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Despite lockdowns, New South buy ventolin with prescription Wales is breaking previous records with regards to asthma treatment case numbers ventolin tabs. The rate and way in which it’s transmitted might be a reason why.People infected with the delta variant of the novel asthma could be transmitting the ventolin for almost two days before showing any symptoms, a new study has found.New research out of the University of Hong Kong suggests pre-symptomatic transmission accounts for nearly 75 percent of delta variant s buy ventolin with prescription and it could explain the reason for New South Wales’s record-breaking daily caseloads.Like what you see?. Sign up to our bodyandsoul.com.au newsletter for more buy ventolin with prescription stories like this“It is just tougher to stop,” said Benjamin Cowling, an epidemiologist at the University of Hong Kong and a co-author of the study, according to the science journal Nature.Data from 167 people in Guandong who were infected with the delta variant between May and June this year, and the data from those in close contact, was examined.Researchers found that, on average, people began exhibiting symptoms 5.8 days after , 1.8 days after they first tested positive.That left almost two days for individuals to shed the viral RNA before they showed any signs or symptoms of asthma treatment.A small number of the study’s participants experienced breakthrough s after receiving the two necessary doses of a asthma treatment.The vaccinated individuals were 65 percent less likely than unvaccinated individuals to infect others and had an overall lower viral load at the peak of .Australia is currently sitting at a little over a third of the adult population is fully vaccinated, with 58 percent having received one dose.At the current rate, we can expect 70 percent of adult Australians to be fully vaccinated by late October 2021, but experts say the benefit of the increase in inoculations won’t be seen until mid-September.Only then will asthma treatment restrictions begin to ease and some public health measures, like masking, may stay in place for years.Any products featured in this article are selected by our editors, who don’t play favourites. If you buy buy ventolin with prescription something, we may get a cut of the sale. Learn more. buy ventolin with prescription.

Difference between bricanyl and ventolin

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Credit http://eclectic-oddities.com/?page_id=150 difference between bricanyl and ventolin. Pixabay/CC0 Public difference between bricanyl and ventolin Domain In the heart of a city, the distances in rural communities may be difficult to envision. The space between neighbors can sometimes be measured in miles rather than blocks.

A drive to the nearest hospital may difference between bricanyl and ventolin take dozens of minutes rather than a handful. The trickle-down effect of such distances can impact many aspects of health care, but especially maternal care and delivery, says Mark Deutchman, MD, a professor of family medicine and associate dean for rural health at the University of Colorado School of Medicine.As principal investigator of a study recently published in the journal Birth analyzing the impact of family physicians in rural maternity care, Deutchman and his co-investigators found that of the 185 rural hospitals surveyed in 10 states, family physicians delivered babies in 67% of the hospitals and were the only physicians who delivered babies in 27% of them.Further, the study found that if family physicians stopped delivering babies in these rural hospitals, patients would have to drive an average of 86 miles round-trip to access maternal care."The purpose of this study was, number one, to understand the extent of family physicians providing maternity care in rural areas," Deutchman explains. "Number two, and even more important, was to understand what would happen to women if family practitioners did not difference between bricanyl and ventolin practice maternity care, and that's the real take-home message.

Family physicians are really, really important."Study highlights importance of family physicians providing maternity careOn this topic, Deutchman speaks from experience. For more than 12 years he practiced family difference between bricanyl and ventolin medicine in White Salmon, Washington, a town of 2,000 residents on the Columbia River. The local hospital is federally designated critical access, which means it has fewer than 20 beds, among other standards."One of the major things I was involved in was maternity care," he says.

"I had a lot of OB patients and did a lot difference between bricanyl and ventolin of deliveries. I was also one of the major providers of surgical OB, of C-sections when they were needed."I'm an advocate for and student of the quality of outcomes in areas where family physicians are a woman's provider of obstetric and gynecologic care. I think difference between bricanyl and ventolin that women deserve to have excellent care no matter where they are and no matter who provides it." After leaving rural practice, Deutchman became a faculty member at the University of Tennessee-Memphis, where he helped train family medicine residents for rural practice.

He continued that focus after joining the University of Colorado School of Medicine in 1995. In 2005, he founded the school's rural track, which this year became a full-fledged program.His recently published research evolved from previous, similar studies he conducted in Colorado and Montana with medical students."It wasn't a study of quality—we weren't looking at individual cases and weren't looking at difference between bricanyl and ventolin outcomes—but we wanted to better understand how much and the sort of maternal care family physicians are providing at rural hospitals," he explains.After refining the survey tool used in the previous studies, Deutchman reached out to colleagues across the country. Those who responded represented 10 states and collected data about rural and frontier hospitals in their states.

They gathered data about the hospitals' obstetrics capacity, who delivers babies at the hospitals and what their specialty is, and other data."Ultimately, we were looking at how important is it for family physicians to provide maternity difference between bricanyl and ventolin care and what would access be if they didn't?. " Deutchman says.Rural program provides specialized training needed for medical students and residentsThe study's results, Deutchman says, highlight the importance of comprehensive, specialized training for medical students and residents who are interested in practicing in rural communities."Basically, the rural program is a way to attract, admit and support medical students and physician assistant students who want to live and work in rural areas when they finish their training," he explains. "We need to have a program so that people who are interested in rural practice will have their aspirations supported and also have a way to test their assumptions about rural practice and see if it's really right for them."The difference between bricanyl and ventolin last thing we want is for students to have romanticized ideas, and then they show up in a small town and it wasn't what they had in mind.

We also don't want to have that revolving door where physicians go to a small community for only two or three years, which fosters distrust and a lack of attachment between doctors and the community."Through the rural program, students not only receive on-campus experience in the classroom and clinical training, but they get significant rural clinic experience with partners throughout Colorado. That aspect of the training is vital, Deutchman says, because students learn in-person about rural health care systems and economics, community engagement, health care ethics, and how to practice in a community where physicians might regularly see patients at the grocery store.Since 2005, Deutchman says, 191 students in the CU School of Medicine have graduated in the rural difference between bricanyl and ventolin track, 40% of whom concentrated on family medicine."A common question is, 'How do you get people interested in rural practice and providing care like delivering babies?. '" Deutchman says.

"Partly, we start out with people who are initially interested, then we help nurture that interest with real facts and real difference between bricanyl and ventolin practical experience."Basically, the whole state of Colorado is short of primary care, especially in rural areas, which cannot support one of every kind of sub-specialist. Rural communities need versatile, broadly-trained and skilled physicians who can share clinical responsibilities with each other to avoid burnout. Family physicians can provide acute difference between bricanyl and ventolin care, chronic care, end of life care, deliver babies, put on casts, repair lacerations—in the most accessible, cost-effective fashion.

It's vital we train and support these physicians who go out and support these rural communities." Explore further Finding a doctor is tough and getting tougher in rural America More information. Mark Deutchman et al, The impact of family physicians in rural maternity care, Birth (2021). DOI.

10.1111/birt.12591 Provided by CU Anschutz Medical Campus Citation. Study finds family physicians deliver babies in majority of rural hospitals (2021, October 19) retrieved 20 October 2021 from https://medicalxpress.com/news/2021-10-family-physicians-babies-majority-rural.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission.

The content is provided for information purposes only.John Yang.. A recent study commissioned by the group found that, before the latest Delta surge, the state had an 11 percent vacancy rate for registered nurses, roughly the same as the national rate. It also found that a quarter of Florida's registered nurses and a third of critical care nurses left positions in the last year, citing job dissatisfaction, burnout, or other opportunities in health care.And it projected that, if current trends remain the same, by 2035, there would be a shortage of nearly 60,000 nurses..

Credit. Pixabay/CC0 Public Domain In the heart of a city, the distances in rural communities may be difficult to envision. The space between neighbors can sometimes be measured in miles rather than blocks. A drive to the nearest hospital may take dozens of minutes rather than a handful.

The trickle-down effect of such distances can impact many aspects of health care, but especially maternal care and delivery, says Mark Deutchman, MD, a professor of family medicine and associate dean for rural health at the University of Colorado School of Medicine.As principal investigator of a study recently published in the journal Birth analyzing the impact of family physicians in rural maternity care, Deutchman and his co-investigators found that of the 185 rural hospitals surveyed in 10 states, family physicians delivered babies in 67% of the hospitals and were the only physicians who delivered babies in 27% of them.Further, the study found that if family physicians stopped delivering babies in these rural hospitals, patients would have to drive an average of 86 miles round-trip to access maternal care."The purpose of this study was, number one, to understand the extent of family physicians providing maternity care in rural areas," Deutchman explains. "Number two, and even more important, was to understand what would happen to women if family practitioners did not practice maternity care, and that's the real take-home message. Family physicians are really, really important."Study highlights importance of family physicians providing maternity careOn this topic, Deutchman speaks from experience. For more than 12 years he practiced family medicine in White Salmon, Washington, a town of 2,000 residents on the Columbia River.

The local hospital is federally designated critical access, which means it has fewer than 20 beds, among other standards."One of the major things I was involved in was maternity care," he says. "I had a lot of OB patients and did a lot of deliveries. I was also one of the major providers of surgical OB, of C-sections when they were needed."I'm an advocate for and student of the quality of outcomes in areas where family physicians are a woman's provider of obstetric and gynecologic care. I think that women deserve to have excellent care no matter where they are and no matter who provides it." After leaving rural practice, Deutchman became a faculty member at the University of Tennessee-Memphis, where he helped train family medicine residents for rural practice.

He continued that focus after joining the University of Colorado School of Medicine in 1995. In 2005, he founded the school's rural track, which this year became a full-fledged program.His recently published research evolved from previous, similar studies he conducted in Colorado and Montana with medical students."It wasn't a study of quality—we weren't looking at individual cases and weren't looking at outcomes—but we wanted to better understand how much and the sort of maternal care family physicians are providing at rural hospitals," he explains.After refining the survey tool used in the previous studies, Deutchman reached out to colleagues across the country. Those who responded represented 10 states and collected data about rural and frontier hospitals in their states. They gathered data about the hospitals' obstetrics capacity, who delivers babies at the hospitals and what their specialty is, and other data."Ultimately, we were looking at how important is it for family physicians to provide maternity care and what would access be if they didn't?.

