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https://www.readbyqxmd.com/read/28926214/diagnosis-and-management-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#1
Van Holden, Donald Slack III, Michael T. McCurdy, Nirav G. Shah
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a clinical diagnosis that is based on changes in dyspnea, cough, and/or sputum production in a COPD patient; however, patients presenting with an acute exacerbation may be undiagnosed or have a variety of comorbid conditions that can complicate diagnosis. This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease...
October 1, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#2
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28918400/healthcare-resource-use-and-costs-of-severe-uncontrolled-eosinophilic-asthma-in-the-uk-general-population
#3
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
#4
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/28875459/once-daily-triple-therapy-in-patients-with-advanced-copd-healthcare-resource-utilization-data-and-associated-costs-from-the-fulfil-trial
#5
Afisi S Ismaila, Ruby Birk, Dhvani Shah, Shiyuan Zhang, Noushin Brealey, Nancy A Risebrough, Maggie Tabberer, Chang-Qing Zhu, David A Lipson
INTRODUCTION: Chronic obstructive pulmonary disease is associated with a high healthcare resource and cost burden. Healthcare resource utilization was analyzed in patients with symptomatic chronic obstructive pulmonary disease at risk of exacerbations in the FULFIL study. Patients received either once-daily, single inhaler triple therapy (fluticasone furoate/umeclidinium/vilanterol) 100 µg/62.5 µg/25 µg or twice-daily dual inhaled corticosteroid/long-acting beta agonist therapy (budesonide/formoterol) 400 µg/12 µg...
September 5, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28868971/mucoadhesive-solid-lipid-microparticles-for-controlled-release-of-a-corticosteroid-in-the-chronic-obstructive-pulmonary-disease-treatment
#6
Erika Amore, Maria Ferraro, Maria Letizia Manca, Mark Gjomarkaj, Gaetano Giammona, Elisabetta Pace, Maria Luisa Bondì
AIM: Therapeutic efficacy of pulmonary diseases is often limited and drug delivery systems offer new solutions to clinical problems. Solid lipid microparticles (SLMs) are suggested as systems for the delivery of therapeutics to the lung as, because of their size, they are able to deposit into secondary bronchi. MATERIALS & METHODS: Here, we describe two novel different SLMs using chitosan and alginate such as mucoadhesive polymers and we also studied their biocompatibility and their effectiveness compared with the free drug in controlling senescence and inflammatory processes in cigarette smoke extracts...
September 4, 2017: Nanomedicine
https://www.readbyqxmd.com/read/28864055/tracheobronchopathy-from-inhaled-corticosteroids
#7
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/28860742/severe-exacerbation-and-pneumonia-in-copd-patients-treated-with-fixed-combinations-of-inhaled-corticosteroid-and-long-acting-beta2-agonist
#8
Hsi-Hsing Yang, Chih-Cheng Lai, Ya-Hui Wang, Wei-Chih Yang, Cheng-Yi Wang, Hao-Chien Wang, Likwang Chen, Chong-Jen Yu
BACKGROUND: It remains unclear whether severe exacerbation and pneumonia of COPD differs between patients treated with budesonide/formoterol and those treated with fluticasone/salmeterol. Therefore, we conducted a comparative study of those who used budesonide/formoterol and those treated with fluticasone/salmeterol for COPD. METHODS: Subjects in this population-based cohort study comprised patients with COPD who were treated with a fixed combination of budesonide/formoterol or fluticasone/salmeterol...
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
#9
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/28840753/comparative-effectiveness-of-indacaterol-glycopyrronium-in-the-treatment-of-chronic-obstructive-pulmonary-disease
#10
Mario Cazzola, Paola Rogliani
Indacaterol/glycopyrronium has been the first long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) fixed dose combination to be approved as a maintenance treatment in chronic obstructive pulmonary disease patients. Comparative effectiveness studies indicate that it is constantly superior to a LAMA or a LABA alone or even a LABA/inhaled corticosteroid combination, regardless of the drugs used. However, definitive data documenting the benefit of indacaterol/glycopyrronium fixed dose combination over these consolidated therapies are still absent in real-world, although the results of pivotal randomized controlled trials show that this is the case...
