air quality in Beijing, Dr. Lanier was called. He also met and toured with former Olympic
Gold Medal (asthmatic) athlete Jeannette
Bolden. Jeanette Has an incredible story of overcoming the stigma of
allergic asthma. As a child, she was
repeatedly hospitalized and was even placed in a home for severe asthmatic
children. Check out http://www.asthmaontrack.com -
you and your children will be inspired.
ALERT ALERT
ALERT ALERT
NEW TIP: Before your turn your heater on …..
It’s going to
get cool before long ( believe it or not) It seems that when the furnace is fired up for the first several
times in the heating season, the mold and algae burn off which have been
growing on the coils. This brown choking cloud of dust usually rolls out when
you are asleep- you may never notice it- but you’ll have coughing and
irritation for days afterwards. For
those with allergies or a possibly compromised respiratory tract, this could
pose a problem.
What's
a person to do? Well, Dr. Bob suggests taping a product such as Swiffer®
refills over the vents to your bedroom at least. This product is electrostatically-charged,
meaning it is better able to pick up more of the dust, dirt, hair, and common
allergens than traditional methods, but also traps more airborne particles on
the cloth when taped over the registers. The suggested retail price for a
pack of 64 Swiffers is around $11, but if you check
at places such as Sam's Club, Lowe's, Home Depot, and others, you might find
a deal on them. To tape the cloths to
the registers, you can use masking tape, but there's another product I found
information on. It is called Intertape Pro-Mask Blue Painter's
Tape®. While it is more expensive than the old light tan masking
tape, it is a high-tack tape is perfect for masking delicate areas such as
wallpaper, painted surfaces, and glass. Removes easily without leaving a
sticky residue.
Top Stories in the news from the American College of Allergy
Asthma and Immunology
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Exercise-induced asthma rate high among college athletes
One in three college athletes may have exercise-induced asthma, despite no
previous history of the disease, according to a study in Medicine & Science in Sports & Exercise.Scientists at Ohio State
University studied 107 athletes, using eucapnic
voluntary hyperpnea testing. The test challenges
or stresses the lungs by making the subject hyperventilate, then measuring
his or her lung function to determine if it decreases from the stress,
mimicking the expected changes in exercise-induced asthma. Forty-two tested
positive for exercise-induced asthma, 36 of which had no previous history
of asthma. Researchers found that neither gender nor the sport they
participated in affected the likelihood of testing positive.
Women’s
allergic conditions don't affect their fertility
Women with
asthma, eczema or hay fever are not less fertile
than women without the conditions, according to a study in the American
Journal of Epidemiology. Researchers at the University
of Nottingham, in the United Kingdom,
say women with these allergic diseases may even be slightly more likely to
have children. They compared fertility rates among 491,516 women who were
15 to 44 years old during a 10-year period. Among the women, 13 percent had
asthma, 14 percent had eczema, and 12 percent had hay fever. However,
researchers found no significant difference in fertility rates between
women with and without asthma, eczema or hay fever. And, 20-something women
with asthma actually had slightly higher fertility rates than the same age
group without asthma.
Record number of U.S. doses ready for next flu season
Flu vaccine manufacturers say they will have a record 132 million doses
ready for the United States’ 2007-2008 flu season, and potentially
more if a fifth company obtains U.S. approval, according to officials at
the U.S. Centers for Disease Control and Prevention. CDC guidelines, which
have recently expanded to cover more age groups, call for 218 million
Americans to get vaccinated, so the estimated supply will still fall short.
The estimates were announced at a recent gathering of flu vaccine manufacturers,
health care providers, and public health officials.
Chitin enzyme may explain some asthma flares
Chitin, the compound that gives shellfish their protective shell and
invertebrates their inner frame, may be what triggers some patient’s
asthma, according to a study in Nature. Scientists at the University of California,
San Francisco,
built on previous animal studies that linked asthma symptoms and chitin
reactions. In mice, they discovered chitin triggered an allergic
inflammatory response in the lungs, as well as increased chitinase, an enzyme produced by cells in the lungs
that fights chitin. The researchers are currently trying to determine the effectiveness
at breaking down chitin among the different versions of chitinase
that humans have due to genetic differences.