" Deutchman says.Rural program provides specialized training needed for medical students and residentsThe study's results, Deutchman says, highlight the importance of comprehensive, specialized training for medical students and residents who are interested in practicing in rural communities."Basically, the rural program is a way to attract, admit and support medical students and physician assistant students who want to live and work in rural areas when they finish their training," he explains. "We need to have a program so that people who are interested in rural practice will have their aspirations supported and also have a way to test their assumptions about rural practice and see if it's really right for them."The last thing we want is for students to have romanticized ideas, and then they show up in a small town and it wasn't what they had in mind. We also don't want to have that revolving door where physicians go to a small community for only two or three years, which fosters distrust and a lack of attachment between doctors and the community."Through the rural program, students not only receive on-campus experience in the classroom and clinical training, but they get significant rural clinic experience with partners throughout Colorado. That aspect of the training is vital, Deutchman says, because students learn in-person about rural health care systems and economics, community engagement, health care ethics, and how to practice in a community where physicians might regularly see patients at the grocery store.Since 2005, Deutchman says, 191 students in the CU School of Medicine have graduated in the rural track, 40% of whom concentrated on family medicine."A common question is, 'How do you get people interested in rural practice and providing care like delivering babies?.

'" Deutchman says. "Partly, we start out with people who are initially interested, then we help nurture that interest with real facts and real practical experience."Basically, the whole state of Colorado is short of primary care, especially in rural areas, which cannot support one of every kind of sub-specialist. Rural communities need versatile, broadly-trained and skilled physicians who can share clinical responsibilities with each other to avoid burnout. Family physicians can provide acute care, chronic care, end of life care, deliver babies, put on casts, repair lacerations—in the most accessible, cost-effective fashion.

It's vital we train and support these physicians who go out and support these rural communities." Explore further Finding a doctor is tough and getting tougher in rural America More information. Mark Deutchman et al, The impact of family physicians in rural maternity care, Birth (2021). DOI. 10.1111/birt.12591 Provided by CU Anschutz Medical Campus Citation.

Study finds family physicians deliver babies in majority of rural hospitals (2021, October 19) retrieved 20 October 2021 from https://medicalxpress.com/news/2021-10-family-physicians-babies-majority-rural.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.John Yang.. A recent study commissioned by the group found that, before the latest Delta surge, the state had an 11 percent vacancy rate for registered nurses, roughly the same as the national rate.

It also found that a quarter of Florida's registered nurses and a third of critical care nurses left positions in the last year, citing job dissatisfaction, burnout, or other opportunities in health care.And it projected that, if current trends remain the same, by 2035, there would be a shortage of nearly 60,000 nurses..

What side effects may I notice from Ventolin?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• chest pain
• feeling faint or lightheaded, falls
• high blood pressure
• irregular heartbeat
• fever
• muscle cramps or weakness
• pain, tingling, numbness in the hands or feet
• vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• cough
• diarrhea
• difficulty sleeping
• fast heartbeat
• headache
• nervousness, trembling
• stuffy or runny nose
• upset stomach

This list may not describe all possible side effects. Call your doctor for medical advice about side effects.

What is ventolin hfa

Patients Figure what is ventolin hfa 1. Figure 1 what is ventolin hfa. Enrollment and what is ventolin hfa Randomization. Of the 1114 patients who were assessed for eligibility, 1062 underwent randomization what is ventolin hfa.

541 were assigned to what is ventolin hfa the remdesivir group and 521 to the placebo group (intention-to-treat population) (Figure 1). 159 (15.0%) were what is ventolin hfa categorized as having mild-to-moderate disease, and 903 (85.0%) were in the severe disease stratum. Of those what is ventolin hfa assigned to receive remdesivir, 531 patients (98.2%) received the treatment as assigned. Fifty-two patients had remdesivir treatment discontinued before day 10 because of an adverse event or a serious adverse event other than death and what is ventolin hfa 10 withdrew consent.

Of those assigned to receive placebo, 517 patients (99.2%) received placebo as assigned. Seventy patients discontinued placebo before day 10 because of an adverse event or what is ventolin hfa a serious adverse event other than death and 14 withdrew consent. A total of 517 patients what is ventolin hfa in the remdesivir group and 508 in the placebo group completed the trial through day 29, recovered, or died. Fourteen patients who received what is ventolin hfa remdesivir and 9 who received placebo terminated their participation in the trial before day 29.

A total of 54 of the patients who were in the mild-to-moderate stratum at randomization were subsequently determined to meet the criteria for severe disease, resulting in 105 patients in the mild-to-moderate disease stratum what is ventolin hfa and 957 in the severe stratum. The as-treated population included 1048 patients who received the assigned treatment (532 in the remdesivir group, including one patient who had been what is ventolin hfa randomly assigned to placebo and received remdesivir, and 516 in the placebo group). Table 1 what is ventolin hfa. Table 1 what is ventolin hfa.

Demographic and Clinical Characteristics of the Patients at Baseline. The mean age of the patients was 58.9 years, and 64.4% were male what is ventolin hfa (Table 1). On the basis of the evolving epidemiology of asthma treatment during the trial, 79.8% of patients what is ventolin hfa were enrolled at sites in North America, 15.3% in Europe, and 4.9% in Asia (Table S1 in the Supplementary Appendix). Overall, 53.3% of the patients were White, 21.3% were Black, 12.7% were Asian, and what is ventolin hfa 12.7% were designated as other or not reported.

250 (23.5%) were Hispanic what is ventolin hfa or Latino. Most patients had either one (25.9%) or two or more (54.5%) of the prespecified coexisting conditions what is ventolin hfa at enrollment, most commonly hypertension (50.2%), obesity (44.8%), and type 2 diabetes mellitus (30.3%). The median number of days between what is ventolin hfa symptom onset and randomization was 9 (interquartile range, 6 to 12) (Table S2). A total of 957 patients what is ventolin hfa (90.1%) had severe disease at enrollment.

285 patients (26.8%) met category 7 criteria on the ordinal scale, 193 (18.2%) category 6, 435 (41.0%) category 5, and 138 (13.0%) category 4. Eleven patients what is ventolin hfa (1.0%) had missing ordinal scale data at enrollment. All these what is ventolin hfa patients discontinued the study before treatment. During the study, 373 patients (35.6% of the 1048 patients in the as-treated population) what is ventolin hfa received hydroxychloroquine and 241 (23.0%) received a glucocorticoid (Table S3).

Primary Outcome Figure what is ventolin hfa 2. Figure 2 what is ventolin hfa. Kaplan–Meier Estimates of Cumulative what is ventolin hfa Recoveries. Cumulative recovery estimates are shown in the overall what is ventolin hfa population (Panel A), in patients with a baseline score of 4 on the ordinal scale (not receiving oxygen.

Panel B), in those with a baseline score of 5 (receiving oxygen. Panel C), in those with a baseline score of 6 what is ventolin hfa (receiving high-flow oxygen or noninvasive mechanical ventilation. Panel D), and in those with what is ventolin hfa a baseline score of 7 (receiving mechanical ventilation or extracorporeal membrane oxygenation [ECMO]. Panel E).Table what is ventolin hfa 2.

Table 2 what is ventolin hfa. Outcomes Overall and According to Score on the Ordinal Scale in what is ventolin hfa the Intention-to-Treat Population. Figure 3 what is ventolin hfa. Figure 3 what is ventolin hfa.

Time to what is ventolin hfa Recovery According to Subgroup. The widths of the confidence intervals have not been adjusted for multiplicity and therefore cannot be used to infer treatment effects. Race and ethnic group were reported by the patients.Patients in the remdesivir group had what is ventolin hfa a shorter time to recovery than patients in the placebo group (median, 10 days, as compared with 15 days. Rate ratio for recovery, what is ventolin hfa 1.29.

95% confidence what is ventolin hfa interval [CI], 1.12 to 1.49. P<0.001) (Figure 2 and Table 2) what is ventolin hfa. In the severe disease stratum (957 patients) the median time to what is ventolin hfa recovery was 11 days, as compared with 18 days (rate ratio for recovery, 1.31. 95% CI, 1.12 to 1.52) what is ventolin hfa (Table S4).

The rate ratio for recovery was largest among patients with a baseline ordinal score of 5 (rate what is ventolin hfa ratio for recovery, 1.45. 95% CI, 1.18 to 1.79). Among patients with a baseline score of 4 and those with a baseline score of 6, what is ventolin hfa the rate ratio estimates for recovery were 1.29 (95% CI, 0.91 to 1.83) and 1.09 (95% CI, 0.76 to 1.57), respectively. For those receiving mechanical ventilation or ECMO at enrollment (baseline ordinal score of 7), the rate what is ventolin hfa ratio for recovery was 0.98 (95% CI, 0.70 to 1.36).

Information on interactions of treatment with what is ventolin hfa baseline ordinal score as a continuous variable is provided in Table S11. An analysis adjusting for baseline ordinal score as a covariate was conducted to evaluate the what is ventolin hfa overall effect (of the percentage of patients in each ordinal score category at baseline) on the primary outcome. This adjusted analysis produced a what is ventolin hfa similar treatment-effect estimate (rate ratio for recovery, 1.26. 95% CI, 1.09 what is ventolin hfa to 1.46).

Patients who underwent randomization during the first 10 days after the onset of symptoms had a rate ratio for recovery of 1.37 (95% CI, 1.14 to 1.64), whereas patients who underwent randomization more than 10 days after the onset of symptoms had a rate ratio for recovery what is ventolin hfa of 1.20 (95% CI, 0.94 to 1.52) (Figure 3). The benefit of remdesivir was larger when given earlier in the illness, though the benefit persisted in most analyses of duration of symptoms (Table S6). Sensitivity analyses in which data were censored at earliest reported use of glucocorticoids or hydroxychloroquine still showed what is ventolin hfa efficacy of remdesivir (9.0 days to recovery with remdesivir vs. 14.0 days to recovery what is ventolin hfa with placebo.

Rate ratio, what is ventolin hfa 1.28. 95% CI, what is ventolin hfa 1.09 to 1.50, and 10.0 vs. 16.0 days what is ventolin hfa to recovery. Rate ratio, what is ventolin hfa 1.32.

