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https://www.readbyqxmd.com/read/28049170/airway-inflammation-in-copd-after-long-term-withdrawal-of-inhaled-corticosteroids
#1
Lisette I Z Kunz, Nick H T Ten Hacken, Thérèse S Lapperre, Wim Timens, Huib A M Kerstjens, Annemarie van Schadewijk, Judith M Vonk, Jacob K Sont, Jiska B Snoeck-Stroband, Dirkje S Postma, Peter J Sterk, Pieter S Hiemstra
Long-term treatment with inhaled corticosteroids (ICS) might attenuate lung function decline and decrease airway inflammation in a subset of patients with chronic obstructive pulmonary disease (COPD), and discontinuing ICS treatment could result in further lung function decline. We hypothesised that airway inflammation increases after ICS withdrawal following long-term ICS treatment in COPD.In the GLUCOLD-1 study (GL1), 114 patients with moderate-severe COPD were randomised to 6-month or 30-month treatment with fluticasone propionate (500 µg twice daily), 30-month treatment with fluticasone/salmeterol (500/50 µg twice daily) or placebo...
January 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28008228/spotlight-on-fluticasone-furoate-vilanterol-trifenatate-for-the-once-daily-treatment-of-asthma-design-development-and-place-in-therapy
#2
REVIEW
Timothy E Albertson, Samuel W Bullick, Michael Schivo, Mark E Sutter
The use of inhaled corticosteroids (ICSs) plays a key role in the treatment of asthmatic patients, and international guidelines have designated ICSs as an early maintenance therapy in controlling asthma symptoms. When asthmatic patients remain symptomatic on ICSs, one common option is to add a long-acting beta2 agonist (LABA) to the maintenance treatment. Fixed combination inhalers that contain both an ICS and a LABA have been popular for both chronic obstructive pulmonary disease (COPD) and asthma. Historically, these inhalers have been dosed twice daily...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27994449/an-evaluation-of-early-medication-use-for-copd-a-population-based-cohort-study
#3
Jamie Falk, Natalia Dik, Shawn Bugden
PURPOSE: The aim of this study was to evaluate the first initiation, sequence of addition, and appropriate prescribing of COPD medications in Manitoba, Canada. PATIENTS AND METHODS: A population-based cohort study of COPD medication use was conducted using administrative health care data (1997-2012). Those aged ≥35 years with COPD based on three or more COPD-related outpatient visits over a rolling 24-month window or at least one COPD-related hospitalization were included...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27993284/non-persistence-and-non-adherence-to-long-acting-copd-medication-therapy-a-retrospective-cohort-study-based-on-a-large-german-claims-dataset
#4
Sabrina Mueller, Thomas Wilke, Benno Bechtel, Yogesh Suresh Punekar, Karen Mitzner, J Christian Virchow
OBJECTIVES: The main objectives of this study, based on a large cohort of German COPD patients, were to assess the level of non-persistence (NP) and non-adherence (NA) with long-acting COPD inhaler treatment and to describe factors that may be associated with NP and NA. METHODS: This was a retrospective cohort analysis based on claims data provided by a German statutory health insurance fund (years 2010-2012). NP was analyzed for treatment-naïve patients only; it was defined as a gap of >90 days in medication availability...
