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Therapeutic Advances in Respiratory Disease

Vibeke Backer, Adam Ellery, Sylvia Borzova, Stephen Lane, Magda Kleiberova, Peter Bengtsson, Tadeusz Tomala, Dominique Basset-Stheme, Carla Bennett, Dirk Lindner, Arthur Meiners, Tim Overend
INTRODUCTION: In recognition of the value of long-term real-world data, a postauthorization safety study of the inhaled corticosteroid (ICS) fluticasone propionate and long-acting β2 -agonist (LABA) formoterol fumarate (fluticasone/formoterol; Flutiform® ) was conducted. METHODS: This was a 12-month observational study of outpatients with asthma aged ⩾ 12 years in eight European countries. Patients were prescribed fluticasone/formoterol according to the licensed indication, and independently of their subsequent enrolment in the study...
January 2018: Therapeutic Advances in Respiratory Disease
Nicolas Villanueva, Lyudmila Bazhenova
Immunotherapy has significantly altered the treatment landscape for many cancers, including non-small cell lung cancer (NSCLC). Currently approved immuno-oncology agents for lung cancer are aimed at the reversal of immune checkpoints, programmed death protein-1 (PD-1) and programmed death ligand-1 (PD-L1). Although responses to checkpoint inhibitors are encouraging, and in some cases durable, these successes are not universal among all treated patients. In order to optimize our treatment approach utilizing immunotherapy, we must better understand the interaction between cancer and the immune system and evasion mechanisms...
January 2018: Therapeutic Advances in Respiratory Disease
Roberto W Dal Negro, Luca Bonadiman, Paola Turco
BACKGROUND: Fluticasone furoate/vilanterol (FF/V) is an effective long-acting β2 agonist/inhaled corticosteroid combination for managing persistent bronchial asthma. The aim of the study was to assess the outcomes achievable in patients with mild to moderate asthma receiving FF/V 92/22 µg once daily for 12 months. METHODS: Data were automatically and anonymously obtained from the institutional database: forced expiratory volume in 1 s predicted values; the exacerbation and hospitalization rates; days of hospitalization; general practitioner (GP) or specialist visits; days of inactivity; courses of systemic steroids or antibiotics were recorded at baseline and after 3, 6 and 12 months of treatment...
January 2018: Therapeutic Advances in Respiratory Disease
Aoife O'Reilly, Stephen Lane
Asthma is a common chronic inflammatory condition of the airways. Conventional therapy comprises inhaled corticosteroid and bronchodilators as well as trigger avoidance and management of comorbid conditions. A small group remain symptomatic despite these strategies and novel therapies have been developed. Bronchial thermoplasty is a nonpharmacological therapy which targets airway smooth muscle to improve asthma control. Clinical trials to date have shown the efficacy and safety of bronchial thermoplasty with a persistent effect on extended follow up...
January 2018: Therapeutic Advances in Respiratory Disease
Justine Briand, Hélène Behal, Cécile Chenivesse, Lidwine Wémeau-Stervinou, Benoit Wallaert
BACKGROUND: Although the 6-min walk test (6MWT) is the gold standard for assessing exercise-induced impairment of gas exchange, it cannot easily be performed in a clinical office environment. The aim of this study was to compare the 1-min sit-to-stand test (1STST) with the 6MWT for the ability to assess exercise-induced oxygen desaturation in patients with interstitial lung diseases (ILDs). METHODS: A total of 107 patients were enrolled and classified into three groups: sarcoidosis, fibrotic idiopathic interstitial pneumonia (f-IIP), and other forms of ILD...
January 2018: Therapeutic Advances in Respiratory Disease
Caroline Stridsman, My Svensson, Viktor Johansson Strandkvist, Linnea Hedman, Helena Backman, Anne Lindberg
BACKGROUND: Fatigue is one of the most common symptoms among subjects with chronic obstructive pulmonary disease (COPD), but is rarely identified in clinical practice. The aim of this study was to evaluate the association between fatigue and health-related quality of life (HRQoL) assessed with clinically useful instruments, both among subjects with and without COPD. Further, to investigate the association between fatigue and the COPD Assessment Test (CAT)-energy question. METHODS: Data were collected in 2014 within the population-based OLIN COPD study...
January 2018: Therapeutic Advances in Respiratory Disease
Melissa A L Vyfhuis, Nasarachi Onyeuku, Tejan Diwanji, Sina Mossahebi, Neha P Amin, Shahed N Badiyan, Pranshu Mohindra, Charles B Simone
Lung cancer remains the leading cause of cancer deaths in the United States (US) and worldwide. Radiation therapy is a mainstay in the treatment of locally advanced non-small cell lung cancer (NSCLC) and serves as an excellent alternative for early stage patients who are medically inoperable or who decline surgery. Proton therapy has been shown to offer a significant dosimetric advantage in NSCLC patients over photon therapy, with a decrease in dose to vital organs at risk (OARs) including the heart, lungs and esophagus...