95% CI, what is ventolin hfa 1.11 to 1.58, respectively) (Table S8). Key Secondary Outcome The odds of improvement in the ordinal scale score were higher in the remdesivir group, as determined by a proportional odds model at the day 15 visit, than in the placebo group (odds ratio for improvement, 1.5. 95% CI, 1.2 to 1.9, adjusted for disease what is ventolin hfa severity) (Table 2 and Fig. S7).

Mortality Kaplan–Meier estimates of mortality by day 15 were 6.7% in the remdesivir group and 11.9% in the placebo group (hazard ratio, 0.55. 95% CI, 0.36 to 0.83). The estimates by day 29 were 11.4% and 15.2% in two groups, respectively (hazard ratio, 0.73. 95% CI, 0.52 to 1.03).

The between-group differences in mortality varied considerably according to baseline severity (Table 2), with the largest difference seen among patients with a baseline ordinal score of 5 (hazard ratio, 0.30. 95% CI, 0.14 to 0.64). Information on interactions of treatment with baseline ordinal score with respect to mortality is provided in Table S11. Additional Secondary Outcomes Table 3.

Table 3. Additional Secondary Outcomes. Patients in the remdesivir group had a shorter time to improvement of one or of two categories on the ordinal scale from baseline than patients in the placebo group (one-category improvement. Median, 7 vs.

9 days. Rate ratio for recovery, 1.23. 95% CI, 1.08 to 1.41. Two-category improvement.

Median, 11 vs. 14 days. Rate ratio, 1.29. 95% CI, 1.12 to 1.48) (Table 3).

Patients in the remdesivir group had a shorter time to discharge or to a National Early Warning Score of 2 or lower than those in the placebo group (median, 8 days vs. 12 days. Hazard ratio, 1.27. 95% CI, 1.10 to 1.46).

The initial length of hospital stay was shorter in the remdesivir group than in the placebo group (median, 12 days vs. 17 days). 5% of patients in the remdesivir group were readmitted to the hospital, as compared with 3% in the placebo group. Among the 913 patients receiving oxygen at enrollment, those in the remdesivir group continued to receive oxygen for fewer days than patients in the placebo group (median, 13 days vs.

21 days), and the incidence of new oxygen use among patients who were not receiving oxygen at enrollment was lower in the remdesivir group than in the placebo group (incidence, 36% [95% CI, 26 to 47] vs. 44% [95% CI, 33 to 57]). For the 193 patients receiving noninvasive ventilation or high-flow oxygen at enrollment, the median duration of use of these interventions was 6 days in both the remdesivir and placebo groups. Among the 573 patients who were not receiving noninvasive ventilation, high-flow oxygen, invasive ventilation, or ECMO at baseline, the incidence of new noninvasive ventilation or high-flow oxygen use was lower in the remdesivir group than in the placebo group (17% [95% CI, 13 to 22] vs.

24% [95% CI, 19 to 30]). Among the 285 patients who were receiving mechanical ventilation or ECMO at enrollment, patients in the remdesivir group received these interventions for fewer subsequent days than those in the placebo group (median, 17 days vs. 20 days), and the incidence of new mechanical ventilation or ECMO use among the 766 patients who were not receiving these interventions at enrollment was lower in the remdesivir group than in the placebo group (13% [95% CI, 10 to 17] vs. 23% [95% CI, 19 to 27]) (Table 3).

Safety Outcomes In the as-treated population, serious adverse events occurred in 131 of 532 patients (24.6%) in the remdesivir group and in 163 of 516 patients (31.6%) in the placebo group (Table S17). There were 47 serious respiratory failure adverse events in the remdesivir group (8.8% of patients), including acute respiratory failure and the need for endotracheal intubation, and 80 in the placebo group (15.5% of patients) (Table S19). No deaths were considered by the investigators to be related to treatment assignment. Grade 3 or 4 adverse events occurred on or before day 29 in 273 patients (51.3%) in the remdesivir group and in 295 (57.2%) in the placebo group (Table S18).

41 events were judged by the investigators to be related to remdesivir and 47 events to placebo (Table S17). The most common nonserious adverse events occurring in at least 5% of all patients included decreased glomerular filtration rate, decreased hemoglobin level, decreased lymphocyte count, respiratory failure, anemia, pyrexia, hyperglycemia, increased blood creatinine level, and increased blood glucose level (Table S20). The incidence of these adverse events was generally similar in the remdesivir and placebo groups. Crossover After the data and safety monitoring board recommended that the preliminary primary analysis report be provided to the sponsor, data on a total of 51 patients (4.8% of the total study enrollment) — 16 (3.0%) in the remdesivir group and 35 (6.7%) in the placebo group — were unblinded.

26 (74.3%) of those in the placebo group whose data were unblinded were given remdesivir. Sensitivity analyses evaluating the unblinding (patients whose treatment assignments were unblinded had their data censored at the time of unblinding) and crossover (patients in the placebo group treated with remdesivir had their data censored at the initiation of remdesivir treatment) produced results similar to those of the primary analysis (Table S9).Trial Objectives, Participants, and Oversight We assessed the safety and immunogenicity of three dose levels of BNT162b1 and BNT162b2. Healthy adults 18 to 55 years of age or 65 to 85 years of age were eligible for inclusion. Key exclusion criteria were known with human immunodeficiency ventolin, hepatitis C ventolin, or hepatitis B ventolin.

An immunocompromised condition. A history of autoimmune disease. A previous clinical or microbiologic diagnosis of asthma treatment. The receipt of medications intended to prevent asthma treatment.

Any previous asthma vaccination. Positive test for asthma IgM or IgG at the screening visit. And positive nasal-swab results on a asthma nucleic acid amplification test within 24 hours before the receipt of trial treatment or placebo. BioNTech was the regulatory sponsor of the trial.

Pfizer was responsible for the trial design. For the collection, analysis, and interpretation of the data. And for the writing of the report. The corresponding author had full access to all the data in the trial and had final responsibility for the decision to submit the manuscript for publication.

All the trial data were available to all the authors. Trial Procedures Using an interactive Web-based response technology system, we randomly assigned trial participants to groups defined according to the treatment candidate, dose level, and age range. Groups of participants 18 to 55 years of age and 65 to 85 years of age were to receive doses of 10 μg, 20 μg, or 30 μg of BNT162b1 or BNT162b2 (or placebo) on a two-dose schedule. One group of participants 18 to 55 years of age was assigned to receive 100-μg doses of BNT162b1 or placebo.

All the participants were assigned to receive two 0.5-ml injections of active treatment (BNT162b1 or BNT162b2) or placebo into the deltoid, administered 21 days apart. The first five participants in each new dose level or age group (with a randomization ratio of 4:1 for active treatment:placebo) were observed for 4 hours after the injection to identify immediate adverse events. All the other participants were observed for 30 minutes. Blood samples were obtained for safety and immunogenicity assessments.

Safety The primary end points in phase 1 of this trial were solicited local reactions (i.e., specific local reactions as prompted by and recorded in an electronic diary), systemic events, and use of antipyretic or pain medication within 7 days after the receipt of treatment or placebo, as prompted by and recorded in an electronic diary. Unsolicited adverse events and serious adverse events (i.e., those reported by the participants, without electronic-diary prompts), assessed from the receipt of the first dose through 1 month and 6 months, respectively, after the receipt of the second dose. Clinical laboratory abnormalities, assessed 1 day and 7 days after the receipt of treatment or placebo. And grading shifts in laboratory assessments between baseline and 1 day and 7 days after the first dose and between 2 days and 7 days after the second dose.

Protocol-specified safety stopping rules were in effect for all the participants in the phase 1 portion of the trial. The full protocol, including the statistical analysis plan, is available with the full text of this article at NEJM.org. An internal review committee and an external data and safety monitoring committee reviewed all safety data. Immunogenicity Immunogenicity assessments (asthma serum neutralization assay and receptor-binding domain [RBD]–binding or S1-binding IgG direct Luminex immunoassays) were conducted before the administration of treatment or placebo, at 7 days and 21 days after the first dose, and at 7 days (i.e., day 28) and 14 days (i.e., day 35) after the second dose.

The neutralization assay, which also generated previously described ventolin-neutralization data from trials of the BNT162 candidates,2,5 used a previously described strain of asthma (USA_WA1/2020) that had been generated by reverse genetics and engineered by the insertion of an mNeonGreen gene into open reading frame 7 of the viral genome.11,12 The 50% neutralization titers and 90% neutralization titers were reported as the interpolated reciprocal of the dilutions yielding 50% and 90% reductions, respectively, in fluorescent viral foci. Any serologic values below the lower limit of quantitation were set to 0.5 times the lower limit of quantitation. Available serologic results were included in the analysis. Immunogenicity data from a human convalescent serum panel were included as a benchmark.

A total of 38 serum samples were obtained from donors 18 to 83 years of age (median age, 42.5 years) who had recovered from asthma or asthma treatment. Samples were obtained at least 14 days after a polymerase chain reaction–confirmed diagnosis and after symptom resolution. Neutralizing geometric mean titers (GMTs) in subgroups of the donors were as follows. 90, among 35 donors with symptomatic s.

156, among 3 donors with asymptomatic . And 618, in 1 donor who was hospitalized. Each serum sample in the panel was from a different donor. Thus, most of the serum samples were obtained from persons with moderate asthma treatment who had not been hospitalized.

The serum samples were obtained from Sanguine Biosciences, the MT Group, and Pfizer Occupational Health and Wellness. Statistical Analysis We report descriptive results of safety and immunogenicity analyses, and the sample size was not based on statistical hypothesis testing. Results of the safety analyses are presented as counts, percentages, and associated Clopper–Pearson 95% confidence intervals for local reactions, systemic events, and any adverse events after the administration of treatment or placebo, according to terms in the Medical Dictionary for Regulatory Activities, version 23.0, for each treatment group. Summary statistics are provided for abnormal laboratory values and grading shifts.

Given the small number of participants in each group, the trial was not powered for formal statistical comparisons between dose levels or between age groups. Immunogenicity analyses of asthma serum neutralizing titers, S1-binding IgG and RBD-binding IgG concentrations, GMTs, and geometric mean concentrations (GMCs) were computed along with associated 95% confidence intervals. The GMTs and GMCs were calculated as the mean of the assay results after the logarithmic transformation was made. We then exponentiated the mean to express results on the original scale.

