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Corticosteroid use in copd

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https://www.readbyqxmd.com/read/28103123/disease-burden-of-patients-with-asthma-copd-overlap-in-a-us-claims-database-impact-of-icd-9-coding-based-definitions
#1
Keele E Wurst, Samantha St Laurent, David Hinds, Kourtney J Davis
The inclusion of an asthma/chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) population in the 2015 Global Initiative for Chronic Obstructive Lung Disease strategic documents has raised questions about the profile of these patients in clinical practice, as they are mostly excluded from asthma and COPD clinical trials. We estimated the disease burden, co-morbidities, and respiratory treatments of patients with asthma/COPD overlap, utilizing the Truven MarketScan commercial and Medicare databases...
January 19, 2017: COPD
https://www.readbyqxmd.com/read/28096287/prediction-models-for-exacerbations-in-patients-with-copd
#2
REVIEW
Beniamino Guerra, Violeta Gaveikaite, Camilla Bianchi, Milo A Puhan
Personalised medicine aims to tailor medical decisions to the individual patient. A possible approach is to stratify patients according to the risk of adverse outcomes such as exacerbations in chronic obstructive pulmonary disease (COPD). Risk-stratified approaches are particularly attractive for drugs like inhaled corticosteroids or phosphodiesterase-4 inhibitors that reduce exacerbations but are associated with harms. However, it is currently not clear which models are best to predict exacerbations in patients with COPD...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28053518/initiation-of-triple-therapy-maintenance-treatment-among-patients-with-copd-in-the-us
#3
Jason C Simeone, Rakesh Luthra, Shuchita Kaila, Xiaoyun Pan, Tarun D Bhagnani, Jieruo Liu, Teresa K Wilcox
BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends triple therapy (long-acting muscarinic receptor antagonists, long-acting beta-2 agonists, and inhaled corticosteroids) for patients with only the most severe COPD. Data on the proportion of COPD patients on triple therapy and their characteristics are sparse and dated. Objective 1 of this study was to estimate the proportion of all, and all treated, COPD patients receiving triple therapy. Objective 2 was to characterize those on triple therapy and assess the concordance of triple therapy use with GOLD guidelines...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28049170/airway-inflammation-in-copd-after-long-term-withdrawal-of-inhaled-corticosteroids
#4
Lisette I Z Kunz, Nick H T Ten Hacken, Thérèse S Lapperre, Wim Timens, Huib A M Kerstjens, Annemarie van Schadewijk, Judith M Vonk, Jacob K Sont, Jiska B Snoeck-Stroband, Dirkje S Postma, Peter J Sterk, Pieter S Hiemstra
Long-term treatment with inhaled corticosteroids (ICS) might attenuate lung function decline and decrease airway inflammation in a subset of patients with chronic obstructive pulmonary disease (COPD), and discontinuing ICS treatment could result in further lung function decline. We hypothesised that airway inflammation increases after ICS withdrawal following long-term ICS treatment in COPD.In the GLUCOLD-1 study (GL1), 114 patients with moderate-severe COPD were randomised to 6-month or 30-month treatment with fluticasone propionate (500 µg twice daily), 30-month treatment with fluticasone/salmeterol (500/50 µg twice daily) or placebo...
