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Corticosteroid use in copd

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https://www.readbyqxmd.com/read/29155116/the-effect-of-steroids-on-complications-readmission-and-reoperation-after-posterior-lumbar-fusion
#1
Michael B Cloney, Roxanna M Garcia, Zachary A Smith, Nader S Dahdaleh
BACKGROUND DATA: The effects of chronic corticosteroid therapy on complications, readmission, and reoperation after posterior lumbar fusion (PLF) remains under-investigated and was examined to determine differences in outcomes. METHODS: We analyzed patients from 2006 to 2013 using the National Surgery Quality Improvement Program database (NSQIP) undergoing PLF. Patients taking steroids for a chronic condition were compared to those not taking steroids. Multivariable regression identified factors independently associated with complications, readmission, and reoperation...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29153881/relationship-of-blood-eosinophil-count-to-exacerbations-in-chronic-obstructive-pulmonary-disease
#2
Robert S Zeiger, Trung N Tran, Rebecca K Butler, Michael Schatz, Qiaowu Li, Deepak B Khatry, Ubaldo Martin, Aniket A Kawatkar, Wansu Chen
BACKGROUND: Eosinophilic airway inflammation characterizes a chronic obstructive pulmonary disease (COPD) phenotype that requires more study. OBJECTIVE: To investigate the relationship of blood eosinophil count to exacerbations in COPD. METHODS: Using administrative pharmacy and health care utilization data from 2009 to 2012, we retrospectively identified patients 40 years or older with a COPD diagnosis, postbronchodilator FEV1/forced vital capacity ratio of less than 0...
November 15, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29150178/-relationships-between-copd-and-nontuberculous-mycobacteria-pulmonary-infections
#3
REVIEW
C Balavoine, C Andréjak, S Marchand-Adam, F X Blanc
Nontuberculous mycobacteria (NTM) pulmonary infections are increasingly frequent in pneumological practice. The diagnosis is based on an association of clinical, microbiological and radiological criteria. Some risk factors for NTM disease have been described, including chronic respiratory diseases, but without specific focus on chronic obstructive pulmonary disease (COPD). COPD patients have more risk to be infected by NTM than patients with the main other chronic respiratory diseases (except cystic fibrosis) (odds ratio [OR] at 15...
November 14, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29148205/inhaled-corticosteroids-and-the-risks-of-low-energy-fractures-in-patients-with-chronic-airway-diseases-a-propensity-score-matched-study
#4
Chun-Hao Tsai, Lin-Yu Laio, Cheng-Li Lin, Wei-Sheng Chung
BACKGROUND AND AIMS: Inhaled corticosteroids (ICSs) are crucial anti-inflammatory medications for chronic airway diseases. Studies investigating the relationship between ICSs and fractures in Asian populations are scant. We investigated whether ICSs increased the risk of low-energy fractures in patients with chronic airway diseases. METHODS: We used the Longitudinal Health Insurance Database to select patients aged 20 years and older with chronic airway diseases (asthma and COPD) between 2000 and 2011 as the base cohort...
November 17, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29138555/the-efficacy-of-extrafine-beclomethasone-dipropionate-formoterol-fumarate-in-copd-patients-who-are-not-frequent-exacerbators-a-post-hoc-analysis-of-the-forward-study
#5
Dave Singh, Stefano Vezzoli, Stefano Petruzzelli, Alberto Papi
The GOLD 2017 strategy document recommends that the pharmacological management of COPD patients be based on the risk of future exacerbations and the severity of symptoms. A threshold of two moderate exacerbations or one hospitalization is used to define high-risk patients. The FORWARD study was a randomized, double-blind, parallel-group trial that compared 48 weeks' treatment with extrafine beclomethasone dipropionate plus formoterol fumarate (BDP-FF) versus FF in severe COPD patients with a history of one or more exacerbations in the previous year...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29138546/prediction-models-for-exacerbations-in-different-copd-patient-populations-comparing-results-of-five-large-data-sources
#6
Martine Hoogendoorn, Talitha L Feenstra, Melinde Boland, Andrew H Briggs, Sixten Borg, Sven-Arne Jansson, Nancy A Risebrough, Julia F Slejko, Maureen Pmh Rutten-van Mölken
Background and objectives: Exacerbations are important outcomes in COPD both from a clinical and an economic perspective. Most studies investigating predictors of exacerbations were performed in COPD patients participating in pharmacological clinical trials who usually have moderate to severe airflow obstruction. This study was aimed to investigate whether predictors of COPD exacerbations depend on the COPD population studied. Methods: A network of COPD health economic modelers used data from five COPD data sources - two population-based studies (COPDGene(®) and The Obstructive Lung Disease in Norrbotten), one primary care study (RECODE), and two studies in secondary care (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoint and UPLIFT) - to estimate and validate several prediction models for total and severe exacerbations (= hospitalization)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29129177/copd-x-australian-and-new-zealand-guidelines-for-the-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-2017-update
#7
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org.au. Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29120273/triple-therapy-in-copd-what-we-know-and-what-we-don-t
#8
Peter M A Calverley, Helgo Magnussen, Marc Miravitlles, Jadwiga A Wedzicha
Triple inhaled therapy for chronic obstructive pulmonary disease (COPD) consists of an inhaled corticosteroid (ICS), a long-acting β2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) taken in combination. Triple therapy is recommended by the Global initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator (preferred initial therapy) or LABA/ICS combination (alternative initial therapy). Although there is evidence for the greater efficacy of triple therapy compared with LABA/ICS and LAMA monotherapy with regards to improved lung function, health status, and exacerbation rate, the efficacy of triple therapy when compared with dual bronchodilation (LABA/LAMA) is as yet unknown...
