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Corticosteroid use in copd

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https://www.readbyqxmd.com/read/28548632/diagnostic-and-prognostic-value-of-inflammatory-parameters-including-neopterin-in-the-setting-of-pneumonia-copd-and-acute-exacerbations
#1
Alex Pizzini, Fabian Lunger, Amra Sahanic, Nada Nemati, Dietmar Fuchs, Günter Weiss, Katharina Kurz, Rosa Bellmann-Weiler
Acute exacerbations and community-acquired pneumonia (CAP) are severe complications in patients with chronic obstructive pulmonary disease (COPD). In this study, we analyzed inflammatory parameters in serum including C-reactive protein (CRP), procalcitonin (PCT), and serum neopterin (NPT) to determine their potential to differentiate between patients with CAP+COPD and with acute exacerbations of COPD (AECOPD) without pneumonia. 102 (39 women and 63 men) patients were included in this retrospective study, of whom 48 presented with CAP without underlying COPD, 20 with CAP+COPD and 34 with AECOPD...
June 2017: COPD
https://www.readbyqxmd.com/read/28533689/medication-related-costs-of-rhinitis-in-australia-a-nostradata-cross-sectional-study-of-pharmacy-purchases
#2
Pete Smith, David Price, Richard Harvey, Andrew Simon Carney, Vicky Kritikos, Sinthia Z Bosnic-Anticevich, Louise Christian, Derek Skinner, Victoria Carter, Alice Marie Sybille Durieux
PURPOSE: There is a relative paucity of research regarding medication expenditure associated with multiple-therapy use for rhinitis in Australia. To describe 1) the nature and extent of multiple-therapy use for rhinitis in Australia using data on therapies purchased with prescription or over-the-counter (OTC) and 2) additional costs incurred by multiple-therapy use compared with intranasal corticosteroid (INCS) therapy alone. PATIENTS AND METHODS: A retrospective observational study was carried out using a database containing anonymous pharmacy transaction data available from 20% of pharmacies in Australia that links doctor prescriptions and OTC purchase information...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28512018/nanoencapsulation-of-a-glucocorticoid-improves-barrier-function-and-anti-inflammatory-effect-on-monolayers-of-pulmonary-epithelial-cell-lines
#3
Lucas A Rigo, Cristiane S Carvalho-Wodarz, Adriana R Pohlmann, Silvia S Guterres, Nicole Schneider-Daum, Claus-Michael Lehr, Ruy C R Beck
The anti-inflammatory effect of polymeric deflazacort nanocapsules (NC-DFZ) was investigated, and possible improvement of epithelial barrier function using filter grown monolayers of A549 and Calu-3 using as models was assessed. NC prepared from poly(ε-caprolactone) (PCL) had a mean size around 200 nm, slightly negative zeta potential (∼ - 8 mV), and low polydispersity index (< 0.10). Encapsulation of DFZ had an efficiency of 85%. No cytotoxic effects were observed at particle concentration of 9.85 x 10(11) NC/ml, which was therefore chosen to evaluate the effect of NC-DFZ at 1% (w/v) of PCL and 0...
May 13, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28506728/-the-effects-of-inhaled-steroids-withdrawal-in-copd
#4
G Jebrak, I Honore, P Serrier, J Dumoulin, P Terrioux, F Soyez, C Maurer, G Mangiapan, M Febvre, L-J Couderc, J-M Braun, T Chinet
The key pathophysiological feature of chronic obstructive pulmonary disease (COPD) is an abnormal inflammatory bronchial reaction after inhalation of toxic substances. The priority is the avoidance of such toxic inhalations, but the use of anti-inflammatory drugs also seems appropriate, especially corticosteroids that are the sole anti-inflammatory drug available for this purpose in France. The risks associated with the prolonged use of these parenteral drugs are well known. Inhalation is therefore the optimal route, but inhaled drugs may also lead to adverse consequences...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28496316/the-effect-of-indacaterol-glycopyrronium-versus-tiotropium-or-salmeterol-fluticasone-on-the-prevention-of-clinically-important-deterioration-in-copd
#5
Antonio R Anzueto, Claus F Vogelmeier, Konstantinos Kostikas, Karen Mezzi, Sebastian Fucile, Giovanni Bader, Steven Shen, Donald Banerji, Robert Fogel
BACKGROUND: Endpoints that evaluate deterioration rather than improvement of disease may have clinical utility in COPD. In this analysis, we compared the effects of different maintenance treatments on the prevention of clinically important deterioration (CID) in moderate-to-severe COPD patients. METHODS: Data were analyzed from three 26-week studies comparing indacaterol/glycopyrronium (IND/GLY) with tiotropium (TIO) or salmeterol/fluticasone (SFC). Two definitions of CID were used; each was a composite of three outcome measures typically associated with COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28495392/elderly-polypharmacy-patients-needs-and-concerns-regarding-medication-assessed-using-the-structured-patient-pharmacist-consultation-model
#6
Sandra Vezmar Kovačević, Branislava Miljković, Katarina Vučićević, Milica Ćulafić, Milena Kovačević, Bojana Golubović, Marija Jovanović, Johan J de Gier
OBJECTIVE: To evaluate elderly polypharmacy patients' needs and concerns regarding medication through the Structured Patient-Pharmacist Consultation (SPPC). METHODS: Older patients on chronic treatment with ≥5 medications were asked to fill in the SPPC form at home. A consultation with the community pharmacist, structured according to patient's answers, followed within 2-4 weeks. Logistic regression associated patients' individual treatment with care issues and consultation outcomes...