January 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/27928190/single-center-retrospective-evaluation-of-inhaled-corticosteroid-use-for-chronic-obstructive-pulmonary-disease-exacerbation-patients-receiving-systemic-corticosteroids
#5
Taylor Steuber, Dane Shiltz
Purpose: To determine the frequency of inappropriate inhaled corticosteroid (ICS) therapy when it is prescribed concurrently with systemic corticosteroids; to identify cost-savings potential in the setting of chronic obstructive pulmonary disease (COPD) exacerbations. Methods: Patients admitted to 1 of 8 hospital locations utilizing an integrated electronic health record within the health system for COPD exacerbations treated with systemic corticosteroids (equivalent to at least 30 mg of oral prednisone) between July 1, 2013 and June 30, 2014 were included in a retrospective chart review...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27927039/muscarinic-antagonists-in-early-stage-clinical-development-for-the-treatment-of-asthma
#6
Timothy E Albertson, James A Chenoweth, Jason Y Adams, Mark E Sutter
Parasympathetic neurons utilize the neurotransmitter acetylcholine to modulate and constrict airway smooth muscles at the muscarinic acetylcholine receptor. Inhaled agents that antagonize the muscarinic (M) acetylcholine receptor, particularly airway M3 receptors, have increasing data supporting use in persistent asthma. Areas covered: Use of inhaled long-acting muscarinic antagonists (LAMA) in asthma is explored. The LAMA tiotropium is approved for maintenance in symptomatic asthma patients despite the use of inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRA) and/or long-acting beta2 agonists (LABA)...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27922741/how-do-dual-long-acting-bronchodilators-prevent-exacerbations-of-chronic-obstructive-pulmonary-disease
#7
Kai M Beeh, Pierre-Regis Burgel, Frits M E Franssen, Jose Luis Lopez-Campos, Stelios Loukides, John R Hurst, Matjaž Fležar, Charlotte Suppli Ulrik, Fabiano Di Marco, Daiana Stolz, Arschang Valipour, Brian Casserly, Björn Ställberg, Konstantinos Kostikas, Jadwiga A Wedzicha
Decreasing the frequency and severity of exacerbations is one of the main goals of treatment for patients with chronic obstructive pulmonary disease (COPD). Several studies have documented that long-acting bronchodilators (LABDs) can reduce exacerbation rate and/or severity, and others have shown that combinations of long-acting β2-adrenergic agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) provide greater reductions in exacerbation frequency than either their monocomponents or LABA/inhaled corticosteroids (LABA/ICS) combinations in patients at low and high risk for these events...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27890625/pharmacological-treatment-optimization-for-stable-chronic-obstructive-pulmonary-disease-proposals-from-the-soci%C3%A3-t%C3%A3-de-pneumologie-de-langue-fran%C3%A3-aise
#8
M Zysman, F Chabot, P Devillier, B Housset, C Morelot-Panzini, N Roche
The Société de Pneumologie de Langue Française proposes a decision algorithm on long-term pharmacological COPD treatment. A working group reviewed the literature published between January 2009 and May 2016. This document lays out proposals and not guidelines. It only focuses on pharmacological treatments except vaccinations, smoking cessation treatments and oxygen therapy. Any COPD diagnosis, based on pulmonary function tests, should lead to recommend smoking cessation, vaccinations, physical activity, pulmonary rehabilitation in case of activity limitation, and short-acting bronchodilators...
December 2016: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/27877033/combination-therapy-of-inhaled-steroids-and-long-acting-beta2-agonists-in-asthma-copd-overlap-syndrome
#9
Suh-Young Lee, Hye Yun Park, Eun Kyung Kim, Seong Yong Lim, Chin Kook Rhee, Yong Il Hwang, Yeon-Mok Oh, Sang Do Lee, Yong Bum Park
BACKGROUND: The efficacy of inhaled corticosteroids (ICSs)/long-acting beta2-agonist (LABA) treatment in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) compared to patients with COPD alone has rarely been examined. This study aimed to evaluate the clinical efficacy for the improvement of lung function after ICS/LABA treatment in patients with ACOS compared to COPD alone patients. METHODS: Patients with stable COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27877031/the-association-between-inhaled-corticosteroid-and-pneumonia-in-copd-patients-the-improvement-of-patients-life-quality-with-copd-in-taiwan-impact-study
#10
Cheng-Yi Wang, Chih-Cheng Lai, Wei-Chih Yang, Chia-Chieh Lin, Likwang Chen, Hao-Chien Wang, Chong-Jen Yu