January 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28031708/trend-of-cost-and-utilization-of-copd-medication-in-korea
#5
Jongmin Lee, Jae Ha Lee, Jee-Ae Kim, Chin Kook Rhee
BACKGROUND: There are only a few longitudinal studies regarding medical utilization and costs for patients with COPD. The purpose of this study was to analyze the trend of medical utilization and costs on a long-term basis. METHODS: Using the Korean Health Insurance Review and Assessment Service (HIRA) data from 2008 to 2013, COPD patients were identified. The trend of medical utilization and costs was also analyzed. RESULTS: The number of COPD patients increased by 13...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28031707/early-efficacy-of-budesonide-formoterol-in-patients-with-moderate-to-very-severe-copd
#6
Peter M Calverley, Göran Eriksson, Christine R Jenkins, Antonio R Anzueto, Barry J Make, Anders Persson, Malin Fagerås, Dirkje S Postma
BACKGROUND AND OBJECTIVE: Large clinical trials have confirmed the long-term efficacy of inhaled corticosteroid/long-acting β2-agonist combinations in patients with chronic obstructive pulmonary disease (COPD). It was hypothesized that significant treatment effects would already be present within 3 months after the initiation of treatment across a range of clinical outcomes, irrespective of COPD severity. METHODS: Post hoc analysis of 3-month post-randomization outcomes, including exacerbation rates, dropouts, symptoms, reliever use, and lung function, from three studies with similar inclusion criteria of moderate-to-very-severe COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28010132/the-risk-of-sepsis-with-inhaled-and-oral-corticosteroids-in-patients-with-copd
#7
Pierre Ernst, Janie Coulombe, Paul Brassard, Samy Suissa
The use of oral and inhaled corticosteroids is associated with increases in the risk of infection, especially pneumonia. The risk of sepsis with corticosteroid treatment in patients with chronic obstructive pulmonary disease (COPD) has been little studied, however. We assessed whether the use of inhaled and oral corticosteroids in COPD is associated with an increase in the risk of sepsis. We carried out a retrospective cohort study using the administrative health databases of the province of Quebec, Canada, over the period 1990-2007...
December 23, 2016: COPD
https://www.readbyqxmd.com/read/28008228/spotlight-on-fluticasone-furoate-vilanterol-trifenatate-for-the-once-daily-treatment-of-asthma-design-development-and-place-in-therapy
#8
REVIEW
Timothy E Albertson, Samuel W Bullick, Michael Schivo, Mark E Sutter
The use of inhaled corticosteroids (ICSs) plays a key role in the treatment of asthmatic patients, and international guidelines have designated ICSs as an early maintenance therapy in controlling asthma symptoms. When asthmatic patients remain symptomatic on ICSs, one common option is to add a long-acting beta2 agonist (LABA) to the maintenance treatment. Fixed combination inhalers that contain both an ICS and a LABA have been popular for both chronic obstructive pulmonary disease (COPD) and asthma. Historically, these inhalers have been dosed twice daily...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28005831/bronchoscopy-safety-in-patients-with-chronic-obstructive-lung-disease
#9
Christina R Bellinger, Irtaza Khan, Arjun B Chatterjee, Edward F Haponik
BACKGROUND: Flexible bronchoscopy is a safe and minimally invasive diagnostic tool used by pulmonologists, but few studies have prospectively compared outcomes in patients with objectively defined obstructive lung disease to those without obstruction. METHODS: We determined whether complications in patients undergoing moderate sedation bronchoscopy differ in those without obstruction compared with chronic obstructive pulmonary disease (COPD). We prospectively followed all patients undergoing moderate sedation bronchoscopy in an inpatient or outpatient setting...
December 21, 2016: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27997807/roflumilast-n-oxide-in-combination-with-formoterol-enhances-the-anti-inflammatory-effect-of-dexamethasone-in-asm-cells
#10
Brijeshkumar S Patel, Md Mostafizur Rahman, Gina Baehring, Dikaia Xenaki, Francesca Su-May Tang, Brian G Oliver, Alaina J Ammit
Roflumilast is an orally active phosphodiesterase 4 (PDE4) inhibitor approved for use in chronic obstructive pulmonary disease. Roflumilast N-oxide (RNO) is the active metabolite of roflumilast and has demonstrated anti-inflammatory impact in vivo and in vitro. To date, the effect of RNO on the synthetic function of airway smooth muscle (ASM) cells is unknown. We address this herein and investigate the effect of RNO on β2-adrenoceptor-mediated, cAMP-dependent responses in ASM cells in vitro, and whether RNO enhances steroid-induced repression of inflammation...
