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https://www.readbyqxmd.com/read/29033625/the-salford-lung-study-a-pioneering-comparative-effectiveness-approach-to-copd-and-asthma-in-clinical-trials
#1
REVIEW
Timothy E Albertson, Susan Murin, Mark E Sutter, James A Chenoweth
The Salford Lung Study (SLS) of patients with asthma and chronic obstructive pulmonary disease (COPD) is a practical, community-based, randomized, open-label pragmatic study on the efficacy and safety of the once-daily dry powder inhaler that combines the inhaled corticosteroid fluticasone furoate (FF) with the long-acting beta2 agonist vilanterol (VI). The asthma component of the SLS is not yet reported but the COPD component, done over a 12-month period, found a statistically significant 8.4% reduction in COPD exacerbations when compared to usual care...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28991556/a-58-year-old-woman-with-pneumonia-and-gram-negative-diplococci
#2
Giuseppe Famularo, Pasquale Sordillo, Alessandro Stasolla, Maria Gabriella Parisi
A 58-year-old woman with COPD, cor pulmonale, diabetes, and hypertension had a productive cough of greenish and purulent sputum, low-grade fever, and shortness of breath. Medications were metformin, losartan, cholecalciferol, folic acid, a multivitamin, fluticasone by inhalation, and, as needed, ipratropium by inhalation. She lived alone and worked as a physician, had received that year's seasonal influenza vaccine, was a heavy smoker, did not drink alcohol or use illicit drugs, and had no personal or family history of allergy and autoimmunity...
October 2017: Chest
https://www.readbyqxmd.com/read/28982774/long-term-effects-of-inhaled-corticosteroids-on-sputum-bacterial-and-viral-loads-in-copd
#3
Marco Contoli, Alessia Pauletti, Maria Rita Rossi, Antonio Spanevello, Paolo Casolari, Andrea Marcellini, Giacomo Forini, Giulia Gnesini, Brunilda Marku, Neil Barnes, Andrea Rizzi, Giacomo Curradi, Gaetano Caramori, Paolo Morelli, Alberto Papi
Inhaled corticosteroid-containing medications reduce the frequency of COPD exacerbations (mainly infectious in origin) while paradoxically increasing the risk of other respiratory infections. The aim was to determine the effects of inhaled corticosteroids on airway microbial load in COPD patients and evaluate the influence of the underlying inflammatory profile on airway colonisation and microbiome.This is a proof-of-concept prospective, randomised, open-label, blinded endpoint study. Sixty patients with stable moderate COPD were randomised to receive one inhalation twice daily of either a combination of salmeterol 50 μg plus fluticasone propionate 500 μg or salmeterol 50 μg for 12 months...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28980320/potent-analogues-of-etiprednol-dicloacetate-a-second-generation-of-soft-corticosteroids
#4
Nicholas Bodor, Zoltán Zubovics, István Kurucz, Sandor Sólyom, Erik Bodor
OBJECTIVES: Loteprednol etabonate (LE) is the first, highly successful soft corticosteroid (SC) designed using the 'inactive metabolite' approach, starting with ∆(1) -cortienic acid (d-CA). The next generation of SCs based on d-CA was etiprednol dicloacetate (ED). The 17α-dichloroacetyl function serves both as a unique pharmacophore and as the source of the molecule's softness. Highly potent SCs were designed based on a combination of ED and LE, introducing 6, 9 and 16 substituents in the molecule...
October 4, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28963086/developing-an-exogenous-pulmonary-surfactant-glucocorticoids-association-effect-of-corticoid-concentration-on-the-biophysical-properties-of-the-surfactant
#5
Alejandra Cimato, Graciela Facorro, Margarita Martínez Sarrasague
Glucocorticoids (GCs) are used to treat lung disease. GCs incorporated in an exogenous pulmonary surfactant (EPS) could be an alternative management to improve drug delivery avoiding side effects. In the development of these pharmaceutical products, it is important to know the maximum amount of GC that can be incorporated and if increasing quantities of GCs alter EPS biophysical properties. Formulations containing EPS and beclomethasone, budesonide or fluticasone were analyzed (PL 10mg/ml; GC 1-2mg/ml). The microstructure was evaluated by electron paramagnetic resonance spectroscopy, GCs incorporated were determined by UV absorption and polarized light microscopy and surfactant activity with pulsating bubble surfactometer...