November 9, 2017: COPD
https://www.readbyqxmd.com/read/29116901/use-of-ics-in-copd-from-blockbuster-medicine-to-precision-medicine
#9
Marco Contoli, Angelo G Corsico, Pierachille Santus, Fabiano Di Marco, Fulvio Braido, Paola Rogliani, Luigi Calzetta, Nicola Scichilone
Chronic obstructive pulmonary disease (COPD) is a major cause of mortality worldwide, whose burden is expected to increase in the next decades, because of numerous risk factors, including the aging of the population. COPD is both preventable and treatable by an effective management including risk factor reduction, prevention, assessment, and treatment of acute exacerbations and co-morbidities. The available agents approved for COPD treatment are long-acting or ultra-long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) bronchodilators, as well as inhaled corticosteroids (ICS) in combination with LABAs...
November 8, 2017: COPD
https://www.readbyqxmd.com/read/29115881/a-review-of-current-and-developing-fixed-dose-laba-lama-combinations-for-treating-copd
#10
Chitra Lal, Charlie Strange
The current GOLD (Global Initiative for Chronic Obstructive Lung Disease) recommendations suggest using long acting β2 agonists (LABA) and long acting muscarinic antagonists (LAMA) in combination for group B COPD patients with persistent symptoms, group C COPD patients with further exacerbations on LAMA therapy alone and for group D COPD patients with or without combination with inhaled corticosteroids (ICS). Thus, there is a lot of interest in developing LABA/LAMA combinations for maintenance therapy of chronic stable COPD...
November 15, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29108938/fractional-exhaled-nitric-oxide-as-a-predictor-of-response-to-inhaled-corticosteroids-in-patients-with-non-specific-respiratory-symptoms-and-insignificant-bronchodilator-reversibility-a-randomised-controlled-trial
#11
David B Price, Roland Buhl, Adrian Chan, Daryl Freeman, Elizabeth Gardener, Clifford Godley, Kevin Gruffydd-Jones, Lorcan McGarvey, Ken Ohta, Dermot Ryan, Jörgen Syk, Ngiap Chuan Tan, TzeLee Tan, Mike Thomas, Sen Yang, Priyanka Raju Konduru, Marcus Ngantcha, Martina Stagno d'Alcontres, Therese S Lapperre
BACKGROUND: Chronic non-specific respiratory symptoms are difficult to manage. This trial aimed to evaluate the association between baseline fractional exhaled nitric oxide (FeNO) and the response to inhaled corticosteroids in patients with non-specific respiratory symptoms. METHODS: In this double-blind randomised placebo-controlled trial, we enrolled undiagnosed patients, aged 18-80 years, with cough, wheeze, or dyspnoea and less than 20% bronchodilator reversibility across 26 primary care centres and hospitals in the UK and Singapore...
November 3, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29099646/emphysematous-phenotype-is-characterized-by-low-blood-eosinophils-a-cross-sectional-study
#12
Andriana I Papaioannou, Konstantinos Kostikas, Anastasia Papaporfyriou, Leonidas Angelakis, Evgenia Papathanasiou, Georgios Hillas, Argyro Mazioti, Petros Bakakos, Nikolaos Koulouris, Spyros Papiris, Stelios Loukides
Sputum and blood eosinophils are proposed as candidate biomarkers for the identification of chronic obstructive pulmonary disease (COPD) patients at risk for exacerbation and treatment response. In this study, we evaluated the associations of eosinophils with the presence of emphysema in COPD patients. Induced sputum and blood eosinophil measurements were performed in consecutive COPD patients. Patients underwent lung function testing and high resolution computed tomography (HRCT) of the chest and the presence of emphysema was quantified...
November 3, 2017: COPD
https://www.readbyqxmd.com/read/29096627/a-28-day-randomized-double-blind-placebo-controlled-parallel-group-study-of-nebulized-revefenacin-in-patients-with-chronic-obstructive-pulmonary-disease
#13
Krishna K Pudi, Chris N Barnes, Edmund J Moran, Brett Haumann, Edward Kerwin
BACKGROUND: Revefenacin is a once-daily long-acting muscarinic antagonist (LAMA) in clinical development for the treatment of patients with chronic obstructive pulmonary disease (COPD). In a dose-ranging study, nebulized once-daily revefenacin had a long duration of action in patients after 7 days' administration of doses up to 700 μg. In this multiple-dose study, the bronchodilation efficacy and adverse events profile were characterized in patients administered nebulized revefenacin once daily for 28 days...
