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https://www.readbyqxmd.com/read/28931659/the-risk-of-mycobacterial-infections-associated-with-inhaled-corticosteroid-use
#1
Sarah K Brode, Michael A Campitelli, Jeffrey C Kwong, Hong Lu, Alex Marchand-Austin, Andrea S Gershon, Frances B Jamieson, Theodore K Marras
Inhaled corticosteroid (ICS) use is associated with an increased risk of pneumonia. This study was performed to determine if ICS use is associated with an increased risk of nontuberculous mycobacterial pulmonary disease (NTM-PD) or tuberculosis (TB).We conducted a population-based nested case-control study using linked laboratory and health administrative databases in Ontario, Canada, including adults aged ≥66 years with treated obstructive lung disease (i.e. asthma, chronic obstructive pulmonary disease (COPD) or asthma-COPD overlap syndrome) between 2001 and 2013...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28918400/healthcare-resource-use-and-costs-of-severe-uncontrolled-eosinophilic-asthma-in-the-uk-general-population
#2
Marjan Kerkhof, Trung N Tran, Joan B Soriano, Sarowar Golam, Danny Gibson, Elizabeth V Hillyer, David B Price
BACKGROUND: Little is known about the prevalence of severe, uncontrolled eosinophilic asthma (SUEA) and associated costs. AIMS: We sought to determine the prevalence of SUEA and compare asthma-related healthcare resource use (HCRU) and associated costs with overall means for a general asthma population. METHODS: This cohort study evaluated anonymised medical record data (December 1989 through June 2015) from the Clinical Practice Research Datalink and the Optimum Patient Care Research Database to study UK patients with active asthma (diagnostic code and one or more drug prescriptions in the baseline year), aged 5 years and older, without concomitant COPD, and with recorded eosinophil count...
September 16, 2017: Thorax
https://www.readbyqxmd.com/read/28883469/characteristics-of-newly-diagnosed-copd-patients-treated-with-triple-inhaled-therapy-by-general-practitioners-a-real-world-italian-study
#3
Fabiano Di Marco, Pierachille Santus, Silvia Terraneo, Elena Peruzzi, Elisa Muscianisi, Claudio Ripellino, Valeria Pegoraro
Factors predicting prescriptions of triple therapy were investigated in a large group of general practitioners in Italy. In the population treated by identified general practitioners, a cohort of newly diagnosed chronic obstructive pulmonary disease patients was extracted from IMS Health Longitudinal Database during the period 2010-2013. From the diagnosis, 1-year follow-up was evaluated. Thirty-two thousand forty-six newly diagnosed chronic obstructive pulmonary disease patients were evaluated (57.7% male, mean age 67 years)...
September 7, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28864055/tracheobronchopathy-from-inhaled-corticosteroids
#4
REVIEW
Bryan C Husta, Suhail Raoof, Serpil Erzurum, Atul C Mehta
Inhaled corticosteroids (ICSs) have become the mainstay of asthma control. They are also recommended as an add-on therapy to long-acting beta agonists and anticholinergics in moderate to severe COPD with recurrent exacerbations. Ultimately this clinical practice has led to the widespread use of ICSs, which are supported by a more favorable side effect profile than that of systemic steroids.
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28860740/clinical-implications-of-blood-eosinophil-count-in-patients-with-non-asthma-copd-overlap-syndrome-copd
#5
Jin Hwa Song, Chang-Hoon Lee, Jin Woo Kim, Won-Yeon Lee, Ji Ye Jung, Joo Hun Park, Ki Suck Jung, Kwang Ha Yoo, Yong Bum Park, Deog Keom Kim
BACKGROUND: Recent studies that assessed the relevance of the blood eosinophil count as a biomarker in patients with COPD may have overestimated it because they included patients with asthma-COPD overlap syndrome (ACOS). We investigated the clinical implications of the blood eosinophil count in patients with non-ACOS COPD. PATIENTS AND METHODS: From a Korean COPD Subtype Study (KOCOSS) cohort, we selected patients with non-ACOS COPD after excluding ACOS patients according to Spanish criteria...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28860739/the-comparative-effectiveness-of-initiating-fluticasone-salmeterol-combination-therapy-via-pmdi-versus-dpi-in-reducing-exacerbations-and-treatment-escalation-in-copd-a-uk-database-study
#6
Rupert Jones, Jessica Martin, Vicky Thomas, Derek Skinner, Jonathan Marshall, Martina Stagno d'Alcontres, David Price
Chronic obstructive pulmonary disease (COPD), a complex progressive disease, is currently the third leading cause of death worldwide. One recommended treatment option is fixed-dose combination therapy of an inhaled corticosteroid (ICS)/long-acting β-agonist. Clinical trials suggest pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) show similar efficacy and safety profiles in COPD. Real-world observational studies have shown that combination therapy has significantly greater odds of achieving asthma control when delivered via pMDIs...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28821412/inhaled-corticosteroid-long-acting-bronchodilator-treatment-mitigates-stemi-clinical-presentation-in-copd-patients
#7
Marco Contoli, Gianluca Campo, Rita Pavasini, Irene Marchi, Alessia Pauletti, Cristina Balla, Antonio Spanevello, Roberto Ferrari, Alberto Papi
BACKGROUND: Patients with myocardial infarction and concomitant COPD are at increased risk of poor clinical outcomes, including death, as compared to patients without COPD. AIM: To investigate and compare the severity of the clinical presentation of ST-segment elevation myocardial infarction (STEMI) and of the short-(7days) and long-term-(end of follow up) mortality in COPD patients treated with inhaled corticosteroids (ICS)/long-acting bronchodilator (LABD) - either long-acting beta2 agonist (LABA) or long-acting muscarinic antagonist (LAMA) - vs...
August 15, 2017: European Journal of Internal Medicine
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
#8
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
#9
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
#10
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...
October 2017: COPD
https://www.readbyqxmd.com/read/28721202/defining-the-inflammatory-signature-of-human-lung-explant-tissue-in-the-presence-and-absence-of-glucocorticoid
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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