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https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#1
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
#2
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
#3
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
#4
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...
June 9, 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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28479113/pharmacotherapy-for-non-cystic-fibrosis-bronchiectasis-results-from-an-ntm-info-research-patient-survey-and-the-bronchiectasis-and-ntm-research-registry
#9
E Henkle, T R Aksamit, A F Barker, J R Curtis, C L Daley, M L Daniels, A DiMango, E Eden, K Fennelly, D E Griffith, M Johnson, M R Knowles, A Leitman, P Leitman, E Malanga, M L Metersky, P G Noone, A E O'Donnell, K N Olivier, D Prieto, M Salathe, B Thomashow, G Tino, G Turino, S Wisclenny, K L Winthrop
PURPOSE: Non-cystic fibrosis bronchiectasis ("bronchiectasis") is a chronic inflammatory lung disease often associated with nontuberculous mycobacterium (NTM) infection. Very little data exist to guide bronchiectasis management decisions. We sought to describe patterns of inhaled corticosteroid (ICS) and antibiotic therapy in the U.S. METHODS: We invited 2,000 patients through NTM Info & Research (NTMir) to complete an anonymous electronic survey. We separately queried baseline clinical and laboratory data from the U...
May 4, 2017: Chest
https://www.readbyqxmd.com/read/28425216/pneumonia-risk-in-asthma-patients-using-inhaled-corticosteroids-a-quasi-cohort-study
#10
Christina J Qian, Janie Coulombe, Samy Suissa, Pierre Ernst
AIM: Studies have linked the use of inhaled corticosteroids (ICS) to excess pneumonia risk in COPD patients. The risk in asthma patients remains unclear. The objective was to examine the risk of pneumonia with ICS in patients 12 to 35 years old with asthma. METHODS: We formed a cohort of asthma patients treated from 1990-2007 using Quebec health insurance databases. Subjects were considered currently exposed if they had an ICS dispensed within the 60 days prior to their pneumonia index event or matched person-moment...
March 28, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28412726/inhaled-corticosteroids-have-a-protective-effect-against-lung-cancer-in-female-patients-with-chronic-obstructive-pulmonary-disease-a-nationwide-population-based-cohort-study
#11
Shih-Feng Liu, Ho-Chang Kuo, Meng-Chih Lin, Shu-Chen Ho, Mei-Lien Tu, Yu-Mu Chen, Yung-Che Chen, Wen-Feng Fang, Chin-Chou Wang, Guan-Heng Liu
Whether the use of inhaled corticosteroids (ICS) protects patients with chronic obstructive pulmonary disease (COPD) from lung cancer remains undetermined. In this retrospective nationwide population-based cohort study, we extracted data of 13,686 female COPD patients (ICS users, n = 1,290, ICS non-users, n = 12,396) diagnosed between 1997 and 2009 from the Taiwan's National Health Insurance database. These patients were followed-up until 2011, and lung cancer incidence was determined. Cox regression analysis was used to estimate hazard ratios (HRs) for lung cancer incidence...
May 2, 2017: Oncotarget
https://www.readbyqxmd.com/read/28410560/role-of-long-acting-muscarinic-antagonist-long-acting-%C3%AE-2-agonist-therapy-in-chronic-obstructive-pulmonary-disease
#12
Sarah E Petite
OBJECTIVE: To compare the available literature regarding the use of long-acting muscarinic antagonist (LAMA)/long-acting β2 agonists (LABA) and inhaled corticosteroid (ICS)/LABA combination inhaler therapy in chronic obstructive pulmonary disease (COPD) maintenance therapy management. DATA SOURCES: A MEDLINE literature search from database inception to February 2017 was conducted using the search terms chronic obstructive pulmonary disease, adrenergic beta-agonist, muscarinic antagonist, and inhaled corticosteroid...
April 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28406337/inhaled-corticosteroid-use-in-chronic-obstructive-pulmonary-disease-and-risk-of-pneumonia-a-nested-case-control-population-based-study-in-lazio-italy-the-outpul-study
#13
Silvia Cascini, Ursula Kirchmayer, Valeria Belleudi, Lisa Bauleo, Riccardo Pistelli, Mirko Di Martino, Giulio Formoso, Marina Davoli, Nera Agabiti
Inhaled corticosteroid (ICS) use in chronic obstructive pulmonary disease (COPD) patients is associated with a reduction of exacerbations and a potential risk of pneumonia. The objective was to determine if ICS use, with or without long-acting β2-agonist, increases pneumonia risk in COPD patients. A cohort study was performed using linked hospital and drug prescription databases in the Lazio region. Patients (45+) discharged with COPD in 2006-2009 were enrolled and followed from cohort entry until first admission for pneumonia, death or study end, 31 December, 2012...
April 13, 2017: COPD
https://www.readbyqxmd.com/read/28395575/safety-of-inhaled-long-acting-anti-muscarinic-agents-in-copd
#14
REVIEW
Nicola A Hanania, Suzanne C Lareau, Barbara P Yawn
Evidence-based guidelines recommend inhaled long-acting anti-muscarinic agents (LAMAs) as first-line maintenance therapy for symptomatic patients with COPD. Several LAMAs are now available for use either as monotherapy or in combination with other COPD medications, including long-acting β2-agonists (LABAs) or inhaled corticosteroids (ICS). The efficacy and long-term safety of these medications have been evaluated in multiple clinical trials and real-life studies. This review evaluates the evidence available on the safety of existing LAMAs alone or in combination with LABAs and ICS in patients with COPD...