Two-sided 95% confidence intervals were obtained by performing logarithmic transformations of titers or concentrations, calculating the 95% confidence interval with reference to Student’s t-distribution, and then exponentiating the limits of the confidence intervals.Trial Design and Oversight The RECOVERY trial is an investigator-initiated platform trial to evaluate the effects of potential treatments in patients hospitalized with asthma treatment. The trial is being conducted at 176 hospitals in the United Kingdom. (Details are provided in the Supplementary Appendix, available with the full text of this article at NEJM.org.) The investigators were assisted by the National Institute for Health Research Clinical Research Network, and the trial is coordinated by the Nuffield Department of Population Health at the University of Oxford, the trial sponsor. Although patients are no longer being enrolled in the hydroxychloroquine, dexamethasone, and lopinavir–ritonavir groups, the trial continues to study the effects of azithromycin, tocilizumab, convalescent plasma, and REGN-COV2 (a combination of two monoclonal antibodies directed against the asthma spike protein).

Other treatments may be studied in the future. The hydroxychloroquine that was used in this phase of the trial was supplied by the U.K. National Health Service (NHS). Hospitalized patients were eligible for the trial if they had clinically-suspected or laboratory-confirmed asthma and no medical history that might, in the opinion of the attending clinician, put patients at substantial risk if they were to participate in the trial.

Initially, recruitment was limited to patients who were at least 18 years of age, but the age limit was removed as of May 9, 2020. Written informed consent was obtained from all the patients or from a legal representative if they were too unwell or unable to provide consent. The trial was conducted in accordance with Good Clinical Practice guidelines of the International Conference on Harmonisation and was approved by the U.K. Medicines and Healthcare Products Regulatory Agency (MHRA) and the Cambridge East Research Ethics Committee.

The protocol with its statistical analysis plan are available at NEJM.org, with additional information in the Supplementary Appendix and on the trial website at www.recoverytrial.net. The initial version of the manuscript was drafted by the first and last authors, developed by the writing committee, and approved by all members of the trial steering committee. The funders had no role in the analysis of the data, in the preparation or approval of the manuscript, or in the decision to submit the manuscript for publication. The first and last members of the writing committee vouch for the completeness and accuracy of the data and for the fidelity of the trial to the protocol and statistical analysis plan.

Randomization and Treatment We collected baseline data using a Web-based case-report form that included demographic data, level of respiratory support, major coexisting illnesses, the suitability of the trial treatment for a particular patient, and treatment availability at the trial site. Using a Web-based unstratified randomization method with the concealment of trial group, we assigned patients to receive either the usual standard of care or the usual standard of care plus hydroxychloroquine or one of the other available treatments that were being evaluated. The number of patients who were assigned to receive usual care was twice the number who were assigned to any of the active treatments for which the patient was eligible (e.g., 2:1 ratio in favor of usual care if the patient was eligible for only one active treatment group, 2:1:1 if the patient was eligible for two active treatments, etc.). For some patients, hydroxychloroquine was unavailable at the hospital at the time of enrollment or was considered by the managing physician to be either definitely indicated or definitely contraindicated.

Patients with a known prolonged corrected QT interval on electrocardiography were ineligible to receive hydroxychloroquine. (Coadministration with medications that prolong the QT interval was not an absolute contraindication, but attending clinicians were advised to check the QT interval by performing electrocardiography.) These patients were excluded from entry in the randomized comparison between hydroxychloroquine and usual care. In the hydroxychloroquine group, patients received hydroxychloroquine sulfate (in the form of a 200-mg tablet containing a 155-mg base equivalent) in a loading dose of four tablets (total dose, 800 mg) at baseline and at 6 hours, which was followed by two tablets (total dose, 400 mg) starting at 12 hours after the initial dose and then every 12 hours for the next 9 days or until discharge, whichever occurred earlier (see the Supplementary Appendix).15 The assigned treatment was prescribed by the attending clinician. The patients and local trial staff members were aware of the assigned trial groups.

Procedures A single online follow-up form was to be completed by the local trial staff members when each trial patient was discharged, at 28 days after randomization, or at the time of death, whichever occurred first. Information was recorded regarding the adherence to the assigned treatment, receipt of other treatments for asthma treatment, duration of admission, receipt of respiratory support (with duration and type), receipt of renal dialysis or hemofiltration, and vital status (including cause of death). Starting on May 12, 2020, extra information was recorded on the occurrence of new major cardiac arrhythmia. In addition, we obtained routine health care and registry data that included information on vital status (with date and cause of death) and discharge from the hospital.

Outcome Measures The primary outcome was all-cause mortality within 28 days after randomization. Further analyses were specified at 6 months. Secondary outcomes were the time until discharge from the hospital and a composite of the initiation of invasive mechanical ventilation including extracorporeal membrane oxygenation or death among patients who were not receiving invasive mechanical ventilation at the time of randomization. Decisions to initiate invasive mechanical ventilation were made by the attending clinicians, who were informed by guidance from NHS England and the National Institute for Health and Care Excellence.

Subsidiary clinical outcomes included cause-specific mortality (which was recorded in all patients) and major cardiac arrhythmia (which was recorded in a subgroup of patients). All information presented in this report is based on a data cutoff of September 21, 2020. Information regarding the primary outcome is complete for all the trial patients. Statistical Analysis For the primary outcome of 28-day mortality, we used the log-rank observed-minus-expected statistic and its variance both to test the null hypothesis of equal survival curves and to calculate the one-step estimate of the average mortality rate ratio in the comparison between the hydroxychloroquine group and the usual-care group.

Kaplan–Meier survival curves were constructed to show cumulative mortality over the 28-day period. The same methods were used to analyze the time until hospital discharge, with censoring of data on day 29 for patients who had died in the hospital. We used the Kaplan–Meier estimates to calculate the median time until hospital discharge. For the prespecified composite secondary outcome of invasive mechanical ventilation or death within 28 days (among patients who had not been receiving invasive mechanical ventilation at randomization), the precise date of the initiation of invasive mechanical ventilation was not available, so the risk ratio was estimated instead.

Estimates of the between-group difference in absolute risk were also calculated. All the analyses were performed according to the intention-to-treat principle. Prespecified analyses of the primary outcome were performed in six subgroups, as defined by characteristics at randomization. Age, sex, race, level of respiratory support, days since symptom onset, and predicted 28-day risk of death.

(Details are provided in the Supplementary Appendix.) Estimates of rate and risk ratios are shown with 95% confidence intervals without adjustment for multiple testing. The P value for the assessment of the primary outcome is two-sided. The full database is held by the trial team, which collected the data from the trial sites and performed the analyses, at the Nuffield Department of Population Health at the University of Oxford. The independent data monitoring committee was asked to review unblinded analyses of the trial data and any other information that was considered to be relevant at intervals of approximately 2 weeks.

The committee was then charged with determining whether the randomized comparisons in the trial provided evidence with respect to mortality that was strong enough (with a range of uncertainty around the results that was narrow enough) to affect national and global treatment strategies. In such a circumstance, the committee would inform the members of the trial steering committee, who would make the results available to the public and amend the trial accordingly. Unless that happened, the steering committee, investigators, and all others involved in the trial would remain unaware of the interim results until 28 days after the last patient had been randomly assigned to a particular treatment group. On June 4, 2020, in response to a request from the MHRA, the independent data monitoring committee conducted a review of the data and recommended that the chief investigators review the unblinded data for the hydroxychloroquine group.

The chief investigators and steering committee members concluded that the data showed no beneficial effect of hydroxychloroquine in patients hospitalized with asthma treatment. Therefore, the enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, and the preliminary result for the primary outcome was made public. Investigators were advised that any patients who were receiving hydroxychloroquine as part of the trial should discontinue the treatment.Supported by a philanthropic donation from Stein Erik Hagen and Canica. By a grant from the Deutsche Forschungsgemeinschaft Cluster of Excellence “Precision Medicine in Chronic Inflammation” (EXC2167).

By a Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico asthma treatment Biobank grant (to Dr. Valenti). By grants from the Italian Ministry of Health (RF-2016-02364358, to Dr. Valenti) and Ministero dell’Istruzione, dell’Università e della Ricerca project “Dipartimenti di Eccellenza 2018–2022” (D15D18000410001 to the Department of Medical Sciences, University of Turin.

By a grant from the Spanish Ministry of Science and Innovation JdC fellowship (IJC2018-035131-I, to Dr. Acosta-Herrera). And by the GCAT Cession Research Project PI-2020-01. HLA typing was performed and supported by the Stefan-Morsch-Stiftung.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org. Dr. Ellinghaus and Ms. Degenhardt and Drs.

Valenti, Franke, and Karlsen contributed equally to this article.The members of the writing committee (David Ellinghaus, Ph.D., Frauke Degenhardt, M.Sc., Luis Bujanda, M.D., Ph.D., Maria Buti, M.D., Ph.D., Agustín Albillos, M.D., Ph.D., Pietro Invernizzi, M.D., Ph.D., Javier Fernández, M.D., Ph.D., Daniele Prati, M.D., Guido Baselli, Ph.D., Rosanna Asselta, Ph.D., Marit M. Grimsrud, M.D., Chiara Milani, Ph.D., Fátima Aziz, B.S., Jan Kässens, Ph.D., Sandra May, Ph.D., Mareike Wendorff, M.Sc., Lars Wienbrandt, Ph.D., Florian Uellendahl-Werth, M.Sc., Tenghao Zheng, M.D., Ph.D., Xiaoli Yi, Raúl de Pablo, M.D., Ph.D., Adolfo G. Chercoles, B.S., Adriana Palom, M.S., B.S., Alba-Estela Garcia-Fernandez, B.S., Francisco Rodriguez-Frias, M.S., Ph.D., Alberto Zanella, M.D., Alessandra Bandera, M.D., Ph.D., Alessandro Protti, M.D., Alessio Aghemo, M.D., Ph.D., Ana Lleo, M.D., Ph.D., Andrea Biondi, M.D., Andrea Caballero-Garralda, M.S., Ph.D., Andrea Gori, M.D., Anja Tanck, Anna Carreras Nolla, B.S., Anna Latiano, Ph.D., Anna Ludovica Fracanzani, M.D., Anna Peschuck, Antonio Julià, Ph.D., Antonio Pesenti, M.D., Antonio Voza, M.D., David Jiménez, M.D., Ph.D., Beatriz Mateos, M.D., Ph.D., Beatriz Nafria Jimenez, B.S., Carmen Quereda, M.D., Ph.D., Cinzia Paccapelo, M.Sc., Christoph Gassner, Ph.D., Claudio Angelini, M.D., Cristina Cea, B.S., Aurora Solier, M.D., David Pestaña, M.D., Ph.D., Eduardo Muñiz-Diaz, M.D., Ph.D., Elena Sandoval, M.D., Elvezia M. Paraboschi, Ph.D., Enrique Navas, M.D., Ph.D., Félix García Sánchez, Ph.D., Ferruccio Ceriotti, M.D., Filippo Martinelli-Boneschi, M.D., Ph.D., Flora Peyvandi, M.D., Ph.D., Francesco Blasi, M.D., Ph.D., Luis Téllez, M.D., Ph.D., Albert Blanco-Grau, B.S., M.S., Georg Hemmrich-Stanisak, Ph.D., Giacomo Grasselli, M.D., Giorgio Costantino, M.D., Giulia Cardamone, Ph.D., Giuseppe Foti, M.D., Serena Aneli, Ph.D., Hayato Kurihara, M.D., Hesham ElAbd, M.Sc., Ilaria My, M.D., Iván Galván-Femenia, M.Sc., Javier Martín, M.D., Ph.D., Jeanette Erdmann, Ph.D., Jose Ferrusquía-Acosta, M.D., Koldo Garcia-Etxebarria, Ph.D., Laura Izquierdo-Sanchez, B.S., Laura R.