May 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28495077/consensus-on-the-asthma-copd-overlap-syndrome-acos-between-the-spanish-copd-guidelines-gesepoc-and-the-spanish-guidelines-on-the-management-of-asthma-gema
#7
Vicente Plaza, Francisco Álvarez, Myriam Calle, Ciro Casanova, Borja G Cosío, Antolín López-Viña, Luís Pérez de Llano, Santiago Quirce, Miguel Román-Rodríguez, Juan José Soler-Cataluña, Marc Miravitlles
Following a proposal by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), sponsor of the Spanish COPD Guidelines (GesEPOC) and the Spanish Guidelines on the Management of Asthma (GEMA), authors of both papers have unified the criteria for the diagnosis of asthma-COPD overlap syndrome (ACOS). This consensus defines ACOS as the presence in a given patient of three elements: significant smoking exposure, chronic airflow limitation and asthma. Diagnosis is confirmed when a patient (35years of age or older), smoker or ex-smoker of more than 10 pack-years, presents airflow limitation (post-bronchodilator FEV1/FVC<0...
May 8, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28483402/doxycycline-for-outpatient-treated-acute-exacerbations-of-copd-a-randomised-double-blind-placebo-controlled-trial
#8
Patricia van Velzen, Gerben Ter Riet, Paul Bresser, Jeroen J Baars, Bob T J van den Berg, Jan W K van den Berg, Paul Brinkman, Jennece W F Dagelet, Johannes M A Daniels, Dewi R G L Groeneveld-Tjiong, René E Jonkers, Coen van Kan, Frans H Krouwels, Karin Pool, Arjan Rudolphus, Peter J Sterk, Jan M Prins
BACKGROUND: Antibiotics do not reduce mortality or short-term treatment non-response in patients receiving treatment for acute exacerbations of COPD in an outpatient setting. However, the long-term effects of antibiotics are unknown. The aim of this study was to investigate if the antibiotic doxycycline added to the oral corticosteroid prednisolone prolongs time to next exacerbation in patients with COPD receiving treatment for an exacerbation in the outpatient setting. METHODS: In this randomised double-blind placebo-controlled trial, we recruited a cohort of patients with COPD from outpatient clinics of nine teaching hospitals and three primary care centres in the Netherlands...
May 5, 2017: Lancet Respiratory Medicine
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/28469498/twenty-five-years-of-chronic-strongyloidiasis-in-an-immigrant
#10
Kalambay N Junior, Rehana Zaman, Mohammed H Zaman, Taufiq Zaman
Chronic strongyloidiasis is an infection of the tropical regions, caused by the nematode Strongyloides stercoralis. In the United States, patients are typically immigrants. The very long asymptomatic phase followed by the clinical presentation of the disease mimics asthma, chronic obstructive pulmonary disease (COPD), or inflammatory bowel disease (IBD) as in this case report. The inconsistency of eosinophilia and the low sensitivity of microscopic stool examination make chronic strongyloidiasis a disease that is frequently misdiagnosed in the United States...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28461091/treatment-with-systemic-steroids-in-severe-chronic-obstructive-pulmonary-disease-exacerbations-use-of-short-regimens-in-routineclinical-practice-and-theirimpact-on-hospital-stay
#11
Pedro J Marcos, Irene Nieto-Codesido, Santiago de Jorge Dominguez-Pazos, Arturo Huerta, Eduardo Márquez, Alejandro Maiso, Rodrigo Verdeal, Isabel Otero-González, Marina Blanco-Aparicio, Carmen Montero-Martínez
INTRODUCTION: It is not known whether clinical practice guidelines for the treatment of COPD exacerbations with short coursesofsystemic corticosteroids(SC-SCS) are followed in clinical practice. METHOD: Prospective, observational cohort study in patients admitted due to severe COPD exacerbation. The primary endpoint was the percentage of patients who received SC-SCS as treatment for severe exacerbation (doses of 200-300mg for 5-6 days). Secondary variables were percentageof patients with duration or reduced dose, dose in the first 24hours, days of intravenous systemic corticosteroids (SCS), and duration of hospital length of stay (LOS)...