September 27, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28961322/scintigraphic-assessment-of-deposition-of-radiolabeled-fluticasone-delivered-from-a-nebulizer-and-metered-dose-inhaler-in-10-healthy-dogs
#6
K E Chow, D Tyrrell, M Yang, L A Abraham, G A Anderson, C S Mansfield
BACKGROUND: Aerosolized medications are increasingly being used to treat respiratory diseases in dogs. No previous studies assessing respiratory tract deposition of radiolabeled aerosols have been performed in conscious dogs. HYPOTHESIS/OBJECTIVES: Assess respiratory tract deposition of radiolabeled, inhalant corticosteroid (fluticasone propionate labeled with (99m) Tc) delivered from a nebulizer and metered dose inhaler (MDI) to healthy dogs. ANIMALS: Ten healthy Foxhounds...
September 29, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28961020/once-daily-fluticasone-furoate-vilanterol-versus-twice-daily-fluticasone-propionate-salmeterol-in-patients-with-asthma-well-controlled-on-ics-laba
#7
David Bernstein, Leslie Andersen, Richard Forth, Loretta Jacques, Louisa Yates
OBJECTIVE: We aimed to demonstrate non-inferiority of once-daily fluticasone furoate/vilanterol 100/25 μg (FF/VI) to twice-daily fluticasone propionate/salmeterol 250/50 μg (FP/SAL) in adults/adolescents with asthma well controlled on inhaled corticosteroid/long-acting β2 agonist (ICS/LABA). METHODS: This was a randomized, double-blind, double-dummy, parallel-group, 24-week study (NCT02301975/GSK study 201378). Patients whose asthma met study-defined criteria for control were randomized 1:1:1 to receive FF/VI, FP/SAL or twice-daily FP 250 μg for 24 weeks...
September 29, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28956463/fluticasone-furoate-and-vilanterol-for-the-treatment-of-chronic-obstructive-pulmonary-disease
#8
Gaetano Caramori, Paolo Ruggeri, Paolo Casolari, Kian Fan Chung, Giuseppe Girbino, Ian M Adcock
Current national and international guidelines for the management of patients with stable chronic obstructive pulmonary disease (COPD) recommend the use of inhaled long-acting bronchodilators, inhaled glucocorticoids and their combinations for maintenance treatment of moderate to severe stable COPD. Areas covered: The role of fluticasone furoate (FF) and vilanterol (VI) once daily combination therapy for the regular treatment of patients with stable COPD is discussed in this review. Expert commentary: The regular treatment of moderate to severe stable COPD with once daily FF/VI combination therapy is effective, as seen in in several large placebo-controlled clinical trials involving many thousands of patients...
October 6, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28947039/pneumonia-risk-with-inhaled-fluticasone-furoate-and-vilanterol-in-copd-patients-with-moderate-airflow-limitation-the-summit-trial
#9
Courtney Crim, Peter M A Calverley, Julie A Anderson, Andrew P Holmes, Sally Kilbride, Fernando J Martinez, Robert D Brook, David E Newby, Julie C Yates, Bartolomé R Celli, Jørgen Vestbo
RATIONALE: Pneumonia risk with inhaled corticosteroid use in chronic obstructive pulmonary disease (COPD) has not been thoroughly assessed in patients with moderate airflow limitation. OBJECTIVES: To determine the incidence of pneumonia and risk factors in COPD patients with moderate airflow limitation who had, or were at high risk for cardiovascular disease. METHODS: In the Study to Understand Mortality and MorbidITy in COPD (SUMMIT), 16,590 subjects with moderate airflow limitation (50% ≤ FEV1 ≤ 70% predicted) and heightened cardiovascular risk were randomized double-blind 1:1:1:1 to inhaled once-daily vilanterol 25 μg (VI), fluticasone furoate 100 μg (FF), vilanterol 25 μg combined with 100 μg fluticasone furoate (FF/VI), or matched placebo...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28947024/real-life-effectiveness-of-asthma-treatment-with-a-fixed-dose-fluticasone-formoterol-pressurised-metered-dose-inhaler-results-from-a-non-interventional-study
#10
O Schmidt, W Petro, G Hoheisel, F Kanniess, P Oepen, B Langer-Brauburger
OBJECTIVE: Prospective, non-interventional study of fixed-dose inhaled corticosteroid (ICS)/long-acting beta2-agonist (LABA) combination therapy with fluticasone propionate/formoterol fumarate (FP/FORM) across a spectrum of community-based patients with asthma in a real-life setting. METHODS: In FP/FORM-treated patients aged ≥12 years, asthma control (Asthma Control Test™ [ACT]), incidence of severe exacerbations, lung function, quality of life (asthma quality of life questionnaire [AQLQ]) and adverse events (AEs) were assessed over one year...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28947022/the-effect-of-umeclidinium-on-lung-function-and-symptoms-in-patients-with-fixed-airflow-obstruction-and-reversibility-to-salbutamol-a-randomised-3-phase-study
