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Naomi Rodrig, 28 Apr 2016
A combination of live-bacterium immunotherapy and standard chemotherapy is safe and effective in patients with malignant pleural mesothelioma (MPM), providing a response rate of nearly 60 percent, according to a recent phase Ib trial. [ELCC 2016, abstract 208O_PR]
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Breastfeeding may lower risk of childhood asthma exacerbations

Pearl Toh
08 Sep 2017

Breastfeeding in children with asthma was associated with a reduced risk of asthma exacerbations, especially in children with a family history of asthma, according to the PACMAN* study.

Compared with asthmatic children who were never breastfed, those who had been breastfed were 45 percent less likely to experience asthma exacerbations at age 4–12 years (adjusted odds ratio [OR], 0.55; p=0.01), after adjusting for age and eczema. The proportion of children with asthma exacerbations were also significantly lower in those who were ever-breastfed vs never-breastfed (9 vs 15 percent; p=0.007). [Pediatr Allergy Immunol 2017;doi:10.1111/pai.12760]

When the analysis was stratified by family asthma history, the association between asthma exacerbations and breastfeeding was only significant in children with a positive history (OR, 0.34; p=0.001), but not in those without (OR, 1.08; p=0.82).  

“[T]he relation might be explained by the influence of breastfeeding on the immune system. Changes in the composition and activity of the gut microbiome in early life can influence the immune system and these changes might indirectly lead to changes in asthma later in life," said study principal investigator Prof Anke-Hilse Maitland-van der Zee from the Department of Respiratory Medicine at the University of Amsterdam in the Netherlands.

Stratifying the analysis by the duration of breastfeeding, the researchers found that breastfeeding for up to 6 months was significantly associated with a lower risk of asthma exacerbations in children (OR, 0.48; p=0.01) while the association was no longer significant for a breastfeeding duration of ≥6 months (OR, 0.71; p=0.20).

However, no association was found between breastfeeding and the likelihood for poor asthma control as assessed by Asthma Control Questionnaire (ACQ)-6 after controlling for family asthma history (OR, 1.04; p=0.83). The results remained even after stratifying the analysis by duration of breastfeeding.

The study involved 960 children (mean age 8.4 years, 62 percent boys, 74 percent breastfed) who were using regular asthma medication for the past 2 years in the Netherlands. Breastfeeding exposure and duration were self-reported by the parents based on questionnaire. Asthma exacerbations in the previous year and asthma control based on ACQ-6 within the last week of visit were also documented.          

“Although in our study breastfeeding was shown to be a protective factor for asthma exacerbations, it is still unclear whether there is a causal relation between breastfeeding and asthma exacerbations,” said Maitland-van der Zee.

“[An] important limitation is the cross-sectional nature of our study. When exposure and outcome are measured at one moment (or period) in time, the risk of reverse causality would be a major problem … The optimal design for this study is a prospective longitudinal design,” said Maitland-van der Zee and co-authors.

They also added that questionnaire-based data are subjected to recall bias and suggested further studies be conducted to confirm the association and understand the underlying mechanisms.

 

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Most Read Articles
Naomi Rodrig, 27 Apr 2016

LUX-Lung 7, a global phase IIb, randomized, open-label trial, demonstrated significant improvements in progression-free survival (PFS), time to treatment failure (TTF) and objective response rate (ORR) with afatinib vs gefitinib as first-line treatment for patients with advanced, EGFR-positive non-small-cell lung cancer (NSCLC). [ELCC 2016, abstract 140PD]

Naomi Rodrig, 28 Apr 2016
A combination of live-bacterium immunotherapy and standard chemotherapy is safe and effective in patients with malignant pleural mesothelioma (MPM), providing a response rate of nearly 60 percent, according to a recent phase Ib trial. [ELCC 2016, abstract 208O_PR]
Pearl Toh, 13 May 2017
Short-term use of oral corticosteroids was associated with increased risks of adverse events such as fracture, sepsis, and venous thromboembolism (VTE), a large US cohort study showed.
Naomi Rodrig, 03 May 2016
Third-generation EGFR tyrosine kinase inhibitors (TKIs) designed to overcome the T790M mutation have been shown to double progression-free survival (PFS) of patients with advanced non-small-cell lung cancer (NSCLC) harbouring activating EGFR mutations, according to reports at the European Lung Cancer Conference (ELCC) 2016 held recently in Geneva, Switzerland.