April
11
New
procedure smooths muscle in asthma patients’
airways
A bronchoscopic procedure, called bronchial thermoplasty, which uses radio waves to smooth
overgrown muscle in the airways, improved moderate to severe asthma
patients’ asthma control, according to a study in the New England
Journal of Medicine. Scientists randomly assigned 112 subjects with
moderate to severe asthma to either three thermoplasty
sessions or their usual drug treatment. At 1 year, morning peak expiratory
flow was better in patients receiving thermoplasty
— 39 liters per minute vs. 8.5 liters per minute for those receiving
usual treatment. The thermoplasty group also
reported more symptom-free days (40 vs. 17), fewer asthma symptoms and
fewer puffs of rescue medication. The procedure is not yet approved by the
U.S. Food and Drug Administration.
Mediterranean diet may lower children’s allergic disease risk
A diet high in fruits, vegetables and nuts, commonly referred to as a Mediterranean
diet, could lessen children’s risk of allergic disease and asthma,
according to a study in Thorax. Scientists at the National Heart and
Lung Institute, London, studied 690
children, from 7 to 18 years old, in rural Crete,
a Greek island. Parents filled out questionnaires about respiratory and
allergic symptoms, as well as a 58-item food frequency questionnaire. The
children also underwent skin prick tests for 10 common aeroallergens. Children who ate a Mediterranean diet, as measured by 12
dietary items, were a third less likely to have allergic rhinitis. Eating
margarine more than doubled the risk of both wheeze and atopy.
Chlorine pools increase workers’ lung problems
People who spend a lot of time near chlorinated pools have a higher
risk of breathing problems, according to a study in European Respiratory
Journal. Researchers at University
of Utrecht in The
Netherlands surveyed 624 swimming pool employees, measured air quality at
six pools, and measured trichloramine — the
most irritating type of chlorine byproduct chloramine
— levels at all 38 pools included in the study. Compared with pool
employees with the least exposure to trichloramines,
swimming instructors had a 2.4-fold greater risk of frequent sinusitis or
sore throat and a 3.4-fold greater risk of chronic cold.
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Aspirin
linked to asthma prevention in men
An
analysis of data from a study investigating aspirin’s role in
preventing first heart attacks suggests aspirin may reduce new-onset
asthma risk in adult males, according to a report in the American
Journal of Respiratory and Critical Care Medicine. Researchers at
Brigham and Women's Hospital, Boston, retrospectively analyzed The
Physicians' Health Study, which randomized 22,071 healthy male
physicians, from 40 to 84 years old, to aspirin or placebo. Subjects
answered questionnaires that included information about asthma
diagnosis at baseline, six months and annually thereafter. The subjects
who took 325 mg of aspirin every other day had 22-percent less risk of
new onset asthma. The potential protective effect was not affected by
baseline risk factors such as age, body mass index, or smoking. And the
protection also was greater among younger men.
Study: Children
with asthma can reliably report own health status
Children
as young as 7 years old can dependably report on their asthma health
status, according to a study in Pediatrics. Scientists at the American Academy of Pediatrics, Elk Grove Village, Ill., interviewed 414 parents and
children separately, using the Children's Health Survey Asthma-Child
Version (CHSA-C) to measure physical health, activities and emotional
health. The children ranged from 7
to 16 years old, with a mean age of 11.5. The scientists evaluated the
data reported by the children for reliability based on internal
consistency and test-retest, for validity by comparison to symptoms and
lung function, and for feasibility reflected by completion time and
missing data. Reliability estimates for the activities and emotional health
scales were in the acceptable (at least .70) range in all but one
category. Internal consistency ratings were acceptable in five of nine
age groups. Test-retest correlations were high for all age groups and
increased with child age.