August 25, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28838685/efficacy-and-safety-of-glycopyrrolate-eflow-%C3%A2-cs-nebulized-glycopyrrolate-in-moderate-to-very-severe-copd-results-from-the-glycopyrrolate-for-obstructive-lung-disease-via-electronic-nebulizer-golden-3-and-4-randomized-controlled-trials
#11
Edward Kerwin, James F Donohue, Thomas Goodin, Robert Tosiello, Alistair Wheeler, Gary T Ferguson
BACKGROUND: SUN-101 is a combination of glycopyrrolate delivered through an innovative, electronic nebulizer, intended for the treatment of patients with COPD. The objective of this study was to assess the efficacy and safety of this new drug device combination. METHODS: Replicate Phase III randomized, double-blind, placebo-controlled studies were conducted to evaluate the efficacy and safety of glycopyrrolate solution administered by an investigational eFlow(®) Closed System (eFlow(®) CS) nebulizer in subjects with moderate-to-very-severe COPD, including those with continued background use of a long-acting beta2-agonist ± inhaled corticosteroid and/or history of cardiovascular (CV) disease...
July 19, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28830839/the-potential-for-targeted-rewriting-of-epigenetic-marks-in-copd-as-a-new-therapeutic-approach
#12
REVIEW
Dan-Dan Wu, Juan Song, Sabine Bartel, Susanne Krauss-Etschmann, Marianne G Rots, Machteld N Hylkema
Chronic obstructive pulmonary disease (COPD) is an age and smoking related progressive, pulmonary disorder presenting with poorly reversible airflow limitation as a result of chronic bronchitis and emphysema. The prevalence, disease burden for the individual, and mortality of COPD continues to increase, whereas no effective treatment strategies are available. For many years now, a combination of bronchodilators and anti-inflammatory corticosteroids has been most widely used for therapeutic management of patients with persistent COPD...
August 19, 2017: Pharmacology & Therapeutics
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
#13
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/28810909/a-multi-center-randomized-controlled-open-label-trial-evaluating-the-effects-of-eosinophil-guided-corticosteroid-sparing-therapy-in-hospitalised-patients-with-copd-exacerbations-the-cortico-steroid-reduction-in-copd-cortico-cop-study-protocol
#14
Pradeesh Sivapalan, Mia Moberg, Josefin Eklöf, Julie Janner, Jørgen Vestbo, Rasmus Rude Laub, Andrea Browatzki, Karin Armbruster, Jon Torgny Wilcke, Niels Seersholm, Ulla Møller Weinreich, Ingrid Louise Titlestad, Helle Frost Andreassen, Charlotte Suppli Ulrik, Uffe Bødtger, Thyge Lynghøj Nielsen, Ejvind Frausing Hansen, Jens Ulrik Stæhr Jensen
BACKGROUND: The most commonly applied treatment for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is a 5-day course of high-dose systemic corticosteroids. However, this treatment has not been shown to reduce mortality and can potentially have serious side effects. Recent research has shown that, presumably, only a subgroup of COPD patients identifieable by blood eosinophil count benefit from a rescue course of prednisolone. By applying a biomarker-guided strategy, the aim of this study is to determine whether it is possible to reduce the use of systemic corticosteroids in AECOPD without influencing the outcome...
