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https://www.readbyqxmd.com/read/28814851/effect-of-allergic-phenotype-on-treatment-response-to-inhaled-bronchodilators-with-or-without-inhaled-corticosteroids-in-patients-with-copd
#1
Shih-Lung Cheng, Hsu Hui Wang, Ching-Hsiung Lin
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder encompassing different phenotypes with different responses to treatment. The present 1-year, two-center hospital-based study investigated whether the plasma immunoglobulin E (IgE) level and/or eosinophil cell count could be used as biomarkers to stratify patients with COPD according to predicted responses to inhaled corticosteroids (ICS)-based therapy. METHODS: A hospital-data based cohort study of COPD patients treated at two territory hospital centers was conducted for 1 year...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28766137/inhaled-glucocorticoids-are-associated-with-vertebral-fractures-in-copd-patients
#2
Pedro Assed Gonçalves, Rafael Dos Santos Neves, Leonardo Vieira Neto, Miguel Madeira, Fernando Silva Guimarães, Laura Maria Carvalho Mendonça, Agnaldo Jose Lopes, Maria Lucia Fleiuss Farias
Chronic obstructive pulmonary disease (COPD) is an independent risk factor for osteoporosis. Oral glucocorticoids are deleterious to bone; however, the impact of inhaled glucocorticoids (ICS) remains unclear. Our objective was to determine whether ICS contribute to osteoporosis and fragility fractures. Sixty-one COPD patients, 35 current users of ICS and 26 who had never received glucocorticoids, were evaluated for bone mineral density (BMD) and body composition and underwent vertebral fracture assessment (VFA)...
August 1, 2017: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/28745524/should-patients-switched-from-d-to-b-in-the-gold-2017-classification-be-discontinued-from-inhaled-corticosteroids
#3
Matevz Harlander, Miriam Barrecheguren, Matjaz Turel, Marc Miravitlles
Inhaled corticosteroids (ICSs) are the cornerstone of the treatment of asthma, but their role in COPD is limited. Several guidelines recommend their use in patients with severe airflow limitation, frequent exacerbations and asthma-COPD overlap (ACO), while the previous GOLD document recommended ICS for patients with high risk of exacerbations and a high level of symptoms (group D). Following the changes in the GOLD document 2017 update, in which impaired lung function is no longer considered as a determinant of exacerbation risk, a high number of COPD patients can now be labeled as group B (low risk of exacerbations and high level of symptoms) instead of D, and hence, no longer fulfill the indication for ICS...
July 26, 2017: COPD
https://www.readbyqxmd.com/read/28721202/defining-the-inflammatory-signature-of-human-lung-explant-tissue-in-the-presence-and-absence-of-glucocorticoid
#4
Tracy L Rimington, Emily Hodge, Charlotte K Billington, Sangita Bhaker, Binaya K C, Iain Kilty, Scott Jelinsky, Ian P Hall, Ian Sayers
BACKGROUND:  Airway inflammation is a feature of many respiratory diseases and there is a need for newer, more effective anti-inflammatory compounds. The aim of this study was to develop an ex vivo human lung explant model which can be used to help study the mechanisms underlying inflammatory responses and which can provide a tool to aid drug discovery for inflammatory respiratory diseases such as asthma and COPD. METHOD:  Parenchymal lung tissue from 6 individual donors was dissected and cultured with two pro-inflammatory stimuli, lipopolysaccharide (LPS) (1 µg/ml) and interleukin-1 beta (IL-1β) (10 ng/ml) in the presence or absence of dexamethasone (1 µM)...