#11
Laurie Lee, Edward Kerwin, Kathryn Collison, Linda Nelsen, Wei Wu, Shuying Yang, Steven Pascoe
INTRODUCTION: The long-acting muscarinic antagonist, umeclidinium (UMEC), combined with the inhaled corticosteroid, fluticasone furoate (FF), improves lung function in symptomatic patients with asthma. We assessed FF/UMEC in patients with a primary diagnosis of asthma or chronic obstructive pulmonary disease (COPD), but physiological characteristics of both (fixed airflow obstruction and reversibility to salbutamol). METHODS: This double-blind, parallel-arm, 3-phase study randomised 338 patients (1:1:1:1:2:2) to FF 100 mcg alone or combined with UMEC (15...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28944123/preventing-cushing-iatrogenic-cushing-syndrome-due-to-ritonavir-fluticasone-interaction
#12
Fasil Tiruneh, Ahmad Awan, Abiot Didana, Saumil Doshi
Ritonavir is commonly used in low doses to boost plasma levels of protease inhibitors in patients with human immunodeficiency virus (HIV) infections. It is also a potent inhibitor of cytochrome P450. We present a 50-year-old African American male with past medical history of HIV on highly active antiretroviral therapy (HAART), which also included ritonavir and long standing asthma that has been treated with inhaled fluticasone, who presented with back pain. He had central obesity, prominent abdominal striae and wasted extremities on physical examination...
July 17, 2017: Curēus
https://www.readbyqxmd.com/read/28939463/design-and-pharmaceutical-applications-of-a-low-flow-rate-single-nozzle-impactor
#13
Hui Wang, Pallavi Bhambri, James Ivey, Reinhard Vehring
A new low-flow-rate (0.5L/min) single-nozzle impactor for the concentration of dilute aerosol particles with selected pharmaceutical applications is described in this paper. The impactor can be configured up to 11 stages with a wide range of cutoff diameters from 0.6μm to 21.1μm, enabling convenient sampling of inhalable drug particles from inhalation devices and drug production processes. Its unique single-nozzle design and removable impaction plate allow direct sample transfer for subsequent compositional, morphological, solid-state, and other analysis...
September 20, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28937774/selective-non-steroidal-glucocorticoid-receptor-modulators-for-the-inhaled-treatment-of-pulmonary-diseases
#14
Martin Hemmerling, Stinabritt Nilsson, Karl Edman, Stefan Eirefelt, Wayne Russell, Ramon Hendrickx, Eskil Johnsson, Carina Kärrman-Mårdh, Markus Berger, Hartmut Rehwinkel, Anna Abrahamsson, Jan Dahm Eacute N, Anders R Eriksson, Balint Gabos, Krister Henriksson, Nafizal Hossain, Svetlana Ivanova, Anne-Helene Jansson, Tina J Jensen, Anders Jerre, Henrik Johansson, Tomas Klingstedt, Matti Lepistö, Martin Lindsjö, Irene Mile, Grigorios Nikitidis, John Steele, Ulrika Tehler, Lisa Wissler, Thomas Hansson
A class of potent, non-steroidal, selective indazole ether based glucocorticoid receptor modulators (SGRMs) was developed for the inhaled treatment of respiratory diseases. Starting from an orally available compound with demonstrated anti-inflammatory activity in rat, a soft drug strategy was implemented to ensure rapid elimination of drug candidates and minimize systemic GR activation. The first clinical candidate 1b (AZD5423) displayed potent inhibition of lung edema in a rat model of allergic airway inflammation following dry powder inhalation combined with a moderate systemic GR-effect, assessed as thymic involution...
September 22, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28933971/the-pharmacokinetics-safety-and-tolerability-of-single-high-strength-doses-of-fluticasone-propionate-and-fluticasone-propionate-salmeterol-delivered-via-a-novel-multidose-dry-powder-inhaler-in-adolescents-and-adults-with-persistent-asthma
#15
Courtney Nugent, Gloria Yiu, Sharon Song, Cynthia Caracta
OBJECTIVE: Characterize fluticasone propionate (Fp) and combination fluticasone propionate and salmeterol (FS) pharmacokinetic and safety profiles, delivered via a novel, inhalation-driven, multidose dry powder inhaler (MDPI). METHODS: This multicenter, open-label, 4-period crossover, single-dose study randomized patients aged ≥12 years with persistent asthma to Fp MDPI 200 mcg, FS MDPI 200/12.5 mcg, Fp dry powder inhaler (DPI) 500 mcg (250 mcg × 2 inhalations), or FS DPI 500/50 mcg...