November 2, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29089754/scientific-rationale-for-the-possible-inhaled-corticosteroid-intraclass-difference-in-the-risk-of-pneumonia-in-copd
#14
REVIEW
Christer Janson, Georgios Stratelis, Anna Miller-Larsson, Tim W Harrison, Kjell Larsson
Inhaled corticosteroids (ICSs) treatment combined with long-acting β2-adrenoceptor agonists (LABAs) reduces the risk of exacerbations in COPD, but the use of ICSs is associated with increased incidence of pneumonia. There are indications that this association is stronger for fluticasone propionate than for budesonide. We have examined systematic reviews assessing the risk of pneumonia associated with fluticasone propionate and budesonide COPD therapy. Compared with placebo or LABAs, we found that fluticasone propionate was associated with 43%-78% increased risk of pneumonia, while only slightly increased risk or no risk was found for budesonide...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29068643/diagnosis-and-management-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-digest
#15
Van Holden, Donald Slack Iii, Michael T McCurdy, Nirav G Shah, Nachi Gupta, Jeffrey Nusbaum
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 20, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29063307/prospective-evaluation-of-poly-4-hydroxybutyrate-mesh-in-cdc-class-i-high-risk-ventral-and-incisional-hernia-repair-18-month-follow-up
#16
John Scott Roth, Gary J Anthone, Don J Selzer, Benjamin K Poulose, James G Bittner, William W Hope, Raymond M Dunn, Robert G Martindale, Matthew I Goldblatt, David B Earle, John R Romanelli, Gregory J Mancini, Jacob A Greenberg, John G Linn, Eduardo Parra-Davila, Bryan J Sandler, Corey R Deeken, Guy R Voeller
BACKGROUND: Long-term resorbable mesh represents a promising technology for complex ventral and incisional hernia repair (VIHR). Preclinical studies indicate that poly-4-hydroxybutyrate (P4HB) resorbable mesh supports strength restoration of the abdominal wall. This study evaluated outcomes of high-risk subjects undergoing VIHR with P4HB mesh. METHODS: This was a prospective, multi-institutional study of subjects undergoing retrorectus or onlay VIHR. Inclusion criteria were CDC Class I, defect 10-350 cm(2), ≤ 3 prior repairs, and ≥ 1 high-risk criteria (obesity (BMI: 30-40 kg/m(2)), active smoker, COPD, diabetes, immunosuppression, coronary artery disease, chronic corticosteroid use, hypoalbuminemia, advanced age, and renal insufficiency)...
October 23, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29055656/non-evidence-based-medicine-example-of-the-use-of-systemic-corticosteroids-in-exacerbation-of-copd
#17
EDITORIAL
M Miravitlles
No abstract text is available yet for this article.
October 18, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29033625/the-salford-lung-study-a-pioneering-comparative-effectiveness-approach-to-copd-and-asthma-in-clinical-trials
#18
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/29030687/tolerability-of-bisoprolol-on-domiciliary-spirometry-in-copd
#19
Sunny Jabbal, Brian J Lipworth
We investigated if serial domiciliary measures of spirometry were sensitive at detecting subtle effects of beta-2 blockade associated with bisoprolol in (n = 17) patients with COPD. After a two-week run in on inhaled corticosteroid (ICS) and long acting beta-2 agonist (LABA): beclometasone/formoterol 100/6 µg, patients' started additional a long acting muscarinic receptor antagonist: (LAMA) Tiotropium 18 µg, with concomitant weekly dose titration of bisoprolol: 1.25-2.5-5 mg. After a further week of bisoprolol 5 mg, they were stepped back down to (ICS/LABA) for one week...
October 14, 2017: Lung
https://www.readbyqxmd.com/read/28986203/inhaled-nebulised-unfractionated-heparin-improves-lung-function-in-moderate-to-very-severe-copd-a-pilot-study
#20
Janis K Shute, Luigino Calzetta, Vittorio Cardaci, Stefania di Toro, Clive P Page, Mario Cazzola
BACKGROUND: COPD is an inflammatory airway disease characterised by progressive airflow limitation and air trapping, leading to lung hyperinflation and exercise limitation. Acute worsening of symptoms, including dyspnea, cough and sputum production, occurs during exacerbations which are associated with significantly reduced health related quality of life, and increased morbidity and mortality. Chronic bronchial mucus production and productive cough are risk factors for exacerbations. Medicines targeting bronchoconstriction and airway inflammation are the current mainstays of COPD therapy...
October 3, 2017: Pulmonary Pharmacology & Therapeutics
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