10.2 Why and when is a steroid-sparing effect of LABA important in asthma?
10.3 Effects of lower dose ICS/LABA versus a higher dose ICS on lung function, symptoms and use of reliever medication
10.4 Effects of lower dose ICS/LABA versus higher dose ICS on exacerbations
10.5 Protocols with tapering ICS doses with and without LABA while maintaining asthma control
10.6 Reducing ICS doses using an adjustable ICS/LABA dosing regimen
10.7 Reducing ICS doses using Symbicort¢ç maintenance and reliever therapy
10.8 Does enhanced anti-inflammatory efficacy explain steroid-sparing effects in ICS/LABA therapy?
10.9 Possible Mechanisms of Steroid-sparing Effects by Addition of LABA to ICS
11 Steroid-sparing Strategies: Other Combinations
Gaetano Caramori, Kazuhiro Ito and Alberto Papi
11.1 Introduction
11.2 Theophylline as steroid-sparing treatment in asthma and COPD
11.3 Selective inhibitors of PDE4
11.4 Modulators of the synthesis or action of key inflammatory mediators
11.5 Anticholinergics
11.6 Leukotriene synthesis inhibitors and leukotriene receptor antagonists
11.7 Anti-lgE therapy
11.8 Macrolides/ketolides
11.9 TNFa inhibitors
11.10 Conclusions
12 Kinases as Anti-inflammatory Targets for Respiratory Disease
Iain Kilty
12.1 Introduction
12.2 Pharmacological targeting of kinases
12.3 Targeting NF-eB activation
12.4 Targeting the MAPKs
12.5 Targeting PI3K
12.6 Further potential kinase targets
12.7 Conclusions
13 Pharmacokinetic/Pharmacodynamic Factors and Steroid Sensitivity
Gonther Hochhaus
13.1 Introduction
13.2 What factors are important for pulmonary efficacy and safety?
13.3 Pharmacodynamic aspects
13.4 Pharmacokinetic drug properties
13.5 Conclusion
14 Improved Lung Deposition: New Inhaler Devices
Omar S. Usmani
14.1 Introduction
14.2 Historical review of inhaled drug therapy
14.3 Deposition of aerosols within the respiratory tract
14.4 Assessing drug deposition in the lungs
14.5 Aerosol generation devices for inhaled drug therapy
Index
Written by well-known experts in field, this is the first book dedicated to dealing with the single most challenging management issue in long-term steroid therapy.
Overcoming Steroid Insensitivity in Respiratory Disease reviews important new advances in therapeutics and provides the clinician with the most up to date information on one of the most significant therapeutic challenges to effective management of these diseases. This unique book is an invaluable resource for all postgraduate students and specialist physicians in pulmonology allergy and asthma. It is also of interest for workers in biomedical and pharmaceutical research