Bettini, M.D., Lauro Sumoy, Ph.D., Leonardo Terranova, Ph.D., Leticia Moreira, M.D., Ph.D., Luigi Santoro, M.S., Luigia Scudeller, M.D., Francisco Mesonero, M.D., Luisa Roade, M.D., Malte C. Rühlemann, Ph.D., Marco Schaefer, Ph.D., Maria Carrabba, M.D., Ph.D., Mar Riveiro-Barciela, M.D., Ph.D., Maria E. Figuera Basso, Maria G. Valsecchi, Ph.D., María Hernandez-Tejero, M.D., Marialbert Acosta-Herrera, Ph.D., Mariella D’Angiò, M.D., Marina Baldini, M.D., Marina Cazzaniga, M.D., Martin Schulzky, M.A., Maurizio Cecconi, M.D., Ph.D., Michael Wittig, M.Sc., Michele Ciccarelli, M.D., Miguel Rodríguez-Gandía, M.D., Monica Bocciolone, M.D., Monica Miozzo, Ph.D., Nicola Montano, M.D., Ph.D., Nicole Braun, Nicoletta Sacchi, Ph.D., Nilda Martínez, M.D., Onur Özer, M.Sc., Orazio Palmieri, Ph.D., Paola Faverio, M.D., Paoletta Preatoni, M.D., Paolo Bonfanti, M.D., Paolo Omodei, M.D., Paolo Tentorio, M.S., Pedro Castro, M.D., Ph.D., Pedro M.

Rodrigues, Ph.D., Aaron Blandino Ortiz, M.D., Rafael de Cid, Ph.D., Ricard Ferrer, M.D., Roberta Gualtierotti, M.D., Rosa Nieto, M.D., Siegfried Goerg, M.D., Salvatore Badalamenti, M.D., Ph.D., Sara Marsal, Ph.D., Giuseppe Matullo, Ph.D., Serena Pelusi, M.D., Simonas Juzenas, Ph.D., Stefano Aliberti, M.D., Valter Monzani, M.D., Victor Moreno, Ph.D., Tanja Wesse, Tobias L. Lenz, Ph.D., Tomas Pumarola, M.D., Ph.D., Valeria Rimoldi, Ph.D., Silvano Bosari, M.D., Wolfgang Albrecht, Wolfgang Peter, Ph.D., Manuel Romero-Gómez, M.D., Ph.D., Mauro D’Amato, Ph.D., Stefano Duga, Ph.D., Jesus M. Banales, Ph.D., Johannes R Hov, M.D., Ph.D., Trine Folseraas, M.D., Ph.D., Luca Valenti, M.D., Andre Franke, Ph.D., and Prof. Tom H.

Karlsen, M.D., Ph.D.) assume responsibility for the overall content and integrity of this article.This article was published on June 17, 2020, at NEJM.org.We thank all the patients who consented to participate in this study, and we express our condolences to the families of patients who died from asthma treatment. We also thank the entire clinical staff during the outbreak situation at the different centers who were able to work on this scientific study in parallel with their clinical duties. All the members of the Humanitas asthma treatment Task Force for contributions to the recruitment of patients (see the Supplementary Notes section in Supplementary Appendix 1). Sören Brunak and Karina Banasik for discussions on the ABO association.

Goncalo Abecasis and his team for providing the Michigan imputation server. Fabrizio Bossa and Francesca Tavano for contributions to control-sample acquisition. Maria Reig for help in the case-sample acquisition. The staff of the Basque Biobank in Spain for assistance in the acquisition of samples.

The staff of GCAT|Genomes for Life, a cohort study of the Genomes of Catalonia, Institute for Health Science Research Germans Trias i Pujol, for data contribution. Alexander Eck, Jenspeter Horst, and Jens Scholz for supporting the HLA typing in the project. And the members of the ethics commissions, review boards, and consortia who fast-track reviewed our applications and enabled this rapid genetic discovery study..

Patients Figure 1 buy ventolin with prescription. Figure 1 buy ventolin with prescription. Enrollment and buy ventolin with prescription Randomization. Of the 1114 patients who were assessed for eligibility, buy ventolin with prescription 1062 underwent randomization. 541 were assigned to the remdesivir group and 521 to the buy ventolin with prescription placebo group (intention-to-treat population) (Figure 1).

159 (15.0%) were categorized as buy ventolin with prescription having mild-to-moderate disease, and 903 (85.0%) were in the severe disease stratum. Of those assigned to receive remdesivir, 531 patients buy ventolin with prescription (98.2%) received the treatment as assigned. Fifty-two patients had remdesivir treatment discontinued before day 10 because of an adverse event or a serious adverse event other than death and 10 withdrew buy ventolin with prescription consent. Of those assigned to receive placebo, 517 patients (99.2%) received placebo as assigned. Seventy patients discontinued placebo before day 10 because of an buy ventolin with prescription adverse event or a serious adverse event other than death and 14 withdrew consent.

A total of buy ventolin with prescription 517 patients in the remdesivir group and 508 in the placebo group completed the trial through day 29, recovered, or died. Fourteen patients who received remdesivir and 9 who received placebo terminated their participation in the trial before buy ventolin with prescription day 29. A total of 54 of the patients who were in the mild-to-moderate stratum at randomization buy ventolin with prescription were subsequently determined to meet the criteria for severe disease, resulting in 105 patients in the mild-to-moderate disease stratum and 957 in the severe stratum. The as-treated population included 1048 patients who received the assigned treatment (532 in the remdesivir group, including one patient who had been randomly assigned to buy ventolin with prescription placebo and received remdesivir, and 516 in the placebo group). Table 1 buy ventolin with prescription.

Table 1 buy ventolin with prescription. Demographic and Clinical Characteristics of the Patients at Baseline. The mean age of the patients was 58.9 years, buy ventolin with prescription and 64.4% were male (Table 1). On the basis of the evolving epidemiology of asthma treatment during the buy ventolin with prescription trial, 79.8% of patients were enrolled at sites in North America, 15.3% in Europe, and 4.9% in Asia (Table S1 in the Supplementary Appendix). Overall, 53.3% of the patients were White, 21.3% were Black, 12.7% were Asian, and 12.7% were designated as other or buy ventolin with prescription not reported.

250 (23.5%) were buy ventolin with prescription Hispanic or Latino. Most patients had either one (25.9%) or two or more (54.5%) of the prespecified coexisting conditions at enrollment, most commonly hypertension buy ventolin with prescription (50.2%), obesity (44.8%), and type 2 diabetes mellitus (30.3%). The median number buy ventolin with prescription of days between symptom onset and randomization was 9 (interquartile range, 6 to 12) (Table S2). A total of 957 patients (90.1%) had severe buy ventolin with prescription disease at enrollment. 285 patients (26.8%) met category 7 criteria on the ordinal scale, 193 (18.2%) category 6, 435 (41.0%) category 5, and 138 (13.0%) category 4.

Eleven patients (1.0%) had buy ventolin with prescription missing ordinal scale data at enrollment. All these patients discontinued buy ventolin with prescription the study before treatment. During the study, 373 patients (35.6% of the 1048 patients in the as-treated population) received hydroxychloroquine and 241 buy ventolin with prescription (23.0%) received a glucocorticoid (Table S3). Primary Outcome buy ventolin with prescription Figure 2. Figure 2 buy ventolin with prescription.

Kaplan–Meier Estimates buy ventolin with prescription of Cumulative Recoveries. Cumulative recovery buy ventolin with prescription estimates are shown in the overall population (Panel A), in patients with a baseline score of 4 on the ordinal scale (not receiving oxygen. Panel B), in those with a baseline score of 5 (receiving oxygen. Panel C), in those with a baseline score of 6 buy ventolin with prescription (receiving high-flow oxygen or noninvasive mechanical ventilation. Panel D), and in those with a baseline score of 7 (receiving mechanical ventilation or extracorporeal membrane oxygenation buy ventolin with prescription [ECMO].

Panel E).Table buy ventolin with prescription 2. Table 2 buy ventolin with prescription. Outcomes Overall buy ventolin with prescription and According to Score on the Ordinal Scale in the Intention-to-Treat Population. Figure 3 buy ventolin with prescription. Figure 3 buy ventolin with prescription.

Time to buy ventolin with prescription Recovery According to Subgroup. The widths of the confidence intervals have not been adjusted for multiplicity and therefore cannot be used to infer treatment effects. Race and ethnic group were reported buy ventolin with prescription by the patients.Patients in the remdesivir group had a shorter time to recovery than patients in the placebo group (median, 10 days, as compared with 15 days. Rate ratio buy ventolin with prescription for recovery, 1.29. 95% confidence interval [CI], 1.12 to buy ventolin with prescription 1.49.