2017: F1000Research
https://www.readbyqxmd.com/read/28720132/efficacy-and-safety-of-direct-switch-to-indacaterol-glycopyrronium-in-patients-with-moderate-copd-the-crystal-open-label-randomised-trial
#5
Claus F Vogelmeier, Mina Gaga, Maryam Aalamian-Mattheis, Timm Greulich, Jose M Marin, Walter Castellani, Vincent Ninane, Stephen Lane, Xavier Nunez, Francesco Patalano, Andreas Clemens, Konstantinos Kostikas
BACKGROUND: Dual bronchodilation combining a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) is the preferred choice of treatment recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 guidelines for the management of patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). The once-daily (q.d.) fixed-dose combination (FDC) of LABA, indacaterol 110 μg and LAMA, glycopyrronium 50 μg (IND/GLY 110/50 μg q...
July 18, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28716642/long-term-use-of-inhaled-corticosteroids-in-copd-and-the-risk-of-fracture
#6
Anne V Gonzalez, Janie Coulombe, Pierre Ernst, Samy Suissa
BACKGROUND: It is uncertain whether long-term use of inhaled corticosteroids (ICSs), widely used to treat COPD, increases the risk of fracture, particularly in women, in view of the postmenopausal risks. We assessed whether long-term ICS use in patients with COPD increases the risk of hip or upper extremity fractures, and examined sex-related differences. METHODS: The Quebec health-care databases were used to form a cohort of patients with COPD over 1990 to 2005, followed until 2007 for the first hip or upper extremity fracture...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28714745/long-term-use-of-inhaled-corticosteroids-and-risk-of-upper-respiratory-tract-infection-in-chronic-obstructive-pulmonary-disease-a-meta-analysis
#7
Mingjin Yang, Hong Chen, Yan Zhang, Yuejun Du, Ying Xu, Ping Jiang, Zhibo Xu
Recent studies have suggested that inhaled corticosteroids (ICS) may be associated with higher risks of tuberculosis and pneumonia in patients with COPD. However, it is not known whether ICS increases the risk of upper respiratory tract infection (URTI). Aim of this study was to explore the relationship between ICS and URTI. Through a comprehensive literature search of PubMed, EMBASE, Cochrane Library, and Google Scholar from inception to March 2016, we identified randomized controlled trials of ICS therapy lasting at least 6 months...
April 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28694698/maintenance-therapy-in-copd-time-to-phase-out-ics-and-switch-to-the-new-lama-laba-inhalers
#8
REVIEW
Syed Mohammad Tariq, Enson C Thomas
Long-term maintenance therapy for COPD is evolving rapidly. Dual bronchodilation with new long-acting muscarinic antagonist and long-acting beta-agonist (LAMA/LABA) fixed dose combination inhalers were introduced over the past 2 years. In clinical trials, these inhalers significantly improved lung function (trough forced expiratory volume in 1 second), patient-reported outcomes, and quality of life measures compared with placebo, their respective monocomponents, and tiotropium. The recorded adverse events of these new inhalers were also similar to those of their monocomponents or placebo...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28684905/a-retrospective-study-to-assess-clinical-characteristics-and-time-to-initiation-of-open-triple-therapy-among-patients-with-chronic-obstructive-pulmonary-disease-newly-established-on-long-acting-mono-or-combination-therapy
#9
Douglas Mapel, François Laliberté, Melissa H Roberts, Susan R Sama, Devi Sundaresan, Dominic Pilon, Patrick Lefebvre, Mei Sheng Duh, Jeetvan Patel
INTRODUCTION: An incremental approach using open-triple therapy may improve outcomes in patients with chronic obstructive pulmonary disease (COPD). However, there is little sufficient, real-world evidence available identifying time to open-triple initiation. METHODS: This retrospective study of patients with COPD, newly initiated on long-acting muscarinic antagonist (LAMA) monotherapy or inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combination therapy, assessed baseline demographics, clinical characteristics, and exacerbations during 12 months prior to first LAMA or ICS/LABA use...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28677404/risk-of-cardiovascular-and-cerebrovascular-events-in-copd-patients-treated-with-long-acting-%C3%AE-2-agonist-combined-with-a-long-acting-muscarinic-or-inhaled-corticosteroid
#10
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
