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https://www.readbyqxmd.com/read/29779416/long-term-triple-therapy-de-escalation-to-indacaterol-glycopyrronium-in-copd-patients-sunset-a-randomized-double-blind-triple-dummy-clinical-trial
#1
Kenneth R Chapman, John R Hurst, Stefan-Marian Frent, Michael Larbig, Robert Fogel, Tadhg Guerin, Donald Banerji, Francesco Patalano, Pankaj Goyal, Pascal Pfister, Konstantinos Kostikas, Jadwiga A Wedzicha
RATIONALE: There are no studies on ICS withdrawal in patients on long-term triple therapy in the absence of frequent exacerbations. OBJECTIVE: To evaluate the efficacy and safety of the direct de-escalation from long-term triple therapy to indacaterol/glycopyrronium in non-frequently exacerbating COPD patients. METHODS: This 26-week, randomized, double-blind, triple-dummy study assessed the direct change from long-term triple therapy to indacaterol/glycopyrronium (110/50μg once daily) or continuation of triple therapy (tiotropium 18μg once daily plus combination of salmeterol/fluticasone propionate [50/500μg] twice daily) in non-frequently exacerbating patients with moderate-to-severe COPD...
May 20, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29763572/determinants-of-response-to-roflumilast-in-severe-copd-pooled-analysis-of-two-randomized-trials
#2
Fernando J Martinez, Klaus F Rabe, Peter M A Calverley, Leonardo M Fabbri, Sanjay Sethi, Emilio Pizzichini, Andrew McIvor, Antonio Anzueto, Vijay K T Alagappan, Shahid Siddiqui, Colin Reisner, Sofia Zetterstrand, Jonas Román, Debasree Purkayastha, Nitin Bagul, Stephen I Rennard
RATIONALE: Roflumilast reduces exacerbations in patients with severe chronic obstructive pulmonary disease associated with chronic bronchitis and a history of exacerbations. Further characterization of patients most likely to benefit is warranted. OBJECTIVES: Define characteristics that most robustly identify patients who derive greatest exacerbation risk reduction with roflumilast. METHODS: Predefined, pooled analyses of REACT (NCT01329029) and RE2 SPOND (NCT01443845) multicenter, randomized, double-blind, placebo-controlled studies...
May 15, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29755730/having-concomitant-asthma-phenotypes-is-common-and-independently-relates-to-poor-lung-function-in-nhanes-2007-2012
#3
Rita Amaral, João A Fonseca, Tiago Jacinto, Ana M Pereira, Andrei Malinovschi, Christer Janson, Kjell Alving
Background: Evidence for distinct asthma phenotypes and their overlap is becoming increasingly relevant to identify personalized and targeted therapeutic strategies. In this study, we aimed to describe the overlap of five commonly reported asthma phenotypes in US adults with current asthma and assess its association with asthma outcomes. Methods: Data from the National Health and Nutrition Examination Surveys (NHANES) 2007-2012 were used (n = 30,442). Adults with current asthma were selected...
2018: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29729941/biologics-and-chronic-obstructive-pulmonary-diseases
#4
Ian D Pavord
The presence of airway inflammation in patients with chronic obstructive pulmonary disease (COPD) provides a rationale for biological agents targeting specific inflammatory pathways. This approach has been strikingly effective in patients with other chronic inflammatory diseases, such as rheumatoid arthritis, psoriasis, and asthma. However, there are important and unresolved challenges in COPD, including our incomplete understanding of heterogeneity of the lower airway inflammatory response and how these contribute to the clinical expression of disease...
May 3, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29724389/blood-eosinophil-levels-as-a-biomarker-in-copd
#5
REVIEW
Guy Brusselle, Ian D Pavord, Sarah Landis, Steven Pascoe, Sally Lettis, Nikhil Morjaria, Neil Barnes, Emma Hilton
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder and patients respond differently to treatment. Blood eosinophils are a potential biomarker to stratify patient subsets for COPD therapy. We reviewed the value of blood eosinophils in predicting exacerbation risk and response to corticosteroid treatment in the available literature (PubMed articles in English; keywords: "COPD" and "eosinophil"; published prior to May 2017). Overall, clinical data suggest that in patients with a history of COPD exacerbations, a higher blood eosinophil count predicts an increased risk of future exacerbations and is associated with improved response to treatment with inhaled corticosteroids (in combination with long-acting bronchodilator[s])...