P<0.001) (Figure buy ventolin with prescription 2 and Table 2). In the severe disease stratum (957 patients) buy ventolin with prescription the median time to recovery was 11 days, as compared with 18 days (rate ratio for recovery, 1.31. 95% CI, 1.12 to 1.52) (Table buy ventolin with prescription S4). The rate buy ventolin with prescription ratio for recovery was largest among patients with a baseline ordinal score of 5 (rate ratio for recovery, 1.45. 95% CI, 1.18 to 1.79).

Among patients with a baseline score of 4 and those with a baseline buy ventolin with prescription score of 6, the rate ratio estimates for recovery were 1.29 (95% CI, 0.91 to 1.83) and 1.09 (95% CI, 0.76 to 1.57), respectively. For those receiving mechanical ventilation or buy ventolin with prescription ECMO at enrollment (baseline ordinal score of 7), the rate ratio for recovery was 0.98 (95% CI, 0.70 to 1.36). Information on interactions of treatment buy ventolin with prescription with baseline ordinal score as a continuous variable is provided in Table S11. An analysis buy ventolin with prescription adjusting for baseline ordinal score as a covariate was conducted to evaluate the overall effect (of the percentage of patients in each ordinal score category at baseline) on the primary outcome. This adjusted analysis produced a similar treatment-effect estimate buy ventolin with prescription (rate ratio for recovery, 1.26.

95% CI, 1.09 to buy ventolin with prescription 1.46). Patients who underwent randomization during the first 10 days after the buy ventolin with prescription onset of symptoms had a rate ratio for recovery of 1.37 (95% CI, 1.14 to 1.64), whereas patients who underwent randomization more than 10 days after the onset of symptoms had a rate ratio for recovery of 1.20 (95% CI, 0.94 to 1.52) (Figure 3). The benefit of remdesivir was larger when given earlier in the illness, though the benefit persisted in most analyses of duration of symptoms (Table S6). Sensitivity analyses in which data were censored at earliest reported use of glucocorticoids or hydroxychloroquine still showed efficacy of remdesivir (9.0 days to recovery with remdesivir buy ventolin with prescription vs. 14.0 days to recovery with buy ventolin with prescription placebo.

Rate ratio, 1.28 buy ventolin with prescription. 95% CI, 1.09 buy ventolin with prescription to 1.50, and 10.0 vs. 16.0 days buy ventolin with prescription to recovery. Rate ratio, buy ventolin with prescription 1.32. 95% CI, 1.11 to 1.58, respectively) (Table buy ventolin with prescription S8).

Key Secondary Outcome The odds of improvement in the ordinal scale score were higher in the remdesivir group, as determined by a proportional odds model at the day 15 visit, than in the placebo group (odds ratio for improvement, 1.5. 95% CI, 1.2 to 1.9, adjusted for buy ventolin with prescription disease severity) (Table 2 and Fig. S7). Mortality Kaplan–Meier estimates of mortality by day 15 were 6.7% in the remdesivir group and 11.9% in the placebo group (hazard ratio, 0.55. 95% CI, 0.36 to 0.83).

The estimates by day 29 were 11.4% and 15.2% in two groups, respectively (hazard ratio, 0.73. 95% CI, 0.52 to 1.03). The between-group differences in mortality varied considerably according to baseline severity (Table 2), with the largest difference seen among patients with a baseline ordinal score of 5 (hazard ratio, 0.30. 95% CI, 0.14 to 0.64). Information on interactions of treatment with baseline ordinal score with respect to mortality is provided in Table S11.

Additional Secondary Outcomes Table 3. Table 3. Additional Secondary Outcomes. Patients in the remdesivir group had a shorter time to improvement of one or of two categories on the ordinal scale from baseline than patients in the placebo group (one-category improvement. Median, 7 vs.

9 days. Rate ratio for recovery, 1.23. 95% CI, 1.08 to 1.41. Two-category improvement. Median, 11 vs.

14 days. Rate ratio, 1.29. 95% CI, 1.12 to 1.48) (Table 3). Patients in the remdesivir group had a shorter time to discharge or to a National Early Warning Score of 2 or lower than those in the placebo group (median, 8 days vs. 12 days.

Hazard ratio, 1.27. 95% CI, 1.10 to 1.46). The initial length of hospital stay was shorter in the remdesivir group than in the placebo group (median, 12 days vs. 17 days). 5% of patients in the remdesivir group were readmitted to the hospital, as compared with 3% in the placebo group.

Among the 913 patients receiving oxygen at enrollment, those in the remdesivir group continued to receive oxygen for fewer days than patients in the placebo group (median, 13 days vs. 21 days), and the incidence of new oxygen use among patients who were not receiving oxygen at enrollment was lower in the remdesivir group than in the placebo group (incidence, 36% [95% CI, 26 to 47] vs. 44% [95% CI, 33 to 57]). For the 193 patients receiving noninvasive ventilation or high-flow oxygen at enrollment, the median duration of use of these interventions was 6 days in both the remdesivir and placebo groups. Among the 573 patients who were not receiving noninvasive ventilation, high-flow oxygen, invasive ventilation, or ECMO at baseline, the incidence of new noninvasive ventilation or high-flow oxygen use was lower in the remdesivir group than in the placebo group (17% [95% CI, 13 to 22] vs.

24% [95% CI, 19 to 30]). Among the 285 patients who were receiving mechanical ventilation or ECMO at enrollment, patients in the remdesivir group received these interventions for fewer subsequent days than those in the placebo group (median, 17 days vs. 20 days), and the incidence of new mechanical ventilation or ECMO use among the 766 patients who were not receiving these interventions at enrollment was lower in the remdesivir group than in the placebo group (13% [95% CI, 10 to 17] vs. 23% [95% CI, 19 to 27]) (Table 3). Safety Outcomes In the as-treated population, serious adverse events occurred in 131 of 532 patients (24.6%) in the remdesivir group and in 163 of 516 patients (31.6%) in the placebo group (Table S17).

There were 47 serious respiratory failure adverse events in the remdesivir group (8.8% of patients), including acute respiratory failure and the need for endotracheal intubation, and 80 in the placebo group (15.5% of patients) (Table S19). No deaths were considered by the investigators to be related to treatment assignment. Grade 3 or 4 adverse events occurred on or before day 29 in 273 patients (51.3%) in the remdesivir group and in 295 (57.2%) in the placebo group (Table S18). 41 events were judged by the investigators to be related to remdesivir and 47 events to placebo (Table S17). The most common nonserious adverse events occurring in at least 5% of all patients included decreased glomerular filtration rate, decreased hemoglobin level, decreased lymphocyte count, respiratory failure, anemia, pyrexia, hyperglycemia, increased blood creatinine level, and increased blood glucose level (Table S20).

The incidence of these adverse events was generally similar in the remdesivir and placebo groups. Crossover After the data and safety monitoring board recommended that the preliminary primary analysis report be provided to the sponsor, data on a total of 51 patients (4.8% of the total study enrollment) — 16 (3.0%) in the remdesivir group and 35 (6.7%) in the placebo group — were unblinded. 26 (74.3%) of those in the placebo group whose data were unblinded were given remdesivir. Sensitivity analyses evaluating the unblinding (patients whose treatment assignments were unblinded had their data censored at the time of unblinding) and crossover (patients in the placebo group treated with remdesivir had their data censored at the initiation of remdesivir treatment) produced results similar to those of the primary analysis (Table S9).Trial Objectives, Participants, and Oversight We assessed the safety and immunogenicity of three dose levels of BNT162b1 and BNT162b2. Healthy adults 18 to 55 years of age or 65 to 85 years of age were eligible for inclusion.

Key exclusion criteria were known with human immunodeficiency ventolin, hepatitis C ventolin, or hepatitis B ventolin. An immunocompromised condition. A history of autoimmune disease. A previous clinical or microbiologic diagnosis of asthma treatment. The receipt of medications intended to prevent asthma treatment.

Any previous asthma vaccination. Positive test for asthma IgM or IgG at the screening visit. And positive nasal-swab results on a asthma nucleic acid amplification test within 24 hours before the receipt of trial treatment or placebo. BioNTech was the regulatory sponsor of the trial. Pfizer was responsible for the trial design.

For the collection, analysis, and interpretation of the data. And for the writing of the report. The corresponding author had full access to all the data in the trial and had final responsibility for the decision to submit the manuscript for publication. All the trial data were available to all the authors. Trial Procedures Using an interactive Web-based response technology system, we randomly assigned trial participants to groups defined according to the treatment candidate, dose level, and age range.

Groups of participants 18 to 55 years of age and 65 to 85 years of age were to receive doses of 10 μg, 20 μg, or 30 μg of BNT162b1 or BNT162b2 (or placebo) on a two-dose schedule. One group of participants 18 to 55 years of age was assigned to receive 100-μg doses of BNT162b1 or placebo. All the participants were assigned to receive two 0.5-ml injections of active treatment (BNT162b1 or BNT162b2) or placebo into the deltoid, administered 21 days apart. The first five participants in each new dose level or age group (with a randomization ratio of 4:1 for active treatment:placebo) were observed for 4 hours after the injection to identify immediate adverse events. All the other participants were observed for 30 minutes.

Blood samples were obtained for safety and immunogenicity assessments. Safety The primary end points in phase 1 of this trial were solicited local reactions (i.e., specific local reactions as prompted by and recorded in an electronic diary), systemic events, and use of antipyretic or pain medication within 7 days after the receipt of treatment or placebo, as prompted by and recorded in an electronic diary. Unsolicited adverse events and serious adverse events (i.e., those reported by the participants, without electronic-diary prompts), assessed from the receipt of the first dose through 1 month and 6 months, respectively, after the receipt of the second dose. Clinical laboratory abnormalities, assessed 1 day and 7 days after the receipt of treatment or placebo. And grading shifts in laboratory assessments between baseline and 1 day and 7 days after the first dose and between 2 days and 7 days after the second dose.