January 2018: Therapeutic Advances in Respiratory Disease
Luis Máiz, Rosa M Girón, Eva Prats, Marta G Clemente, Eva Polverino, Silvia Caño, Rosa Cordovilla, Jordi Dorca, Carlos Peñalver, Félix Baranda, Miguel A Martínez-García
BACKGROUND: The excessive retention of sputum in the airways, leading to pulmonary infections, is a common consequence of bronchiectasis. Although inhalation of 7% hypertonic saline (HS) has proven an effective method to help remove the mucus, many patients are intolerant of this treatment. The addition of 0.1% hyaluronic acid to HS (HS+HA) could increase tolerance to HS in these patients. The main objective of this study was to evaluate the tolerability of HS+HA in bronchiectasis patients who are intolerant to HS...
January 2018: Therapeutic Advances in Respiratory Disease
Shanhu Qiu, Xue Cai, Xuyi Wang, Can He, Martina Zügel, Jürgen Michael Steinacker, Uwe Schumann
BACKGROUND: Although step counters are popularly employed for physical rehabilitation in chronic obstructive pulmonary disease (COPD) patients, their effectiveness is inconsistent and even questioned. This meta-analysis aimed to investigate whether step counter use increases physical activity or improves exercise capacity in COPD patients. METHODS: Electronic databases were searched for randomized controlled trials that assessed the efficacy of step counter use in increasing physical activity or in improving exercise capacity...
January 2018: Therapeutic Advances in Respiratory Disease
Coenraad F N Koegelenberg, Jane A Shaw, Elvis M Irusen, Y C Gary Lee
Malignant pleural effusion (MPE) affects more than 1 million people globally. There is a dearth of evidence on the therapeutic approach to MPE, and not surprisingly a high degree of variability in the management thereof. We aimed to provide practicing clinicians with an overview of the current evidence on the management of MPE, preferentially focusing on studies that report patient-related outcomes rather than pleurodesis alone, and to provide guidance on how to approach individual cases. A pleural intervention for MPE will perforce be palliative in nature...
January 2018: Therapeutic Advances in Respiratory Disease
Maisi Muniz Cabral David, Evelim Leal de Freitas Dantas Gomes, Maryjose Carvalho Mello, Dirceu Costa
BACKGROUND: Asthma is characterized by hyperresponsiveness of the airways, and exercise-induced bronchospasm (EIB) is a symptom that limits a large proportion of asthmatic patients, especially children. Continuous positive airway pressure (CPAP) leads to a reduction in the reactivity of the airways. The aim of this study was to evaluate the effect of outpatient treatment with CPAP and bilevel pressure combined with respiratory physical therapy for children and adolescents with asthma following bronchial hyperresponsiveness caused by an exercise bronchoprovocation test...
January 2018: Therapeutic Advances in Respiratory Disease
Anna Płoszczuk, Miroslava Bosheva, Kay Spooner, Tammy McIver, Sanjeeva Dissanayake
BACKGROUND: The efficacy and safety of fluticasone propionate/formoterol fumarate pressurized metered-dose inhaler (pMDI) (fluticasone/formoterol; Flutiform® ; 100/10 µg b.i.d.) was compared with fluticasone propionate (Flixotide® Evohaler® pMDI; 100 µg b.i.d.) and fluticasone/salmeterol (Seretide® Evohaler® pMDI; 100/50 µg b.i.d.) in a pediatric asthma population (EudraCT number: 2010-024635-16). METHODS: A double-blind, double-dummy, parallel group, multicenter study...
January 2018: Therapeutic Advances in Respiratory Disease
Roland Arnitz, Markus Stein, Petra Bauer, Barbara Lanthaler, Herbert Jamnig, Sabine Scholl-Bürgi, Katharina Stempfl-Al-Jazrawi, Hanno Ulmer, Bernhard Baumgartner, Sabine Embacher, Simon Geisler, Johanna M Gostner, Bernhard Müllinger, Beate Kälz, Markus Nagl
BACKGROUND: N-chlorotaurine (NCT), a long-lived oxidant produced by human leukocytes, can be synthesized chemically and used topically as a well-tolerated antiseptic to different body regions including sensitive ones. The aim of this study was to test the tolerability of inhaled 1% NCT in aqueous solution upon repeated application. METHODS: The study was performed double-blind and randomized with a parallel test group (1% NCT) and control group (0.9% NaCl as placebo)...