May 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29709671/biological-exacerbation-clusters-demonstrate-asthma-and-copd-overlap-with-distinct-mediator-and-microbiome-profiles
#6
Michael A Ghebre, Pee Hwee Pang, Sarah Diver, Dhananjay Desai, Mona Bafadhel, Koirobi Haldar, Tatiana Kebadze, Suzanne Cohen, Paul Newbold, Laura Rapley, Joanne Woods, Paul Rugman, Ian D Pavord, Sebastian L Johnston, Michael Barer, Richard D May, Christopher E Brightling
BACKGROUND: Exacerbations of asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous. OBJECTIVE: We sought to investigate the sputum cellular, mediator, and microbiome profiles of both asthma and COPD exacerbations. METHODS: Patients with severe asthma or moderate-to-severe COPD were prospectively recruited to a single centre. Sputum mediators were available in 32 asthma and 73 COPD patients assessed at exacerbation. Biologic clusters were determined using factor and cluster analyses on a panel of sputum mediators...
April 27, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29709670/blood-eosinophil-thresholds-and-exacerbations-in-chronic-obstructive-pulmonary-disease
#7
Jeong H Yun, Andrew Lamb, Robert Chase, Dave Singh, Margaret M Parker, Aabida Saferali, JØrgen Vestbo, Ruth Tal-Singer, Peter J Castaldi, Edwin K Silverman, Craig P Hersh
BACKGROUND: Eosinophilic airway inflammation in COPD is associated with exacerbations and responsivity to steroids, suggesting potential shared mechanisms with eosinophilic asthma. However there is no consistent blood eosinophil level that has been used to define the increased exacerbation risk. OBJECTIVE: To investigate blood eosinophil levels associated with exacerbation risk in COPD METHODS: Blood eosinophil counts and exacerbation risk were analyzed in moderate-to-severe COPD subjects, using two independent studies of former and current smokers with longitudinal data...
April 27, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29696728/predictive-value-of-eosinophils-and-neutrophils-on-clinical-effects-of-ics-in-copd
#8
Floor J Hartjes, Judith M Vonk, Alen Faiz, Pieter S Hiemstra, Thérèse S Lapperre, Huib A M Kerstjens, Dirkje S Postma, Maarten van den Berge
BACKGROUND AND OBJECTIVE: Inflammation is present to a variable degree and composition in patients with COPD. This study investigates associations between both eosinophils and neutrophils in blood, sputum, airway wall biopsies and bronchoalveolar lavage (BAL) and their potential use as biomarkers for clinical response to inhaled corticosteroids (ICS). METHODS: In total, 114 steroid-naïve COPD patients of the Groningen Leiden Universities Corticosteroids in Obstructive Lung Disease (GLUCOLD) study using ICS or placebo during 30-month follow-up were included...
April 26, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29681729/risk-factors-for-respiratory-hospitalizations-in-a-population-of-patients-with-a-clinical-diagnosis-of-copd
#9
Jovica Veljanovski, Daniel R Ouellette
Purpose: The purpose of this study was to examine differences between patients clinically diagnosed with COPD with and without obstruction by spirometry and to identify risk factors for respiratory hospitalizations. Materials and methods: This is a retrospective analysis of all patients diagnosed with COPD at a large academic Internal Medicine Clinic in 2014, who had spirometry performed during the period 2013-2014. Two groups existed: one with obstruction termed classical COPD and another without obstruction...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29650563/blood-eosinophil-count-and-risk-of-pneumonia-hospitalisations-in-individuals-with-copd
#10
Signe Vedel-Krogh, Børge G Nordestgaard, Peter Lange, Jørgen Vestbo, Sune F Nielsen
Introduction: Blood eosinophil count in COPD is associated with higher exacerbation rate and favorable response to corticosteroids; however, frequent exacerbations and use of inhaled corticosteroids could also elevate pneumonia risk. We tested the hypothesis that high blood eosinophil counts are associated with high risk of pneumonia in individuals with severe COPD from the general population. Methods: We included 7,180 individuals with COPD, including 643 with FEV1 <50% of the predicted value from the Copenhagen General Population Study, from 2003-2011...