Six-shot
series has promise for ragweed allergy sufferers
A new
treatment of six weekly shots may offer relief from ragweed allergy
symptoms for more than a year, according to a small randomized,
double-blind, placebo-controlled study published in The New England
Journal of Medicine. Researchers at Johns Hopkins Asthma and Allergy Center in Baltimore studied 25 subjects who
reported ragweed allergic problems each fall season. The series of
shots, called AIC, which stands for Amb a
1-immunostimulatory oligodeoxyribonucleotide
conjugate, produced more than 1 year of relief for 14 subjects. In
addition, subjects who received the treatment reported fewer hay fever
symptoms and a better quality of life and used less allergy medication
than volunteers who received six placebo shots. A larger study seeking
to enroll 140 volunteers is under way. (WE ARE DOING THESE STUDIES)
mor Study: Allergic rhinitis
affects sleep quality
Physicians should be aware of the close
relationship between allergic rhinitis and sleep disorders, more
Law moves decongestants behind the counter
nationwide
Following similar state laws, as of Sept. 30, new
federal restrictions will require stores to move decongestants behind
the pharmacy counter or in a locked case, making it harder for
Americans to access the medicines.. moree
Early
fungal exposure may increase allergy risk
Infants
exposed to airborne fungal spores Penicillium
and Aspergillus may be at higher risk of
developing non-fungal allergies, according to a study in Pediatric
Allergy and Immunology. more
Asthmatic smokers can improve lung function quickly by quitting
Smokers who have asthma and quit smoking can realize more than 15
percent improvement in lung function tests in less than two months\ more
Introducing
grains later increases wheat allergy risk
Delaying
the introduction of cereal grains until after 6 months old increases
the risk of wheat allergy. more
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Inhaled
corticosteroids may boost cataract risk in elderly more
FDA: Antihistamine linked to breathing problems, death
Phenergan, should not be used for
children younger than two years old because of possible breathing
problems. more
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Preschoolers in day care at higher risk for allergy symptoms
more
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This site
accepts no sponsorship or advertisement and is totally funded by Lanier
Education and Research Network
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Cutting edge therapy for allergy,
asthma, 
Is allergy involved in
your asthma ?
( you
bet. In over 90% of asthma – allergy is a issue) Waiting to outgrow it ? ( so is granny)
Sick and
tired of allergy?
Click
for your options
 RUSH Immunotherapy – get it over quicker? We have a vast experience Click here for the facts and precautions
 You’ll find the answer to
questions by clicking here… Click here for the questionaire you need to fill out if you are
coming in for a new patient visit for Hives or swelling
 Chronic Cough
 HEADACHES?
Use
this thirty question test to get started with your doctor – print it out
“Drainage” Even if you don’t have heartburn – you MAY
have gastroesophageal reflux – click here
Sinus infections? This is the work-up
Polyps – uh oh Click here for the latest news
NEW: Online textbook of allergy from
the American Academy
of Allergy Asthma and
Immunology, The Allergy Report
Xolair for doctors and
patients
commonly
asked questions and practical answers on
Xolair ( Omalizumab) from an experience of hundreds of patients –
and contact with hundred of doctors who prescribe Xolair. This is not a
company site.
Xolair ( Omalizumab) in asthma
Xolair ( Omalizumab) in allergy
Xolair ( Omalizumab)in pregnancy
Xolair ( Omalizumab) doses, pricing/ unknowns
Dr.
Lanier and Dr. Chang’’s textbook chapter on Xolair ( Omalizumab) ( Blaiss editor)
Dr.
Lanier and Dr. Chang’s Textbook chapter on Xolair( Omalizumab) ( Lieberman)
Dr.
Lanier’s Allergy
Proceedings on Unanswered Questions about anti-IgE ( Omalizumab)
Dr.
Lanier’s Symposia for World
Allergy Organization Journal on the Possible Risks of Xolair (
Omalizumab)
Dr.
Lanier’s “Risks of
Xolair
( Omalizumab)
with Parasites”
Dr.
Lanier’s Risk of
anaphylaxis on allergy shots while taking Xolair
(
Omalizumab) abstract
Dr.
Lanier’s observation of
Fluctuating IgE levels in patients treated with Omalizumab
XOLAIR WARNING.
The FDA has announced that it
had requested Genentech, Inc. to add a boxed warning to the product label for
Xolair. The boxed warning emphasizes that Xolair may cause a severe allergic
reaction after any dose of Xolair, even if there was no reaction to the first
dose. Also, severe allergic reactions after administration of Xolair may be
delayed up to 24 hours after the dose is given. The FDA cautions health care
providers should be prepared to manage life-threatening severe allergic
reactions following Xolair administration and observe patients for at
least two hours after an injection. Following administration of Xolair,
patients should also carry and know how to initiate emergency self-treatment
for anaphylaxis. To view the FDA news release, click on this link or
copy and paste it into your web browser:
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01567.html
Obesity, asthma association
stronger in non-allergic women
Obese women
with no allergy history are at greater risk for asthma than obese men with no
allergy history, according to a study in Chest. Scientists at the University of Ottawa studied a cross-sectional
survey of 86,144 Canadian adults. Obese women had an adjusted odds ratio for
asthma of 1.85, relative to women who weren’t obese. The obese men had
an adjusted odds ratio for asthma of 1.21. According to the authors,
“One unit of increased BMI was associated with an approximate 6 percent
increase in asthma risk in women, and 3 percent in men.” The
association was even stronger among obese, non-allergic women. They had a 9.5
percent asthma risk, relative to 3.1 percent for non-allergic women who
weren’t obese. more
Migraines
common among allergic rhinitis sufferers
Many people
with allergic rhinitis also suffer from migraine headaches,.
