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Corticosteroid use in copd

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https://www.readbyqxmd.com/read/28644389/chronic-respiratory-infection-in-patients-with-chronic-obstructive-pulmonary-disease-what-is-the-role-of-antibiotics
#1
REVIEW
Marc Miravitlles, Antonio Anzueto
Chronic infections are associated with exacerbation in patients with chronic obstructive pulmonary disease (COPD). The major objective of the management of these patients is the prevention and effective treatment of exacerbations. Patients that have increased sputum production, associated with purulence and worsening shortness of breath, are the ones that will benefit from antibiotic therapy. It is important to give the appropriate antibiotic therapy to prevent treatment failure, relapse, and the emergence of resistant pathogens...
June 23, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#2
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/28626506/impact-of-nonadherence-to-inhaled-corticosteroid-laba-therapy-on-copd-exacerbation-rates-and-healthcare-costs-in-a-commercially-insured-us-population
#3
Jill R Davis, Bingcao Wu, David M Kern, Ozgur Tunceli, Kathleen M Fox, John Horton, Randall F Legg, Frank Trudo
BACKGROUND: Evidence of poor patient adherence to medications for chronic obstructive pulmonary disease (COPD) is well-documented, but its impact on disease exacerbation rates and associated healthcare costs remains unclear. OBJECTIVE: To assess the association between adherence levels to different inhaled corticosteroid/long-acting ß2-adrenergic agonist (LABA) and COPD exacerbation rates and costs in a commercially insured population. METHODS: In this observational cohort study, patients with COPD (aged ≥40 years) who were treatment-naïve to inhaled corticosteroid/LABA and were initiating budesonide plus formoterol or fluticasone plus salmeterol between March 1, 2009, and January 31, 2014, were identified in a national representative claims database and were followed for up to 12 months...
April 2017: American Health & Drug Benefits
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
#4
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
#5
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/28579771/a-cross-sectional-survey-of-current-treatment-and-symptom-burden-of-patients-with-copd-consulting-for-routine-care-according-to-gold-2014-classifications
#6
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/28559466/inhaled-drug-therapy-2016-the-year-in-review
#7
Rajiv Dhand
Some recent salient publications related to inhaled drug therapy are discussed. Unexpectedly, a 2.5-μg once-daily dose of tiotropium (Respimat) had greater efficacy than the 5.0-μg daily dose. Occurrence of a reverse dose response serves to caution us that administering more drug is not always beneficial. Small-airway inflammation contributes to pathogenesis of asthma, especially severe asthma. However, there is no conclusive evidence that the use of small-particle aerosols to target small airways improves clinical outcomes in controlled clinical trials...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28548632/diagnostic-and-prognostic-value-of-inflammatory-parameters-including-neopterin-in-the-setting-of-pneumonia-copd-and-acute-exacerbations
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
June 6, 2017: Oncotarget
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