Protocol-specified safety stopping rules were in effect for all the participants in the phase 1 portion of the trial. The full protocol, including the statistical analysis plan, is available with the full text of this article at NEJM.org. An internal review committee and an external data and safety monitoring committee reviewed all safety data. Immunogenicity Immunogenicity assessments (asthma serum neutralization assay and receptor-binding domain [RBD]–binding or S1-binding IgG direct Luminex immunoassays) were conducted before the administration of treatment or placebo, at 7 days and 21 days after the first dose, and at 7 days (i.e., day 28) and 14 days (i.e., day 35) after the second dose. The neutralization assay, which also generated previously described ventolin-neutralization data from trials of the BNT162 candidates,2,5 used a previously described strain of asthma (USA_WA1/2020) that had been generated by reverse genetics and engineered by the insertion of an mNeonGreen gene into open reading frame 7 of the viral genome.11,12 The 50% neutralization titers and 90% neutralization titers were reported as the interpolated reciprocal of the dilutions yielding 50% and 90% reductions, respectively, in fluorescent viral foci.

Any serologic values below the lower limit of quantitation were set to 0.5 times the lower limit of quantitation. Available serologic results were included in the analysis. Immunogenicity data from a human convalescent serum panel were included as a benchmark. A total of 38 serum samples were obtained from donors 18 to 83 years of age (median age, 42.5 years) who had recovered from asthma or asthma treatment. Samples were obtained at least 14 days after a polymerase chain reaction–confirmed diagnosis and after symptom resolution.

Neutralizing geometric mean titers (GMTs) in subgroups of the donors were as follows. 90, among 35 donors with symptomatic s. 156, among 3 donors with asymptomatic . And 618, in 1 donor who was hospitalized. Each serum sample in the panel was from a different donor.

Thus, most of the serum samples were obtained from persons with moderate asthma treatment who had not been hospitalized. The serum samples were obtained from Sanguine Biosciences, the MT Group, and Pfizer Occupational Health and Wellness. Statistical Analysis We report descriptive results of safety and immunogenicity analyses, and the sample size was not based on statistical hypothesis testing. Results of the safety analyses are presented as counts, percentages, and associated Clopper–Pearson 95% confidence intervals for local reactions, systemic events, and any adverse events after the administration of treatment or placebo, according to terms in the Medical Dictionary for Regulatory Activities, version 23.0, for each treatment group. Summary statistics are provided for abnormal laboratory values and grading shifts.

Given the small number of participants in each group, the trial was not powered for formal statistical comparisons between dose levels or between age groups. Immunogenicity analyses of asthma serum neutralizing titers, S1-binding IgG and RBD-binding IgG concentrations, GMTs, and geometric mean concentrations (GMCs) were computed along with associated 95% confidence intervals. The GMTs and GMCs were calculated as the mean of the assay results after the logarithmic transformation was made. We then exponentiated the mean to express results on the original scale. Two-sided 95% confidence intervals were obtained by performing logarithmic transformations of titers or concentrations, calculating the 95% confidence interval with reference to Student’s t-distribution, and then exponentiating the limits of the confidence intervals.Trial Design and Oversight The RECOVERY trial is an investigator-initiated platform trial to evaluate the effects of potential treatments in patients hospitalized with asthma treatment.

The trial is being conducted at 176 hospitals in the United Kingdom. (Details are provided in the Supplementary Appendix, available with the full text of this article at NEJM.org.) The investigators were assisted by the National Institute for Health Research Clinical Research Network, and the trial is coordinated by the Nuffield Department of Population Health at the University of Oxford, the trial sponsor. Although patients are no longer being enrolled in the hydroxychloroquine, dexamethasone, and lopinavir–ritonavir groups, the trial continues to study the effects of azithromycin, tocilizumab, convalescent plasma, and REGN-COV2 (a combination of two monoclonal antibodies directed against the asthma spike protein). Other treatments may be studied in the future. The hydroxychloroquine that was used in this phase of the trial was supplied by the U.K.

National Health Service (NHS). Hospitalized patients were eligible for the trial if they had clinically-suspected or laboratory-confirmed asthma and no medical history that might, in the opinion of the attending clinician, put patients at substantial risk if they were to participate in the trial. Initially, recruitment was limited to patients who were at least 18 years of age, but the age limit was removed as of May 9, 2020. Written informed consent was obtained from all the patients or from a legal representative if they were too unwell or unable to provide consent. The trial was conducted in accordance with Good Clinical Practice guidelines of the International Conference on Harmonisation and was approved by the U.K.

Medicines and Healthcare Products Regulatory Agency (MHRA) and the Cambridge East Research Ethics Committee. The protocol with its statistical analysis plan are available at NEJM.org, with additional information in the Supplementary Appendix and on the trial website at www.recoverytrial.net. The initial version of the manuscript was drafted by the first and last authors, developed by the writing committee, and approved by all members of the trial steering committee. The funders had no role in the analysis of the data, in the preparation or approval of the manuscript, or in the decision to submit the manuscript for publication. The first and last members of the writing committee vouch for the completeness and accuracy of the data and for the fidelity of the trial to the protocol and statistical analysis plan.

Randomization and Treatment We collected baseline data using a Web-based case-report form that included demographic data, level of respiratory support, major coexisting illnesses, the suitability of the trial treatment for a particular patient, and treatment availability at the trial site. Using a Web-based unstratified randomization method with the concealment of trial group, we assigned patients to receive either the usual standard of care or the usual standard of care plus hydroxychloroquine or one of the other available treatments that were being evaluated. The number of patients who were assigned to receive usual care was twice the number who were assigned to any of the active treatments for which the patient was eligible (e.g., 2:1 ratio in favor of usual care if the patient was eligible for only one active treatment group, 2:1:1 if the patient was eligible for two active treatments, etc.). For some patients, hydroxychloroquine was unavailable at the hospital at the time of enrollment or was considered by the managing physician to be either definitely indicated or definitely contraindicated. Patients with a known prolonged corrected QT interval on electrocardiography were ineligible to receive hydroxychloroquine.

(Coadministration with medications that prolong the QT interval was not an absolute contraindication, but attending clinicians were advised to check the QT interval by performing electrocardiography.) These patients were excluded from entry in the randomized comparison between hydroxychloroquine and usual care. In the hydroxychloroquine group, patients received hydroxychloroquine sulfate (in the form of a 200-mg tablet containing a 155-mg base equivalent) in a loading dose of four tablets (total dose, 800 mg) at baseline and at 6 hours, which was followed by two tablets (total dose, 400 mg) starting at 12 hours after the initial dose and then every 12 hours for the next 9 days or until discharge, whichever occurred earlier (see the Supplementary Appendix).15 The assigned treatment was prescribed by the attending clinician. The patients and local trial staff members were aware of the assigned trial groups. Procedures A single online follow-up form was to be completed by the local trial staff members when each trial patient was discharged, at 28 days after randomization, or at the time of death, whichever occurred first. Information was recorded regarding the adherence to the assigned treatment, receipt of other treatments for asthma treatment, duration of admission, receipt of respiratory support (with duration and type), receipt of renal dialysis or hemofiltration, and vital status (including cause of death).

Starting on May 12, 2020, extra information was recorded on the occurrence of new major cardiac arrhythmia. In addition, we obtained routine health care and registry data that included information on vital status (with date and cause of death) and discharge from the hospital. Outcome Measures The primary outcome was all-cause mortality within 28 days after randomization. Further analyses were specified at 6 months. Secondary outcomes were the time until discharge from the hospital and a composite of the initiation of invasive mechanical ventilation including extracorporeal membrane oxygenation or death among patients who were not receiving invasive mechanical ventilation at the time of randomization.

Decisions to initiate invasive mechanical ventilation were made by the attending clinicians, who were informed by guidance from NHS England and the National Institute for Health and Care Excellence. Subsidiary clinical outcomes included cause-specific mortality (which was recorded in all patients) and major cardiac arrhythmia (which was recorded in a subgroup of patients). All information presented in this report is based on a data cutoff of September 21, 2020. Information regarding the primary outcome is complete for all the trial patients. Statistical Analysis For the primary outcome of 28-day mortality, we used the log-rank observed-minus-expected statistic and its variance both to test the null hypothesis of equal survival curves and to calculate the one-step estimate of the average mortality rate ratio in the comparison between the hydroxychloroquine group and the usual-care group.

Kaplan–Meier survival curves were constructed to show cumulative mortality over the 28-day period. The same methods were used to analyze the time until hospital discharge, with censoring of data on day 29 for patients who had died in the hospital. We used the Kaplan–Meier estimates to calculate the median time until hospital discharge. For the prespecified composite secondary outcome of invasive mechanical ventilation or death within 28 days (among patients who had not been receiving invasive mechanical ventilation at randomization), the precise date of the initiation of invasive mechanical ventilation was not available, so the risk ratio was estimated instead. Estimates of the between-group difference in absolute risk were also calculated.

All the analyses were performed according to the intention-to-treat principle. Prespecified analyses of the primary outcome were performed in six subgroups, as defined by characteristics at randomization. Age, sex, race, level of respiratory support, days since symptom onset, and predicted 28-day risk of death. (Details are provided in the Supplementary Appendix.) Estimates of rate and risk ratios are shown with 95% confidence intervals without adjustment for multiple testing. The P value for the assessment of the primary outcome is two-sided.

The full database is held by the trial team, which collected the data from the trial sites and performed the analyses, at the Nuffield Department of Population Health at the University of Oxford. The independent data monitoring committee was asked to review unblinded analyses of the trial data and any other information that was considered to be relevant at intervals of approximately 2 weeks. The committee was then charged with determining whether the randomized comparisons in the trial provided evidence with respect to mortality that was strong enough (with a range of uncertainty around the results that was narrow enough) to affect national and global treatment strategies. In such a circumstance, the committee would inform the members of the trial steering committee, who would make the results available to the public and amend the trial accordingly. Unless that happened, the steering committee, investigators, and all others involved in the trial would remain unaware of the interim results until 28 days after the last patient had been randomly assigned to a particular treatment group.

On June 4, 2020, in response to a request from the MHRA, the independent data monitoring committee conducted a review of the data and recommended that the chief investigators review the unblinded data for the hydroxychloroquine group. The chief investigators and steering committee members concluded that the data showed no beneficial effect of hydroxychloroquine in patients hospitalized with asthma treatment. Therefore, the enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, and the preliminary result for the primary outcome was made public. Investigators were advised that any patients who were receiving hydroxychloroquine as part of the trial should discontinue the treatment.Supported by a philanthropic donation from Stein Erik Hagen and Canica. By a grant from the Deutsche Forschungsgemeinschaft Cluster of Excellence “Precision Medicine in Chronic Inflammation” (EXC2167).