To investigate the association between inhaled corticosteroid (ICS) exposure patterns and the risk of pneumonia in chronic obstructive pulmonary disease (COPD) patients, we performed a nested case-control study. Between 1998 and 2010, 51,739 patients, including 19,838 cases of pneumonia, were matched to 74,849 control subjects selected from a cohort of COPD patients using ICSs via risk-set sampling of the database constructed by the National Health Research Institutes of Taiwan. After adjusting for covariates, the current use of ICSs was associated with a 25% increase in the risk of pneumonia (odds ratio [OR] =1...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27852080/prevalence-of-small-airway-dysfunction-among-copd-patients-with-different-gold-stages-and-its-role-in-the-impact-of-disease
#11
Ernesto Crisafulli, Roberta Pisi, Marina Aiello, Matteo Vigna, Panagiota Tzani, Anna Torres, Giuseppina Bertorelli, Alfredo Chetta
BACKGROUND: In chronic obstructive pulmonary disease (COPD) patients, small-airway dysfunction (SAD) is considered a functional hallmark of disease. However, the exact role of SAD in the clinical presentation of COPD is not yet completely understood; moreover, it is not known whether SAD may have a relationship with the impact of disease. OBJECTIVES: To evaluate the prevalence of SAD among COPD patients categorized by the old and the new GOLD classification and to ascertain whether there is a relationship between SAD and impact of disease measured by the COPD Assessment Test (CAT) questionnaire...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27843303/communication-during-counseling-sessions-about-inhaled-corticosteroids-at-the-community-pharmacy
#12
Jeanine A Driesenaar, Peter Agm De Smet, Rolf van Hulten, Litje Hu, Sandra van Dulmen
BACKGROUND: Pharmaceutical care is one of the major tasks of pharmacists, which aims to improve patient outcomes. Counseling patients with asthma or chronic obstructive pulmonary disease about their use of inhaled corticosteroids (ICS) might enhance medication adherence and symptom control. Therefore, effective pharmacist-patient communication is very important. In this regard, both affective communication, for handling emotions, and instrumental communication, for exchanging biomedical and lifestyle information, are relevant...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27830584/inhaled-corticosteroids-with-combination-inhaled-long-acting-beta2-agonists-and-long-acting-muscarinic-antagonists-for-chronic-obstructive-pulmonary-disease
#13
REVIEW
Daniel J Tan, Clinton J White, Julia Ae Walters, E Haydn Walters
BACKGROUND: Management of chronic obstructive pulmonary disease (COPD) commonly involves long-acting bronchodilators including beta-agonists (LABA) and muscarinic antagonists (LAMA). In individuals with persistent symptoms or frequent exacerbations, inhaled corticosteroids (ICS) are also used. LABA and LAMA bronchodilators are now available in single combination inhalers. However, the benefits and risks of adding ICS to combination LABA/LAMA inhalers remains unclear. OBJECTIVES: To assess the effect of adding an inhaled corticosteroid (ICS) to combination long-acting beta₂-agonist (LABA)/long-acting muscarinic antagonist (LAMA) inhalers for the treatment of stable COPD...
10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27825347/non-neuronal-cholinergic-system-contributes-to-corticosteroid-resistance-in-chronic-obstructive-pulmonary-disease-patients
#14
Javier Milara, Angela Cervera, Alfredo de Diego, Celia Sanz, Gustavo Juan, Amadeu Gavaldà, Montserrat Miralpeix, Esteban Morcillo, Julio Cortijo
BACKGROUND: Inhaled corticosteroid (ICS) with long-acting beta-2 agonists is a well-documented combination therapy for chronic obstructive pulmonary disease (COPD) based on its additive anti-inflammatory properties. By contrast, the recommendation of ICS in combination with long-acting muscarinic antagonist (LAMA) is not evidence-based. In this study, neutrophils obtained from COPD patients were used to compare the anti-inflammatory effects of aclidinium bromide (a long-acting muscarinic antagonist) with corticosteroids and their potential additive effect...
November 8, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27819513/can-assessment-of-disease-burden-prior-to-changes-in-initial-copd-maintenance-treatment-provide-insight-into-remaining-unmet-needs-a-retrospective-database-study-in-uk-primary-care
#15
Sarah H Landis, Keele Wurst, Hoa Van Le, Kerina Bonar, Yogesh S Punekar
This retrospective cohort study aimed to assess treatment patterns over 24 months amongst patients with chronic obstructive pulmonary disease (COPD), initiating a new COPD maintenance treatment, and to understand clinical indicators of treatment change. Patients included in the study initiated a long-acting β2-agonist (LABA), a long-acting muscarinic antagonist (LAMA), or a combination of LABA and an inhaled corticosteroid (ICS/LABA) between January 1, 2009, and November 30, 2013, as recorded in the United Kingdom Clinical Practice Research Datalink (UK CPRD)...