BACKGROUND: The recent approval of several fixed-dose combination long-acting β2-agonist (LABA) and long-acting muscarinic antagonist (LAMA) products has increased the use of dual bronchodilators in the treatment of chronic obstructive pulmonary disease (COPD). Understanding the comparative safety of this combination is important for informing treatment decisions. OBJECTIVE: To compare the risk of cardiovascular and cerebrovascular (CCV) events associated with LABA/LAMA compared with a combination of LABA and inhaled corticosteroid (ICS)...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28670116/treatment-trends-in-patients-with-asthma-copd-overlap-syndrome-in-a-copd-cohort-findings-from-a-real-world-survey
#11
Bo Ding, Mark Small
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is an increasingly recognized phenotype. Few randomized clinical trials have been conducted in patients with ACOS; therefore, scientific evidence concerning ACOS is scarce and a therapeutic approach remains unclear. The aim of this study was to evaluate current treatment trends for patients with ACOS, identified as those with a dual definition of asthma and COPD, in a real-world COPD cohort. METHODS: Data were analyzed from patients with asthma and COPD in the USA, France, Germany, Italy, Spain, and the UK who participated in the 2012 and 2013 Adelphi Respiratory Disease Specific Programmes (DSPs)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28663549/determinants-of-initial-inhaled-corticosteroid-use-in-patients-with-gold-a-b-copd-a-retrospective-study-of-uk-general-practice
#12
James D Chalmers, Abigail Tebboth, Alicia Gayle, Andrew Ternouth, Nick Ramscar
Initial use of inhaled corticosteroid therapy is common in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) A or B chronic obstructive pulmonary disease, contrary to GOLD guidelines. We investigated UK prescribing of inhaled corticosteroid therapy in these patients, to identify predictors of inhaled corticosteroid use in newly diagnosed chronic obstructive pulmonary disease patients. A cohort of newly diagnosed GOLD A/B chronic obstructive pulmonary disease patients was identified from the UK Clinical Practice Research Datalink (June 2005-June 2015)...
June 29, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#13
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28617814/risk-of-pneumonia-in-obstructive-lung-disease-a-real-life-study-comparing-extra-fine-and-fine-particle-inhaled-corticosteroids
#14
Samatha Sonnappa, Richard Martin, Elliot Israel, Dirkje Postma, Wim van Aalderen, Annie Burden, Omar S Usmani, David B Price
BACKGROUND: Regular use of inhaled corticosteroids (ICS) in patients with obstructive lung diseases has been associated with a higher risk of pneumonia, particularly in COPD. The risk of pneumonia has not been previously evaluated in relation to ICS particle size and dose used. METHODS: Historical cohort, UK database study of 23,013 patients with obstructive lung disease aged 12-80 years prescribed extra-fine or fine-particle ICS. The endpoints assessed during the outcome year were diagnosis of pneumonia, acute exacerbations and acute respiratory events in relation to ICS dose...
2017: PloS One
https://www.readbyqxmd.com/read/28609599/assessment-and-management-of-asthma-and-chronic-obstructive-pulmonary-disease-in-australian-general-practice
#15
Helen K Reddel, Lisa Valenti, Kylie L Easton, Julie Gordon, Clare Bayram, Graeme C Miller
BACKGROUND: Dispensing data suggest potential issues with the quality use of medicines for airways disease. OBJECTIVE: The objective of this article was to describe the management of asthma and chronic obstructive pulmonary disease (COPD) in general practice, and investigate the appropriateness of prescribing. METHODS: The method used for this study consisted of a national cross‑sectional survey of 91 Australian general practitioners (GPs) participating in the Bettering the Evaluation and Care of Health (BEACH) program...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28606478/withdrawal-of-inhaled-corticosteroids-in-copd-a-meta-analysis
#16
Luigino Calzetta, Maria Gabriella Matera, Fulvio Braido, Marco Contoli, Angelo Corsico, Fabiano Di Marco, Pierachille Santus, Nicola Scichilone, Mario Cazzola, Paola Rogliani
BACKGROUND: Conflicting findings exist on the benefit of withdrawal of inhaled corticosteroid (ICS) in chronic obstructive pulmonary disease (COPD). We performed a quantitative synthesis in order to assess real impact of ICS discontinuation in COPD patients. METHODS: We carried out a meta-analysis via random-effects model on the available clinical evidence to evaluate the effect of ICS discontinuation in COPD. Randomized clinical trials and observational real-life studies investigating the effects of ICS withdrawal on the risk of COPD exacerbation, lung function (forced expiratory volume in 1 s [FEV1]) and quality of life (St...