January 2018: Therapeutic Advances in Respiratory Disease
Qin Enyuan, Xu Mingpeng, Gan Luoman, Gan Jinghua, Li Yu, Li Wentao, Hou Changchun, Li Lihua, Meng Xiaoyan, Zhou Lei, Liu Guangnan
BACKGROUND: Patients with endotracheal intubation or tracheostomy are subject to benign tracheal stenosis (TS), for which current therapies are unsatisfactory. We conducted a preliminary investigation of drugs and drug combinations for the prevention and treatment of TS in a rabbit model. METHODS: Fifty-four rabbits were apportioned into nine groups according to treatment: sham-operated control; untreated TS model; amikacin; budesonide; erythromycin; penicillin; amikacin + budesonide; erythromycin + budesonide; and penicillin + budesonide...
January 2018: Therapeutic Advances in Respiratory Disease
Lindsay G S Bengtson, Michael DePietro, Jeffrey McPheeters, Kathleen M Fox
BACKGROUND: Randomized clinical trials have shown long-acting mono bronchodilator therapy to be efficacious in improving lung function and dyspnea, while reducing exacerbations; however, less is known regarding the effectiveness in routine clinical practice. This study examined treatment patterns, rescue medication use, healthcare resource utilization and costs, and exacerbations in patients with chronic obstructive pulmonary disease (COPD) who initiated long-acting mono bronchodilator therapy in real-world settings...
January 2018: Therapeutic Advances in Respiratory Disease
Courtney M Wheatley, Sarah E Baker, Cori M Daines, Hanna Phan, Marina G Martinez, Wayne J Morgan, Eric M Snyder
BACKGROUND: The Vibralung Acoustical Percussor is a new airway clearance therapy (ACT) utilizing intrapulmonary sound waves in addition to positive expiratory pressure (PEP). We evaluated the safety of the Vibralung and collected preliminary data on its ability to mediate sputum expectoration in individuals with cystic fibrosis (CF). METHODS: Over two separate studies, 10 and 11 mild to moderate CF patients were recruited for study I and II, respectively. Study I: Vibralung was used for 20 min with either no sound (NS: PEP only) or sound (S: PEP and sound) on randomized visits...
January 2018: Therapeutic Advances in Respiratory Disease
Jing Zhang, Jinping Zheng, Kewu Huang, Yahong Chen, Jingping Yang, Wanzhen Yao
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common in patients with underlying moderate to severe COPD and are associated with increased health and economic burden. International and Chinese guidelines recommend using glucocorticoids for the management of AECOPD because glucocorticoid therapy has been shown to benefit clinical outcomes. However, only scant data are available for current status of glucocorticoid therapy in hospitalized AECOPD patients in China...
January 2018: Therapeutic Advances in Respiratory Disease
James C Coons, Taylor Miller
Treprostinil diolamine is the first oral prostacyclin approved for the treatment of pulmonary arterial hypertension (PAH) to improve exercise capacity. Clinical studies have demonstrated modest benefit as monotherapy, whereas no difference in exercise capacity was observed with combination therapy. However, these trials were limited by subtherapeutic dosing owing to intolerable adverse effects. Prostacyclin-related adverse effects, such as nausea, diarrhea, headache, flushing, and jaw pain, are prevalent. More recent pharmacokinetic and clinical studies illustrate the dose-response relationship and the importance of achieving clinically effective doses...
January 2018: Therapeutic Advances in Respiratory Disease
Arjun Khunger, Monica Khunger, Vamsidhar Velcheti
Mutations in the BRAF oncogene are found in 2-4% of all non-small cell lung cancer (NSCLC) patients. The most common activating mutation present within the BRAF oncogene is associated with valine substitution for glutamate at position 600 (V600E) within the BRAF kinase. BRAF-targeted therapies are effective in patients with melanoma and NSCLC harboring BRAF V600E mutation. In both melanoma and NSCLC, dual inhibition of both BRAF and the downstream mitogen-activated protein kinase (MEK) improves response rates compared with BRAF inhibition alone...
January 2018: Therapeutic Advances in Respiratory Disease
Mario Malerba, Matteo Nardin, Giuseppe Santini, Nadia Mores, Alessandro Radaeli, Paolo Montuschi
Maintenance pharmacological treatment for stable chronic obstructive pulmonary disease (COPD) is based on inhaled drugs, including long-acting muscarinic receptor antagonists (LAMA), long-acting β2 -adrenoceptor agonists (LABA) and inhaled corticosteroids (ICS). Inhaled pharmacological treatment can improve patients' daily symptoms and reduce decline of pulmonary function and acute exacerbation rate. Treatment with all three inhaled drug classes is reserved for selected, more severe, patients with COPD when symptoms are not sufficiently controlled by dual LABA/LAMA therapy and exacerbations are frequent...
January 2018: Therapeutic Advances in Respiratory Disease
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