April 12, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29642882/assessing-the-healthcare-resource-use-associated-with-inappropriate-prescribing-of-inhaled-corticosteroids-for-people-with-chronic-obstructive-pulmonary-disease-copd-in-gold-groups-a-or-b-an-observational-study-using-the-clinical-practice-research-datalink
#11
James D Chalmers, Chris Poole, Samantha Webster, Abigail Tebboth, Scott Dickinson, Alicia Gayle
BACKGROUND: Recent recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) position inhaled corticosteroids (ICS) for use in chronic obstructive pulmonary disease (COPD) patients experiencing exacerbations (≥ 2 or ≥ 1 requiring hospitalisation); i.e. GOLD groups C and D. However, it is known that ICS is frequently prescribed for patients with less severe COPD. Potential drivers of inappropriate ICS use may be historical clinical guidance or a belief among physicians that intervening early with ICS would improve outcomes and reduce resource use...
April 11, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29627118/alveolar-and-bronchial-nitric-oxide-in-chronic-obstructive-pulmonary-disease-and-asthma-copd-overlap
#12
Bernardino Alcázar-Navarrete, Francisca Castellano Miñán, Pablo Santiago Díaz, Oliveiro Ruiz Rodríguez, Pedro J Romero Palacios
INTRODUCTION: Exhaled nitric oxide (FENO ) measurements differentiate COPD phenotypes from asthma-COPD overlap (ACO). To date, no study has been conducted to determine whether alveolar and bronchial components differ in this group of patients. METHODS: This was an observational cross-sectional study recruiting ambulatory COPD patients. FENO was measured, differentiating alveolar (CANO ) from bronchial (JawNO ) components using a multiple-flow technique. CANO and JawNO values were compared between eosinophilic COPD patients (defined as ≥ 300 eosinophils/μL in peripheral blood test, or ≥ 2% eosinophils or ≥ 3% eosinophils), and a linear regression analysis was performed to determine clinical and biological variables related to these measurements...
April 4, 2018: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29626211/targeting-cytokines-to-treat-asthma-and-chronic-obstructive-pulmonary-disease
#13
REVIEW
Peter J Barnes
Cytokines play a key role in orchestrating and perpetuating the chronic airway inflammation in asthma and chronic obstructive pulmonary disease (COPD), making them attractive targets for treating these disorders. Asthma and some cases of COPD are mainly driven by type 2 immune responses, which comprise increased airway eosinophils, T helper 2 (TH 2) cells and group 2 innate lymphoid cells (ILC2s) and the secretion of IL-4, IL-5 and IL-13. Clinical trials of antibodies that block these interleukins have shown reduced acute exacerbations and oral corticosteroid use and improvements in lung function and symptoms in selected patients...
April 6, 2018: Nature Reviews. Immunology
https://www.readbyqxmd.com/read/29620545/endobronchial-biopsy-in-the-final-diagnosis-of-chronic-obstructive-pulmonary-disease-and-asthma-a-clinicopathological-study
#14
Maria Abdulrahim Arafah, Emad Raddaoui, Faisal Al Kassimi, Esam H Alhamad, Ahmed Amer Alboukai, Ahlam Abdullah Alshedoukhy, Abderrahman Ouban
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are chronic conditions with an increasing prevalence in developing countries. The evaluation of endobronchial biopsies has emerged as a tool to differentiate between both conditions via the measurement of the reticular basement membrane (RBM) thickness with various conclusions drawn from different studies. OBJECTIVES: Compare the thickness of the RBM between asthma and COPD and evaluate other histomorphological features in both groups...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29615049/a-gata3-specific-dnazyme-attenuates-sputum-eosinophilia-in-eosinophilic-copd-patients-a-feasibility-randomized-clinical-trial
#15
Timm Greulich, Jens M Hohlfeld, Petra Neuser, Katrin Lueer, Andreas Klemmer, Carmen Schade-Brittinger, Susanne Harnisch, Holger Garn, Harald Renz, Ursula Homburg, Jonas Renz, Anne Kirsten, Frauke Pedersen, Meike Müller, Claus F Vogelmeier, Henrik Watz
BACKGROUND: A subset of COPD-patients presents with eosinophilic airway inflammation. While treatment of asthmatic patients with the GATA3-specific DNAzyme SB010 attenuated sputum eosinophilia after allergen challenge, this specific treatment has not been evaluated in patients with COPD. Our objective was to evaluate the feasibility and safety of inhaled SB010 in COPD patients with sputum eosinophilia. METHODS: We conducted a randomized, double-blind, placebo-controlled, multicentre clinical trial in COPD-patients with sputum eosinophilia (≥2...