April 28, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28448027/dry-powder-and-nebulized-aerosol-inhalation-of-pharmaceuticals-delivered-to-mice-using-a-nose-only-exposure-system
#12
Jonathan E Phillips, Xuxia Zhang, James A Johnston
Obstructive respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD) are currently treated by inhaled anti-inflammatory and bronchodilator drugs. Despite the availability of multiple treatments, both diseases are growing public health concerns. The majority of asthma patients are well controlled on current inhaled therapies but a substantial number of patients with severe asthma are not. Asthma affects an estimated 300 million people worldwide and approximately 20 percent have a severe form of the disease...
April 6, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28445159/invasive-pulmonary-aspergillosis-in-patients-with-chronic-obstructive-pulmonary-disease-a-case-report-and-review-of-the-literature
#13
Zhiyao Bao, Hong Chen, Min Zhou, Guochao Shi, Qingyun Li, Huanying Wan
Invasive pulmonary aspergillosis (IPA) is an infection that often occurs in immunocompromised patients and has a high mortality rate. In recent years, the reported incidence of IPA in the context of chronic obstructive pulmonary disease (COPD) has seemingly increased. The combination of factors such as long-term corticosteroid use, increasing rate of bacterial exacerbations over time, lung immune imbalance, and malnutrition are responsible for the emergence of IPA in COPD patients. A diagnosis of IPA in COPD patients is difficult to make, which explains the delay in antifungal therapy and the high mortality rate...
April 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28436723/asymptomatic-peripheral-artery-disease-can-limit-maximal-exercise-capacity-in-chronic-obstructive-pulmonary-disease-patients-regardless-of-airflow-obstruction-and-lung-hyperinflation
#14
Ernesto Crisafulli, Chiara Scelfo, Panagiota Tzani, Marina Aiello, Giuseppina Bertorelli, Alfredo Chetta
Background Silent/asymptomatic peripheral artery disease may occur in patients with chronic obstructive pulmonary disease, but it is poorly investigated. The primary aim of this study was to evaluate in chronic obstructive pulmonary disease patients the impact of asymptomatic/silent peripheral artery disease on maximal exercise capacity; the secondary aim was to search for predictors of peripheral artery disease. Methods We prospectively enrolled chronic obstructive pulmonary disease outpatients. Data on anthropometric characteristics, lung function, cardiopulmonary exercise test and ankle-brachial index were recorded...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28435240/risk-of-pneumonia-with-budesonide-containing-treatments-in-copd-an-individual-patient-level-pooled-analysis-of-interventional-studies
#15
Sally Hollis, Carin Jorup, Dan Lythgoe, Gunnar Martensson, Pontus Regnell, Göran Eckerwall
BACKGROUND: Concerns have been raised that treatment of COPD with inhaled corticosteroids may increase pneumonia risk. Responding to a request from the European Medicines Agency Pharmacovigilance Risk Assessment Committee, a pooled analysis of interventional studies compared pneumonia risk with inhaled budesonide-containing versus non-budesonide-containing treatments and the impact of other clinically relevant factors. METHODS: AstraZeneca-sponsored, parallel-group, double-blind, randomized controlled trials meeting the following criteria were included: >8 weeks' duration; ≥60 patients with COPD; inhaled budesonide treatment arm (budesonide/formoterol or budesonide); and non-budesonide-containing comparator arm (formoterol or placebo)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28425216/pneumonia-risk-in-asthma-patients-using-inhaled-corticosteroids-a-quasi-cohort-study
#16
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
#17
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
#18
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
#19
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
#20
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...
April 20, 2017: Postgraduate Medicine
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