December 20, 2016: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/27994453/drop-in-lung-function-during-asthma-and-copd-exacerbations-can-it-be-assessed-without-spirometry
#11
Hasse Melbye, Salwan Al-Ani, Mark Spigt
BACKGROUND: When assessing patients with exacerbation of asthma or COPD, it may be useful to know the drop in forced expiratory volume in 1 second (FEV1) compared with stable state, in particular when considering treatment with oral corticosteroids. The objective of the study was to identify indicators of drop in FEV1 during exacerbations. METHODS: In this prospective multicenter study from primary care, patients diagnosed with asthma or COPD were examined at stable state and during exacerbations the following year...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27994449/an-evaluation-of-early-medication-use-for-copd-a-population-based-cohort-study
#12
Jamie Falk, Natalia Dik, Shawn Bugden
PURPOSE: The aim of this study was to evaluate the first initiation, sequence of addition, and appropriate prescribing of COPD medications in Manitoba, Canada. PATIENTS AND METHODS: A population-based cohort study of COPD medication use was conducted using administrative health care data (1997-2012). Those aged ≥35 years with COPD based on three or more COPD-related outpatient visits over a rolling 24-month window or at least one COPD-related hospitalization were included...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27990628/action-plans-with-brief-patient-education-for-exacerbations-in-chronic-obstructive-pulmonary-disease
#13
REVIEW
Maxwell Howcroft, E Haydn Walters, Richard Wood-Baker, Julia Ae Walters
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are a major driver of decline in health status and impose high costs on healthcare systems. Action plans offer a form of self-management that can be delivered in the outpatient setting to help individuals recognise and initiate early treatment for exacerbations, thereby reducing their impact. OBJECTIVES: To compare effects of an action plan for COPD exacerbations provided with a single short patient education component and without a comprehensive self-management programme versus usual care...
19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27932434/rapidly-progressing-dual-infection-with-aspergillus-and-rhizopus-when-soil-inhabitants-become-deadly-invaders
#14
Milind Bhagat, Alwyn Rapose
We present a case report of a 61-year-old patient with acute pulmonary and cerebral infections with Aspergillus and Rhizopus. The only risk factor for invasive fungal disease was high-dose corticosteroids used to treat her chronic obstructive pulmonary disease exacerbation. She had rapid progression and succumbed to her infections within 2 weeks of diagnosis in spite of aggressive antifungal therapy and surgery. To the best of our knowledge, this is the first reported case of rapidly fatal dual infection with Aspergillus and Rhizopus Our case highlights the role of high-dose corticosteroids as a risk factor for invasive fungal disease in patients without traditional risk factors like haematological malignancies, solid organ transplantation or uncontrolled diabetes...