April 4, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29609004/emerging-biological-therapies-for-treating-chronic-obstructive-pulmonary-disease-a-pairwise-and-network-meta-analysis
#16
Paola Rogliani, Maria Gabriella Matera, Ermanno Puxeddu, Marco Mantero, Francesco Blasi, Mario Cazzola, Luigino Calzetta
Inflammation in chronic obstructive pulmonary disease (COPD) is often corticosteroid resistant and, thus, alternative anti-inflammatory approaches are needed. Since it is still not clear whether blocking specific pro-inflammatory factors may provide clinical benefit in COPD, we have performed a meta-analysis to quantify the impact of monoclonal antibodies (mABs) targeting the cytokine/chemokine-mediated inflammation in COPD. A pairwise and network meta-analyses were performed by extracting data from randomized clicnial trials on COPD concerning the impact of mABs vs...
March 30, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29583021/copd-2017-a-year-in-review
#17
Ernesto Crisafulli, Antoni Torres
In this review, we focused on original manuscripts published in the 2017 that provided additional information on the clinical and therapeutic features of the chronic obstructive pulmonary disease (COPD). We have chosen eight of these studies, collected in four topics concerning the pharmacological treatment (tiotropium) of mild-moderate patients, the pharmacological (fluticasone furoate/vilanterol/umeclidinium) and non-pharmacological treatment (non-invasive mechanical ventilation) of severe patients, the etiology of acute exacerbation of COPD involving seasonal airway pathogens and the role of eosinophils with particular interest to the monoclonal antibody directed against interleukin-5 (mepolizumab)...
March 27, 2018: COPD
https://www.readbyqxmd.com/read/29575948/blood-biomarkers-in-chronic-airways-diseases-and-their-role-in-diagnosis-and-management
#18
Job J M H van Bragt, Susanne J H Vijverberg, Els J M Weersink, Levi B Richards, Anne H Neerincx, Peter J Sterk, Elisabeth H D Bel, Anke H Maitland-van der Zee
The complexity and heterogeneous nature of asthma and chronic obstructive pulmonary disease (COPD) results in difficulties in diagnosing and treating patients. Biomarkers that can identify underlying mechanisms, identify patient phenotypes and to predict treatment response could be of great value for adequate treatment. Areas covered: Biomarkers play an important role for the development of novel targeted therapies in airways disease. Blood biomarkers are relatively non-invasive, easy to obtain and easy to apply in routine care...
May 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29558236/demographic-and-clinical-characteristics-of-copd-patients-at-different-blood-eosinophil-levels-in-the-uk-clinical-practice-research-datalink
#19
Sarah Landis, Robert Suruki, Joe Maskell, Kerina Bonar, Emma Hilton, Chris Compton
Blood eosinophil count may be a useful biomarker for predicting response to inhaled corticosteroids and exacerbation risk in chronic obstructive pulmonary disease (COPD) patients. The optimal cut point for categorizing blood eosinophil counts in these contexts remains unclear. We aimed to determine the distribution of blood eosinophil count in COPD patients and matched non-COPD controls, and to describe demographic and clinical characteristics at different cut points. We identified COPD patients within the UK Clinical Practice Research Database aged ≥40 years with a FEV1 /FVC <0...
March 20, 2018: COPD
https://www.readbyqxmd.com/read/29503537/relationship-of-annual-change-in-bone-mineral-density-with-extent-of-emphysematous-lesions-and-pulmonary-function-in-patients-with-copd
#20
Kenichi Goto, Emiko Ogawa, Kaoruko Shimizu, Hironi Makita, Hidenobu Suzuki, Yoshiki Kawata, Noboru Niki, Masaharu Nishimura, Yasutaka Nakano
Background: Osteoporosis is a well-known comorbidity in COPD. It is associated with poor health status and prognosis. Although the exact pathomechanisms are unclear, osteoporosis is suggested to be either a comorbidity due to shared risk factors with COPD or a systematic effect of COPD with a cause-effect relationship. This study aimed to evaluate whether progression of osteoporosis is synchronized with that of COPD. Materials and methods: Data from 103 patients with COPD included in the Hokkaido COPD cohort study were analyzed...
2018: International Journal of Chronic Obstructive Pulmonary Disease
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