November 7, 2016: COPD
https://www.readbyqxmd.com/read/27817816/incidence-of-oral-thrush-in-patients-with-copd-prescribed-inhaled-corticosteroids-effect-of-drug-dose-and-device
#16
P N Richard Dekhuijzen, Maria Batsiou, Leif Bjermer, Sinthia Bosnic-Anticevich, Henry Chrystyn, Alberto Papi, Roberto Rodríguez-Roisin, Monica Fletcher, Lucy Wood, Alessandra Cifra, Joan B Soriano, David B Price
BACKGROUND AND AIMS: Little information is available on real-life occurrence of oral thrush in COPD patients treated with ICS. We investigated oral thrush incidence in COPD patients prescribed FDC ICS/LABA therapies and assessed whether it is modulated by the ICS type, dose, and delivery device. METHODS: We conducted a historical, observational, matched cohort study (one baseline year before and one outcome year after initiation of therapy) using data from the UK Optimum Patient Care Research Database...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27808096/first-maintenance-therapy-for-copd-in-the-uk-between-2009-and-2012-a-retrospective-database-analysis
#17
David Price, Marc Miravitlles, Ian Pavord, Mike Thomas, Jadwiga Wedzicha, John Haughney, Katsiaryna Bichel, Daniel West
Clinical guidelines recommend long-acting bronchodilators as first maintenance therapy for chronic obstructive pulmonary disease (COPD), with inhaled corticosteroids (ICS) reserved for patients with more severe disease and exacerbations. The aim of this analysis was to examine real-life prescribing of first maintenance therapy for COPD in the UK. Data were extracted from the UK Optimum Patient Care Research Database for patients with a first prescription for COPD maintenance therapy between 2009 and 2012 and a diagnosis of COPD at or before the date of the first prescription for COPD maintenance therapy...
November 3, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27799761/costs-of-chronic-obstructive-pulmonary-disease-in-urban-areas-of-china-a-cross-sectional-study-in-four-cities
#18
Xiaoying Chen, Na Wang, Yue Chen, Tian Xiao, Chaowei Fu, Biao Xu
PURPOSE: The economic burden of COPD has not been well studied in China. This study investigated the total costs caused by COPD and the influencing factors for the high economic burden in urban areas of China. PATIENTS AND METHODS: A cross-sectional study was carried out among 678 COPD patients in four cities in China in 2011. The average annual direct medical costs (DMCs), direct nonmedical costs (DNMCs), and indirect costs (ICs) on COPD were measured by median and mean (± standard deviation)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27787715/bifunctional-drugs-for-the-treatment-of-respiratory-diseases
#19
Clive Page, Mario Cazzola
Over the last decade, there has been a steady increase in the use of fixed dose combinations for the treatment of a range of diseases, including cancer, AIDS, tuberculosis and other infectious diseases. It is now evident that patients with asthma or chronic obstructive pulmonary disease (COPD) can also benefit from the use of fixed dose combinations, including combinations of a long-acting β2-agonist (LABA) and an inhaled corticosteroid (ICS), and combinations of LABAs and long-acting muscarinic receptor antagonists (LAMAs)...
October 28, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27783268/fixed-dose-combination-inhalers
#20
Mario Cazzola, Maria Gabriella Matera
In asthma and chronic obstructive pulmonary disease (COPD), an important step in simplifying management and improving adherence with prescribed therapy is to reduce the dose frequency to the minimum necessary to maintain disease control. Fixed-dose combination (FDC) therapy might enhance compliance by decreasing the number of medications and/or the number of daily doses. Furthermore, they have the potential for enhancing, sensitizing, and prolonging the effects of monocomponents. Combination therapy with an inhaled corticosteroid (ICS) and a long-acting β-agonist (LABA) is considered an important approach for treating patients with asthma and patients with severe COPD who have frequent exacerbations...
October 26, 2016: Handbook of Experimental Pharmacology
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