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Impact of the Arg 16 allele of the B2AR gene on the effect of withdrawal of LABA in patients with moderate to severe asthma.

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Title: Impact of the Arg 16 allele of the B2AR gene on the effect of withdrawal of LABA in patients with moderate to severe asthma.
Authors: Slankard, Marjorie (AUTHOR), Michelis, Mary Ann (AUTHOR), Mansukhani, Mahesh (AUTHOR), McGoey, Barbara (AUTHOR), Paige, Amy (AUTHOR), Andrews, Howard (AUTHOR), Lederer, David (AUTHOR), Canfield, Stephen (AUTHOR), DiMango, Emily (AUTHOR)
Source: Journal of Asthma. Oct2016, Vol. 53 Issue 8, p783-789. 7p. 2 Diagrams, 2 Charts, 1 Graph.
Subjects: Asthma treatment, Adrenergic beta agonists, Genetic polymorphisms, Adrenergic receptors, Genotypes
Abstract: Introduction: Long-acting beta agonists (LABAs) are effective for controlling asthma, however questions about their safety have led to concerns over use. Genetic polymorphisms at the 16 amino acid position of the beta-2 adrenergic receptor gene (B2AR) may be associated with increased risk.Methods: A randomized, double blind study was conducted in patients with moderate to severe asthma being treated with combined inhaled corticosteroids/LABA (ICS/LABA), comparing the effect of LABA continuation versus withdrawal on asthma outcomes among patients stratified by B2AR genotype (Arg/Arg vs. Gly/Gly at the 16th amino acid position).Results: 67 participants (31 Arg/Arg, 36 Gly/Gly) were randomized to receive fluticasone alone (F) or continue combined fluticasone/salmeterol (F/S) after a run-in period on F/S. Among Gly/Gly subjects, those in the F/S treatment group showed improvement in AM PEFR (+ 8.4 L/s) whereas those receiving F alone experienced a reduction in AM PEFR over the study period (−14.4 L/s), (p= 0.06). There was no significant difference in morning peak expiratory flow rate (AM PEFR) in Arg/Arg participants randomized to receive F/S (−15.7L) vs F alone (−5.6 L/s) (p= 0.61). There was no significant difference in exacerbations in the Arg/Arg subjects treated with F/S compared with those treated with F (p= 0.65).Conclusions: Withdrawal of LABA therapy in asthmatics with the Arg/Arg genotype at the 16th amino acid position of B2AR did not lead to significant improvement in AM PEFR. LABA withdrawal in the Gly/Gly genotype however led to a borderline significant decline in AM PEFR. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Asthma is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Impact of the Arg 16 allele of the B2AR gene on the effect of withdrawal of LABA in patients with moderate to severe asthma.
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  Data: <searchLink fieldCode="AR" term="%22Slankard%2C+Marjorie%22">Slankard, Marjorie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Michelis%2C+Mary+Ann%22">Michelis, Mary Ann</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mansukhani%2C+Mahesh%22">Mansukhani, Mahesh</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McGoey%2C+Barbara%22">McGoey, Barbara</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Paige%2C+Amy%22">Paige, Amy</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Andrews%2C+Howard%22">Andrews, Howard</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lederer%2C+David%22">Lederer, David</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Canfield%2C+Stephen%22">Canfield, Stephen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22DiMango%2C+Emily%22">DiMango, Emily</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Asthma%22">Journal of Asthma</searchLink>. Oct2016, Vol. 53 Issue 8, p783-789. 7p. 2 Diagrams, 2 Charts, 1 Graph.
– Name: Subject
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  Data: <searchLink fieldCode="DE" term="%22Asthma+treatment%22">Asthma treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Adrenergic+beta+agonists%22">Adrenergic beta agonists</searchLink><br /><searchLink fieldCode="DE" term="%22Genetic+polymorphisms%22">Genetic polymorphisms</searchLink><br /><searchLink fieldCode="DE" term="%22Adrenergic+receptors%22">Adrenergic receptors</searchLink><br /><searchLink fieldCode="DE" term="%22Genotypes%22">Genotypes</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Introduction: Long-acting beta agonists (LABAs) are effective for controlling asthma, however questions about their safety have led to concerns over use. Genetic polymorphisms at the 16 amino acid position of the beta-2 adrenergic receptor gene (B2AR) may be associated with increased risk.Methods: A randomized, double blind study was conducted in patients with moderate to severe asthma being treated with combined inhaled corticosteroids/LABA (ICS/LABA), comparing the effect of LABA continuation versus withdrawal on asthma outcomes among patients stratified by B2AR genotype (Arg/Arg vs. Gly/Gly at the 16th amino acid position).Results: 67 participants (31 Arg/Arg, 36 Gly/Gly) were randomized to receive fluticasone alone (F) or continue combined fluticasone/salmeterol (F/S) after a run-in period on F/S. Among Gly/Gly subjects, those in the F/S treatment group showed improvement in AM PEFR (+ 8.4 L/s) whereas those receiving F alone experienced a reduction in AM PEFR over the study period (−14.4 L/s), (p= 0.06). There was no significant difference in morning peak expiratory flow rate (AM PEFR) in Arg/Arg participants randomized to receive F/S (−15.7L) vs F alone (−5.6 L/s) (p= 0.61). There was no significant difference in exacerbations in the Arg/Arg subjects treated with F/S compared with those treated with F (p= 0.65).Conclusions: Withdrawal of LABA therapy in asthmatics with the Arg/Arg genotype at the 16th amino acid position of B2AR did not lead to significant improvement in AM PEFR. LABA withdrawal in the Gly/Gly genotype however led to a borderline significant decline in AM PEFR. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Journal of Asthma is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.3109/02770903.2016.1161049
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      – SubjectFull: Genetic polymorphisms
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      – TitleFull: Impact of the Arg 16 allele of the B2AR gene on the effect of withdrawal of LABA in patients with moderate to severe asthma.
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              Text: Oct2016
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