more
Early fish consumption may lower allergy risk
Children who eat fish before 1 year of age may have a decreased risk of
developing asthma and allergic disease, more
Asthma, allergic
disease among kids increasing worldwide
The number of
children with asthma and other allergic diseases is on the rise worldwide, more
Study:
Early asthma prevention for at-risk kids unsuccessful
modified
early exposure to house dust mites and increased omega-3 fatty acid intake do
not prevent asthma in children with family history of the disease.. more
Asthmatics decreasing prescription use early in pregnancy
A large number of women significantly reduce their asthma medication use
early in their pregnancies, putting themselves and their babies at risk,.
more
Obesity
may have bigger affect on pregnancy than asthma
Complications
of pregnancy among obese women with asthma may have more to do with obesity
than with asthma. more
Cat
dander may bother patients with other allergies
Patients with allergies to mold, dust mites or timothy grass might
also be affected by cat dander, even if they aren’t specifically
allergic to cats, according to a study in the American Journal of Respiratory and Critical
Care Medicine. Researchers from several organizations in Europe analyzed cross-sectional data from 1,884
participants at 20 centers in the European Community Respiratory Health
Survey, which measured house dust mite and cat allergen in mattress dust
samples, and IgE sensitization to four allergens. They found higher bronchial
responsiveness when exposed to cat dander in research subjects who weren't
allergic to cats, but were sensitive to three other common allergens: dust
mites, mold or timothy grass. The authors concluded, "cat allergen
exposure at moderate levels may be harmful to all atopic adults."
Vitamin
C, omega-3s may lower asthma risk
A teenager’s adequate intake of vitamin C and omega-3 fatty acids may
promote respiratory health and lessen the effects of oxidative stress,
according to a study in Chest.
Researchers at the Harvard School of Public Health in Boston,
the U.S. EPA and Health Canada
studied 2,112 12th-grade students from 13 areas in the United States and Canada during the 1998-99 school
year, assessing associations between diet, pulmonary function and respiratory
symptoms. The researchers found that those who consumed less than one-quarter
of a serving of fruit a day had lower average lung-function scores. Those who
took in less than 5.2 milligrams a day of vitamin E had an increased risk of
reported asthma. And taking in less than 22 milligrams per day of omega-3
fatty acids was associated with increased risk of chronic bronchitis,
wheezing and asthma.
Supplemental
selenium doesn’t improve asthma
Supplementing with selenium doesn’t appear to have clinical
benefit in adults with asthma, according to a study in Thorax, even
though selenium levels tend to be low among that population. Researchers at
Imperial College London tested 197 adults from London with asthma, randomly assigning
subjects to receive for 24 weeks either a yeast and selenium (100 micrograms
daily) preparation or yeast-only placebo. Subjects receiving the selenium
preparation had a 48-percent increase in blood levels of selenium during the
trial. However, while some indicators of asthma severity improved more in the
selenium group than in the placebo group, the difference was not
statistically significant.
AMA
votes to lobby for laws allowing anaphylaxis treatment drugs at school
Delegates at the American Medical Association recently voted at its
annual policy meeting to lobby for laws allowing severely allergic children
to bring lifesaving drugs to school. The new policy refers to drugs including
prescription epinephrine and other injectable
medicines that treat severe allergic reactions. The policy also urges schools
to develop preparedness plans for handling severe allergic reactions and
ensuring that all affected children have an individual emergency care
plan.
Five percent in U.S.
report food allergies
More than 5 percent of U.S.
adults may have food allergies, according to a study in the Journal of
Allergy and Clinical Immunology. Researchers at the Food and Drug
Administration used data from a 2001 national survey. About half of those
with food allergies reported being allergic to at least one of the eight most
common food allergens: milk and other dairy foods; fish; eggs; crustaceans,
such as lobster and shrimp; tree nuts, such as walnuts; peanuts; soy; and
wheat. Among those who read food labels, 40 percent reported
“serious” or “very serious” difficulty trying to
protect themselves. However, since the survey was
administered, new legislation that went into effect in 2006 now requires food
makers to list the eight most common food allergens in plain English.
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