September 21, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28931659/the-risk-of-mycobacterial-infections-associated-with-inhaled-corticosteroid-use
#16
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/28929816/which-inhaled-corticosteroid-and-long-acting-%C3%AE-agonist-combination-is-better-in-patients-with-moderate-to-severe-asthma-a-dry-powder-inhaler-or-a-pressurized-metered-dose-inhaler
#17
Masato Muraki, Kyuya Gose, Soichiro Hanada, Hirochiyo Sawaguchi, Yuji Tohda
Two main types of devices are used to facilitate the administration of inhaled corticosteroid (ICS) and long-acting β-agonist (LABA) in combination, dry powder inhalers (DPIs) and pressurized metered-dose inhalers (pMDIs). There are few reports comparing the effects of the two devices, and it is unknown which should be recommended for asthma patients with given sets of characteristics. In the current study, the beneficial effects and side effects associated with DPIs and pMDIs were compared, and the question of which device should be recommended for asthma patients was investigated...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28926855/a-comparison-of-the-efficacy-of-once-daily-fluticasone-furoate-vilanterole-with-twice-daily-fluticasone-propionate-salmeterol-in-elderly-asthmatics
#18
Yoshihisa Ishiura, Masaki Fujimura, Yasutaka Shiba, Noriyuki Ohkura, Johsuke Hara, Miki Abo, Kazuo Kasahara
Background Asthma in the elderly population has been focused because it affects quality of life and results in a higher hospitalization rate and mortality. Fluticasone furoate (FF)/vilanterole (VI) is a novel inhaled corticosteroids (ICS)/long-acting β2 agonist (LABA) combination being developed for once-daily administration for asthma with greater anti-inflammatory activity and longer duration of bronchidilation. The Ellipta(TM) dry powder inhaler (DPI) has also been available as a new device with high levels of satisfaction and preference...
September 19, 2017: Drug Research
https://www.readbyqxmd.com/read/28903864/effectiveness-of-fluticasone-furoate-plus-vilanterol-on-asthma-control-in-clinical-practice-an-open-label-parallel-group-randomised-controlled-trial
#19
Ashley Woodcock, Jørgen Vestbo, Nawar Diar Bakerly, John New, J Martin Gibson, Sheila McCorkindale, Rupert Jones, Susan Collier, James Lay-Flurrie, Lucy Frith, Loretta Jacques, Joanne L Fletcher, Catherine Harvey, Henrik Svedsater, David Leather
BACKGROUND: Evidence for management of asthma comes from closely monitored efficacy trials done in highly selected patient groups. There is a need for randomised trials that are closer to usual clinical practice. METHODS: We did an open-label, randomised, controlled, two-arm effectiveness trial at 74 general practice clinics in Salford and South Manchester, UK. Patients aged 18 years or older with a general practitioner's diagnosis of symptomatic asthma and on maintenance inhaler therapy were randomly assigned to initiate treatment with a once-daily inhaled combination of either 100 μg or 200 μg fluticasone furoate with 25 μg vilanterol or optimised usual care and followed up for 12 months...
September 10, 2017: Lancet
https://www.readbyqxmd.com/read/28890299/comparison-of-fluticasone-formoterol-with-budesonide-formoterol-pmdi-in-adults-with-moderate-to-severe-persistent-asthma-results-from-a-12-week-randomized-controlled-trial
#20
Akash Balki, S Balamurugan, Suhas Bardapurkar, Sonia Dalal, Ajeet Singh, B P Singh, Abhijit Vaidya, Jaideep A Gogtay
BACKGROUND: Combination therapy of inhaled corticosteroid/long acting β2-agonist (ICS/LABA) is the cornerstone of managing asthmatics who are uncontrolled with low-medium dose of ICS. The novel ICS/LABA combination of fluticasone propionate and formoterol (flu/form) provides potent anti-inflammatory and rapid bronchodilatory effect. This randomized, multi-centre, double-blind study compared the efficacy and safety of flu/form (125/6 mcg BD; Maxiflo(®)) with the well-established budesonide/formoterol combination (bud/form 200/6 mcg BD), both delivered through a pressurized metered dose inhaler (pMDI) in patients with moderate to severe persistent asthma over 12 weeks...
September 7, 2017: Pulmonary Pharmacology & Therapeutics
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