August 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28579771/a-cross-sectional-survey-of-current-treatment-and-symptom-burden-of-patients-with-copd-consulting-for-routine-care-according-to-gold-2014-classifications
#17
Bo Ding, Mark Small, Ulf Holmgren
BACKGROUND: As part of the Respiratory Disease Specific Program (DSP) conducted to provide observations of clinical practice from a physician and matched patient viewpoint, this study aimed to establish how patients with COPD are treated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system and to quantify the symptom burden. METHODS: Data were obtained from the Respiratory DSP, a cross-sectional survey of patients with a diagnosis of COPD consulting for routine care in France, Germany, Italy, Spain, the UK, and the USA during the third quarter of 2013...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28578989/-changing-patterns-of-medication-prescription-for-copd-patients-in-france-impact-of-long-acting-muscarinic-antagonists-availability
#18
G Jébrak, P-R Burgel, D Caillaud, G Deslée, G Brinchault, P Chanez, I Court-Fortune, R Escamilla, P Nesme-Meyer, C Pinet, T Perez, J-L Paillasseur, N Roche
INTRODUCTION: We studied the pattern changes over time of medication prescriptions for COPD and their conformity with French and international recommendations using data from patients in the prospective French cohort "Initiatives BPCO". METHOD: Eight hundred and forty-six patients have been included during a first period from August, 2001 till May 2006 (n=425) and a second period from June, 2006 till June, 2012 (n=421). The pivotal date was based on the tiotropium availability in France...
May 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28558829/which-bronchodilator-reversibility-criteria-can-predict-severe-acute-exacerbation-in-chronic-obstructive-pulmonary-disease-patients
#19
Junghyun Kim, Woo Jin Kim, Chang-Hoon Lee, Sang Haak Lee, Myung-Goo Lee, Kyeong-Cheol Shin, Kwang Ha Yoo, Ji-Hyun Lee, Seong Yong Lim, Ju Ock Na, Hun-Gyu Hwang, Yoonki Hong, Myoung Nam Lim, Chul-Gyu Yoo, Ki Suck Jung, Sang-Do Lee
BACKGROUND: It is unclear whether various bronchodilator reversibility (BDR) criteria affect the prognosis of chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate the impact of positive BDR defined according to various BDR criteria on the risk of severe acute exacerbation (AE) in COPD patients. METHODS: Patients from four prospective COPD cohorts in South Korea who underwent follow-up for at least 1 year were enrolled in this study...
May 30, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28523172/roles-of-roflumilast-a-selective-phosphodiesterase-4-inhibitor-in-airway-diseases
#20
REVIEW
Theerasuk Kawamatawong
Asthma and chronic obstructive pulmonary disease (COPD) are common chronic respiratory diseases. Both diseases have incompletely distinct pathophysiology, clinical manifestation, and treatment responsiveness. Pulmonary and systemic inflammations are the hallmarks of COPD. Most asthma responds to inhaled corticosteroid (ICS) treatment. In contrast, COPD is a corticosteroid-resistant disease. Bronchodilators are a preferred treatment method of COPD, with the aim of improving symptoms and preventing exacerbation...
April 2017: Journal of Thoracic Disease
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