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Therapeutic Advances in Respiratory Disease

Warangkana Keeratichananont, Apichat Kaewdech, Suriya Keeratichananont
BACKGROUND: Autologous blood is a novel, high-efficacy sclerosant for treatment of malignant pleural effusion (MPE), similar to tetracycline. There has been no comparative data between autologous blood and a worldwide sclerosant like talc. We aimed to compare the effectiveness of autologous blood versus talc pleurodesis. METHODS: A prospective study was conducted at Songklanagarind Hospital, Songkhla, Thailand. A total of 123 symptomatic MPE cases were randomized to receive autologous blood pleurodesis (ABP) versus pleurodesis with talc slurry...
January 2018: Therapeutic Advances in Respiratory Disease
Corrado Pelaia, Cecilia Calabrese, Rosa Terracciano, Francesco de Blasio, Alessandro Vatrella, Girolamo Pelaia
Omalizumab was the first, and for a long time the only available monoclonal antibody for the add-on treatment of severe allergic asthma. In particular, omalizumab selectively targets human immunoglobulin (Ig)E, forming small-size immune complexes that inhibit IgE binding to its high- and low-affinity receptors. Therefore, omalizumab effectively blunts the immune response in atopic asthmatic patients, thus significantly improving the control of asthma symptoms and successfully preventing disease exacerbations...
January 2018: Therapeutic Advances in Respiratory Disease
Biagio Ricciuti, Sara Baglivo, Andrea De Giglio, Rita Chiari
Epidermal growth factor receptor ( EGFR) gene mutations identify a molecularly defined subset of non-small cell lung cancer (NSCLC) patients who display an excellent sensitivity to EGFR tyrosine kinase inhibitors (TKIs). First-generation reversible EGFR TKIs, gefitinib and erlotinib have been proven to improve the objective response rate and to prolong the progression-free survival compared with standard chemotherapy in large phase III trials. Unfortunately, virtually all patients develop resistance to treatment, usually within 9-12 months...
January 2018: Therapeutic Advances in Respiratory Disease
Rosalia Emma, Jaymin B Morjaria, Virginia Fuochi, Riccardo Polosa, Massimo Caruso
Asthma is a chronic inflammatory condition involving the airways with varying pathophysiological mechanisms, clinical symptoms and outcomes, generally controlled by conventional therapies including inhaled corticosteroids and long-acting β2 agonists. However, these therapies are unable to successfully control symptoms in about 5-10% of severe asthma patients. Atopic asthma, characterized by high immunoglobulin (Ig)E or eosinophilia, represents about 50% of asthmatic patients. Interleukin (IL)-5 is the main cytokine responsible of activation of eosinophils, hence therapeutic strategies have been investigated and developed for clinical use...
January 2018: Therapeutic Advances in Respiratory Disease
José M Porcel
The use of biomarkers on pleural fluid (PF) specimens may assist the decision-making process and enhance clinical diagnostic pathways. Three paradigmatic examples are heart failure, tuberculosis and, particularly, malignancy. An elevated PF concentration of the amino-terminal fragment of probrain natriuretic peptide (>1500 pg/ml) is a hallmark of acute decompensated heart failure. Adenosine deaminase, interferon-γ and interleukin-27 are three valuable biomarkers for diagnosing tuberculous pleurisy, yet only the first has been firmly established in clinical practice...
January 2018: Therapeutic Advances in Respiratory Disease
Borja G Cosío, David Dacal, Luis Pérez de Llano
Asthma and chronic obstructive pulmonary disease (COPD) are both highly prevalent conditions that can coexist in the same individual: the so-called 'asthma -COPD overlap' (ACO). Its prevalence and prognosis vary widely depending on how ACO is defined in each publication, the severity of bronchial obstruction of patients included and the treatment they are receiving. Although there is a lack of evidence about the biology of ACO, the overlap of both diseases should express a mixture of a Th1 inflammatory pattern (characteristic of COPD) and a Th2 signature (characteristic of asthma)...
January 2018: Therapeutic Advances in Respiratory Disease
Toyoaki Hida
Programmed cell death (PD)-1 immune checkpoint inhibitors have emerged as promising options for the treatment of multiple cancer types. Nivolumab is a fully human immunoglobulin G4 monoclonal antibody, which inhibits the PD-1 receptor and has been approved in the United States, Europe, and Asia for the treatment of advanced NSCLC. This review focuses on nivolumab's efficacy and safety in the treatment of NSCLC patients in Japan.
January 2018: Therapeutic Advances in Respiratory Disease
Pilar Rivera-Ortega, Conal Hayton, John Blaikley, Colm Leonard, Nazia Chaudhuri
Idiopathic pulmonary fibrosis (IPF) is a fibrotic interstitial lung disease associated with significant morbidity and mortality. Previously, IPF has been managed using immunosuppressive therapy; however, it has been shown that this is associated with increased mortality. In the last 5 years, two disease-modifying agents have been licensed for use in IPF, namely pirfenidone and nintedanib. Nintedanib is a tyrosine kinase inhibitor with antifibrotic properties that has also been shown to significantly reduce the progression of the disease...
January 2018: 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
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