By a Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico asthma treatment Biobank grant (to Dr. Valenti). By grants from the Italian Ministry of Health (RF-2016-02364358, to Dr. Valenti) and Ministero dell’Istruzione, dell’Università e della Ricerca project “Dipartimenti di Eccellenza 2018–2022” (D15D18000410001 to the Department of Medical Sciences, University of Turin. By a grant from the Spanish Ministry of Science and Innovation JdC fellowship (IJC2018-035131-I, to Dr.

Acosta-Herrera). And by the GCAT Cession Research Project PI-2020-01. HLA typing was performed and supported by the Stefan-Morsch-Stiftung. Disclosure forms provided by the authors are available with the full text of this article at NEJM.org. Dr.

Ellinghaus and Ms. Degenhardt and Drs. Valenti, Franke, and Karlsen contributed equally to this article.The members of the writing committee (David Ellinghaus, Ph.D., Frauke Degenhardt, M.Sc., Luis Bujanda, M.D., Ph.D., Maria Buti, M.D., Ph.D., Agustín Albillos, M.D., Ph.D., Pietro Invernizzi, M.D., Ph.D., Javier Fernández, M.D., Ph.D., Daniele Prati, M.D., Guido Baselli, Ph.D., Rosanna Asselta, Ph.D., Marit M. Grimsrud, M.D., Chiara Milani, Ph.D., Fátima Aziz, B.S., Jan Kässens, Ph.D., Sandra May, Ph.D., Mareike Wendorff, M.Sc., Lars Wienbrandt, Ph.D., Florian Uellendahl-Werth, M.Sc., Tenghao Zheng, M.D., Ph.D., Xiaoli Yi, Raúl de Pablo, M.D., Ph.D., Adolfo G. Chercoles, B.S., Adriana Palom, M.S., B.S., Alba-Estela Garcia-Fernandez, B.S., Francisco Rodriguez-Frias, M.S., Ph.D., Alberto Zanella, M.D., Alessandra Bandera, M.D., Ph.D., Alessandro Protti, M.D., Alessio Aghemo, M.D., Ph.D., Ana Lleo, M.D., Ph.D., Andrea Biondi, M.D., Andrea Caballero-Garralda, M.S., Ph.D., Andrea Gori, M.D., Anja Tanck, Anna Carreras Nolla, B.S., Anna Latiano, Ph.D., Anna Ludovica Fracanzani, M.D., Anna Peschuck, Antonio Julià, Ph.D., Antonio Pesenti, M.D., Antonio Voza, M.D., David Jiménez, M.D., Ph.D., Beatriz Mateos, M.D., Ph.D., Beatriz Nafria Jimenez, B.S., Carmen Quereda, M.D., Ph.D., Cinzia Paccapelo, M.Sc., Christoph Gassner, Ph.D., Claudio Angelini, M.D., Cristina Cea, B.S., Aurora Solier, M.D., David Pestaña, M.D., Ph.D., Eduardo Muñiz-Diaz, M.D., Ph.D., Elena Sandoval, M.D., Elvezia M.

Paraboschi, Ph.D., Enrique Navas, M.D., Ph.D., Félix García Sánchez, Ph.D., Ferruccio Ceriotti, M.D., Filippo Martinelli-Boneschi, M.D., Ph.D., Flora Peyvandi, M.D., Ph.D., Francesco Blasi, M.D., Ph.D., Luis Téllez, M.D., Ph.D., Albert Blanco-Grau, B.S., M.S., Georg Hemmrich-Stanisak, Ph.D., Giacomo Grasselli, M.D., Giorgio Costantino, M.D., Giulia Cardamone, Ph.D., Giuseppe Foti, M.D., Serena Aneli, Ph.D., Hayato Kurihara, M.D., Hesham ElAbd, M.Sc., Ilaria My, M.D., Iván Galván-Femenia, M.Sc., Javier Martín, M.D., Ph.D., Jeanette Erdmann, Ph.D., Jose Ferrusquía-Acosta, M.D., Koldo Garcia-Etxebarria, Ph.D., Laura Izquierdo-Sanchez, B.S., Laura R. Bettini, M.D., Lauro Sumoy, Ph.D., Leonardo Terranova, Ph.D., Leticia Moreira, M.D., Ph.D., Luigi Santoro, M.S., Luigia Scudeller, M.D., Francisco Mesonero, M.D., Luisa Roade, M.D., Malte C. Rühlemann, Ph.D., Marco Schaefer, Ph.D., Maria Carrabba, M.D., Ph.D., Mar Riveiro-Barciela, M.D., Ph.D., Maria E. Figuera Basso, Maria G. Valsecchi, Ph.D., María Hernandez-Tejero, M.D., Marialbert Acosta-Herrera, Ph.D., Mariella D’Angiò, M.D., Marina Baldini, M.D., Marina Cazzaniga, M.D., Martin Schulzky, M.A., Maurizio Cecconi, M.D., Ph.D., Michael Wittig, M.Sc., Michele Ciccarelli, M.D., Miguel Rodríguez-Gandía, M.D., Monica Bocciolone, M.D., Monica Miozzo, Ph.D., Nicola Montano, M.D., Ph.D., Nicole Braun, Nicoletta Sacchi, Ph.D., Nilda Martínez, M.D., Onur Özer, M.Sc., Orazio Palmieri, Ph.D., Paola Faverio, M.D., Paoletta Preatoni, M.D., Paolo Bonfanti, M.D., Paolo Omodei, M.D., Paolo Tentorio, M.S., Pedro Castro, M.D., Ph.D., Pedro M.

Rodrigues, Ph.D., Aaron Blandino Ortiz, M.D., Rafael de Cid, Ph.D., Ricard Ferrer, M.D., Roberta Gualtierotti, M.D., Rosa Nieto, M.D., Siegfried Goerg, M.D., Salvatore Badalamenti, M.D., Ph.D., Sara Marsal, Ph.D., Giuseppe Matullo, Ph.D., Serena Pelusi, M.D., Simonas Juzenas, Ph.D., Stefano Aliberti, M.D., Valter Monzani, M.D., Victor Moreno, Ph.D., Tanja Wesse, Tobias L. Lenz, Ph.D., Tomas Pumarola, M.D., Ph.D., Valeria Rimoldi, Ph.D., Silvano Bosari, M.D., Wolfgang Albrecht, Wolfgang Peter, Ph.D., Manuel Romero-Gómez, M.D., Ph.D., Mauro D’Amato, Ph.D., Stefano Duga, Ph.D., Jesus M. Banales, Ph.D., Johannes R Hov, M.D., Ph.D., Trine Folseraas, M.D., Ph.D., Luca Valenti, M.D., Andre Franke, Ph.D., and Prof. Tom H. Karlsen, M.D., Ph.D.) assume responsibility for the overall content and integrity of this article.This article was published on June 17, 2020, at NEJM.org.We thank all the patients who consented to participate in this study, and we express our condolences to the families of patients who died from asthma treatment.

We also thank the entire clinical staff during the outbreak situation at the different centers who were able to work on this scientific study in parallel with their clinical duties. All the members of the Humanitas asthma treatment Task Force for contributions to the recruitment of patients (see the Supplementary Notes section in Supplementary Appendix 1). Sören Brunak and Karina Banasik for discussions on the ABO association. Goncalo Abecasis and his team for providing the Michigan imputation server. Fabrizio Bossa and Francesca Tavano for contributions to control-sample acquisition.

Maria Reig for help in the case-sample acquisition. The staff of the Basque Biobank in Spain for assistance in the acquisition of samples. The staff of GCAT|Genomes for Life, a cohort study of the Genomes of Catalonia, Institute for Health Science Research Germans Trias i Pujol, for data contribution. Alexander Eck, Jenspeter Horst, and Jens Scholz for supporting the HLA typing in the project. And the members of the ethics commissions, review boards, and consortia who fast-track reviewed our applications and enabled this rapid genetic discovery study..

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University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, does ventolin contain lactose Australia, Westmead Hospital, Sydney, NSW, Australia, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW,AustraliaPublication date:01 June 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as asthma treatment, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

The IJTLD is dedicated to understanding lung disease and to the does ventolin contain lactose dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.Editorial BoardInformation for AuthorsSubscribe to this TitleInternational Journal of Tuberculosis and Lung DiseasePublic Health ActionIngenta Connect is not responsible for the content or availability of external websitesDownload Article.

Download (PDF 45.7 kb) No AbstractNo Reference information available - does ventolin contain lactose sign in for access. No Supplementary Data.No Article MediaNo MetricsDocument Type. EditorialAffiliations:1.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore 2. Infectious Diseases Translational Research Programme, Department of Medicine, does ventolin contain lactose Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Institute for Health Innovation &. Technology, National University of Singapore, Singapore 3.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporePublication date:01 June 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as asthma treatment, asthma, COPD, child lung health and the hazards of does ventolin contain lactose tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication.

EditorialAffiliations:1. University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, University of Groningen, Groningen, The Netherlands, Tuberculosis Center Beatrixoord, University Medical Center Groningen, University of Groningen, Haren,The Netherlands 2. Department of , Barts Health NHS Trust, London, UK, Blizard Institute, Queen Mary University of London, London, UK 3. University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia, Westmead Hospital, Sydney, NSW, Australia, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW,AustraliaPublication date:01 June 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as asthma treatment, asthma, COPD, child lung health and the hazards of tobacco and air pollution.

Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details. The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.Editorial BoardInformation for AuthorsSubscribe to this TitleInternational Journal of Tuberculosis and Lung DiseasePublic Health ActionIngenta Connect is not responsible for the content or availability of external websitesDownload Article. Download (PDF 45.7 kb) No AbstractNo Reference information available - sign in for access.

No Supplementary Data.No Article MediaNo MetricsDocument Type. EditorialAffiliations:1. Saw Swee Hock School of Public Health, National University of Singapore, Singapore 2. Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Institute for Health Innovation &. Technology, National University of Singapore, Singapore 3.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, SingaporePublication date:01 June 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as asthma treatment, asthma, COPD, child lung health and the hazards of tobacco and air pollution.