August 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28801434/comparative-effectiveness-of-six-chinese-herb-formulas-for-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-protocol-for-systematic-review-and-network-meta-analysis
#15
Shaonan Liu, Jing Chen, Yihan He, Lei Wu, Jiaqi Lai, Jinhong Zuo, Lihong Yang, Xinfeng Guo
INTRODUCTION: Chinese medicine is commonly used to combine with pharmacotherapy for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Six Chinese herb formulas involving Weijing decoction, Maxingshigan decoction, Yuebijiabanxia decoction, Qingqihuatan decoction, Dingchuan decoction and Sangbaipi decoction are recommended in Chinese medicine clinical guideline or textbook, to relieve patients with phlegm-heat according to Chinese syndrome differentiation...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28767773/long-acting-muscarinic-antagonists-vs-long-acting-%C3%AE-2-agonists-in-copd-exacerbations-a-systematic-review-and-meta-analysis
#16
Israel Silva Maia, Mariângela Pimentel Pincelli, Victor Figueiredo Leite, João Amadera, Anna Maria Buehler
Objective: To determine whether long-acting muscarinic antagonists (LAMAs) provide superior therapeutic effects over long-acting β2 agonists (LABAs) for preventing COPD exacerbations. Methods: This was a systematic review and meta-analysis of randomized clinical trials involving patients with stable, moderate to severe COPD according to the Global Initiative for Chronic Obstructive Lung Disease criteria, treated with a LAMA (i.e., tiotropium bromide, aclidinium, or glycopyrronium), followed for at least 12 weeks and compared with controls using a LABA in isolation or in combination with a corticosteroid...
July 31, 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28753070/impact-of-mucolytic-agents-on-copd-exacerbations-a-pair-wise-and-network-meta-analysis
#17
Mario Cazzola, Paola Rogliani, Luigino Calzetta, Nicola A Hanania, Maria Gabriella Matera
Mucolytics are potentially useful for the management of chronic obstructive pulmonary disease (COPD), although there is conflicting advice on their use in different guideline documents. Furthermore, there is paucity of data comparing the efficacy of the different mucolytic agents in reducing the odds of COPD exacerbations. We performed pair-wise and network meta-analyses to evaluate the impact of mucoly-tics in COPD. Randomized clinical trials lasting at least 3 months and investigating the effects of mucolytics on COPD exacerbations were identified from published studies and repository databases...
October 2017: COPD
https://www.readbyqxmd.com/read/28750556/the-quebec-respiratory-health-education-network-integrating-a-model-of-self-management-education-in-copd-primary-care
#18
Jean Bourbeau, Raquel Farias, Pei Zhi Li, Guylaine Gauthier, Livia Battisti, Valérie Chabot, Marie-France Beauchesne, Denis Villeneuve, Patricia Côté, Louis-Philippe Boulet
The objective of this study is to evaluate whether a chronic obstructive pulmonary disease (COPD) self-management education program with coaching of a case manager improves patient-related outcomes and leads to practice changes in primary care. COPD patients from six family medicine clinics (FMCs) participated in a 1-year educational program offered by trained case managers who focused on treatment adherence, inhaler techniques, smoking cessation, and the use of an action plan for exacerbations. Health-care utilization, health-related quality of life (HRQL), treatment adherence, inhaler technique, and COPD knowledge were assessed at each visit with validated questionnaires...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28745524/should-patients-switched-from-d-to-b-in-the-gold-2017-classification-be-discontinued-from-inhaled-corticosteroids
#19
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...
July 26, 2017: COPD
https://www.readbyqxmd.com/read/28737971/fluticasone-furoate-vilanterol-and-lung-function-decline-in-patients-with-moderate-copd-and-heightened-cardiovascular-risk
#20
Peter M A Calverley, Julie A Anderson, Robert D Brook, Courtney Crim, Natacha Gallot, Sally Kilbride, Fernando Martinez, Julie Yates, David E Newby, Jørgen Vestbo, Robert Wise, Bartolome R Celli
RATIONALE: Many patients with chronic obstructive pulmonary disease (COPD) have an accelerated loss of lung function. It is unclear whether drug treatment can modify this in moderately severe disease. OBJECTIVES: In a pre-specified analysis of the key secondary outcome in the Study to Understand Mortality and MorbidITy (SUMMIT), we investigated whether the inhaled corticosteroid fluticasone furoate 100 μg (FF), the long-acting beta-agonist vilanterol 25 µg (VI) or the combination (FF/VI) modified the rate of decline in FEV1 compared with placebo...
July 24, 2017: American Journal of Respiratory and Critical Care Medicine
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