December 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27928190/single-center-retrospective-evaluation-of-inhaled-corticosteroid-use-for-chronic-obstructive-pulmonary-disease-exacerbation-patients-receiving-systemic-corticosteroids
#15
Taylor Steuber, Dane Shiltz
Purpose: To determine the frequency of inappropriate inhaled corticosteroid (ICS) therapy when it is prescribed concurrently with systemic corticosteroids; to identify cost-savings potential in the setting of chronic obstructive pulmonary disease (COPD) exacerbations. Methods: Patients admitted to 1 of 8 hospital locations utilizing an integrated electronic health record within the health system for COPD exacerbations treated with systemic corticosteroids (equivalent to at least 30 mg of oral prednisone) between July 1, 2013 and June 30, 2014 were included in a retrospective chart review...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27927039/muscarinic-antagonists-in-early-stage-clinical-development-for-the-treatment-of-asthma
#16
Timothy E Albertson, James A Chenoweth, Jason Y Adams, Mark E Sutter
Parasympathetic neurons utilize the neurotransmitter acetylcholine to modulate and constrict airway smooth muscles at the muscarinic acetylcholine receptor. Inhaled agents that antagonize the muscarinic (M) acetylcholine receptor, particularly airway M3 receptors, have increasing data supporting use in persistent asthma. Areas covered: Use of inhaled long-acting muscarinic antagonists (LAMA) in asthma is explored. The LAMA tiotropium is approved for maintenance in symptomatic asthma patients despite the use of inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRA) and/or long-acting beta2 agonists (LABA)...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27920512/the-burden-of-chronic-obstructive-pulmonary-disease-associated-with-maintenance-monotherapy-in-the-uk
#17
Susan C Edwards, Sian E Fairbrother, Anna Scowcroft, Gavin Chiu, Andrew Ternouth, Brian J Lipworth
BACKGROUND: This study characterized a cohort of chronic obstructive pulmonary disease (COPD) patients on maintenance bronchodilator monotherapy for ≥6 months to establish their disease burden, measured by health care utilization. METHODS: Data were extracted from the UK Clinical Practice Research Datalink and linked to Hospital Episode Statistics. The monotherapy period spanned the first prescription of a long-acting β2-adrenergic agonist or a long-acting muscarinic antagonist until the end of the study (December 31, 2013) or until step up to dual/triple therapy, for example, addition of another long-acting bronchodilator, an inhaled corticosteroid, or both...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27888990/a-randomized-controlled-multicentric-study-of-inhaled-budesonide-and-intravenous-methylprednisolone-in-the-treatment-on-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#18
Zhen Ding, Xiu Li, Youjin Lu, Guangsheng Rong, Ruiqing Yang, Ruixia Zhang, Guiqin Wang, Xiqiang Wei, Yongqing Ye, Zhaoxia Qian, Hongyan Liu, Daifeng Zhu, Ruiqing Zhou, Kun Zhu, Rongping Ni, Kui Xia, Nan Luo, Cong Pei
BACKGROUND: Almost all international guidelines recommend corticosteroids for management of exacerbations of chronic obstructive pulmonary disease (COPD), because it leads to improved outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Nevertheless, due to its side effects, there are still concerns regarding the use of systemic corticosteroid (SC). Inhaled corticosteroids (IC) can be used as an alternative to SC, while reducing the risk of occurrence of side effects...
December 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27877031/the-association-between-inhaled-corticosteroid-and-pneumonia-in-copd-patients-the-improvement-of-patients-life-quality-with-copd-in-taiwan-impact-study
#19
Cheng-Yi Wang, Chih-Cheng Lai, Wei-Chih Yang, Chia-Chieh Lin, Likwang Chen, Hao-Chien Wang, Chong-Jen Yu
To investigate the association between inhaled corticosteroid (ICS) exposure patterns and the risk of pneumonia in chronic obstructive pulmonary disease (COPD) patients, we performed a nested case-control study. Between 1998 and 2010, 51,739 patients, including 19,838 cases of pneumonia, were matched to 74,849 control subjects selected from a cohort of COPD patients using ICSs via risk-set sampling of the database constructed by the National Health Research Institutes of Taiwan. After adjusting for covariates, the current use of ICSs was associated with a 25% increase in the risk of pneumonia (odds ratio [OR] =1...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27864038/a-systematic-review-with-meta-analysis-of-fluticasone-furoate-vilanterol-combination-for-the-treatment-of-stable-copd
#20
Gustavo J Rodrigo, Hugo Neffen
BACKGROUND: Current guidelines recommend the use of inhaled corticosteroids/long-acting beta2-agonists as first-line therapy for COPD patients at risk for acute exacerbations and/or severe airflow limitation. This systematic review assesses available evidence on the efficacy and safety of fluticasone furoate/vilanterol (FF/VI) combination versus each alone, for the treatment of patients with severe to very severe stable COPD. METHODS: Randomized, placebo-controlled trials of >8 weeks of duration were included...
November 15, 2016: Pulmonary Pharmacology & Therapeutics
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