June 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28375647/fulfil-trial-once-daily-triple-therapy-in-patients-with-chronic-obstructive-pulmonary-disease
#15
David A Lipson, Helen Barnacle, Ruby Birk, Noushin Brealey, Nicholas Locantore, David A Lomas, Andrea Ludwig-Sengpiel, Rajat Mohindra, Maggie Tabberer, Chang-Qing Zhu, Steven J Pascoe
RATIONALE: Randomized data comparing triple therapy with dual inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA) therapy in patients with chronic obstructive pulmonary disease (COPD) are limited. OBJECTIVES: We compared the effects of once-daily triple therapy on lung function and health-related quality of life with twice-daily ICS/LABA therapy. METHODS: FULFIL was a randomized, double-blind, double-dummy study comparing 24 weeks of once-daily triple therapy (fluticasone furoate/umeclidinium/vilanterol 100 μg/62...
April 4, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28360514/laba-lama-combinations-versus-lama-monotherapy-or-laba-ics-in-copd-a-systematic-review-and-meta-analysis
#16
Gustavo J Rodrigo, David Price, Antonio Anzueto, Dave Singh, Pablo Altman, Giovanni Bader, Francesco Patalano, Robert Fogel, Konstantinos Kostikas
BACKGROUND: Randomized controlled trials (RCTs) indicate that long-acting bronchodilator combinations, such as β2-agonist (LABA)/muscarinic antagonist (LAMA), have favorable efficacy compared with commonly used COPD treatments. The objective of this analysis was to compare the efficacy and safety of LABA/LAMA with LAMA or LABA/inhaled corticosteroid (ICS) in adults with stable moderate-to-very-severe COPD. METHODS: This systematic review and meta-analysis (PubMed/MEDLINE, Embase, Cochrane Library and clinical trial/manufacturer databases) included RCTs comparing ≥12 weeks' LABA/LAMA treatment with LAMA and/or LABA/ICS (approved doses only)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28334727/discovering-the-relative-efficacy-of-inhaled-medications-for-chronic-obstructive-pulmonary-disease-multiple-treatment-comparisons
#17
REVIEW
Ying Zhu, Tong Zhang, Haiyan Li, Yang Yang, Qiong Chen, Lei Kong, Bo Tai
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is managed by three major classes of inhaled medications: inhaled corticosteroids (ICS), long-acting Beta 2-agonist (LABA), long-acting muscarinic antagonist (LAMA). Single inhaled medication is usually replaced by combined inhaled medications for efficacy enhancement. However, this practice should be supported by clinical evidence for large-scale implementations. METHODS: The relative efficacy of inhaled medications is determined by three endpoints: changes in the trough forced expiratory volume in 1 second (tFEV1), changes in the St George's Respiratory Questionnaire (SGRQ) score and the proportion of SGRQ responders which represents a reduction in SGRQ total score at week 24 of ≥4...
2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28293106/inhaled-treatment-of-copd-a-delphi-consensus-statement
#18
Vincent Ninane, Jean-Louis Corhay, Paul Germonpré, Wim Janssens, Guy F Joos, Giuseppe Liistro, Walter Vincken, Sandra Gurdain, Evelyne Vanvlasselaer, An Lehouck
BACKGROUND: Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. OBJECTIVES: To evaluate the level of medical experts' consensus on their preferred first-choice treatment within different COPD categories. METHODS: A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28255905/inhaled-corticosteroid-use-and-the-risk-of-pneumonia-and-copd-exacerbations-in-the-uplift-study
#19
Jaymin B Morjaria, Alan Rigby, Alyn H Morice
RATIONALE: Unlike many other COPD studies, the 4-year UPLIFT trial permitted inhaled corticosteroid (ICS) use during run-in and treatment phases. This provided the opportunity to prospectively observe the continuing effects of ICS on respiratory events in closely observed COPD population. OBJECTIVES: We aimed to determine rate and number of episodes of pneumonia and exacerbations of COPD in patients entering the study on no ICS, fluticasone proprionate (FP), and other ICS...
June 2017: Lung
https://www.readbyqxmd.com/read/28235977/use-of-concomitant-inhaled-corticosteroids-pooled-data-from-two-phase-iii-studies-of-aclidinium-plus-formoterol-in-copd
#20
Anthony D'Urzo, Dave Singh, Esther Garcia Gil
Bronchodilator therapy is the backbone of the management of chronic obstructive pulmonary disease. In some patients, inhaled corticosteroids can be prescribed in combination with bronchodilators. Through a subgroup analysis of pooled data from two large phase III clinical trials of bronchodilator therapy according to concomitant inhaled corticosteroid use (user vs. non-user), we sought to evaluate the clinical benefit of adding inhaled corticosteroids to dual bronchodilator therapy in chronic obstructive pulmonary disease...
December 2017: NPJ Primary Care Respiratory Medicine
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