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copd randomized controlled trial

Fernando J Martinez, Jørgen Vestbo, Julie A Anderson, Robert D Brook, Bartolome R Celli, Nicholas J Cowans, Courtney Crim, Mark Dransfield, Sally Kilbride, Julie Yates, David E Newby, Dennis Niewoehner, Peter Ma Calverley
BACKGROUND: Inhaled corticosteroids have been shown to decrease exacerbations in COPD patients with moderate to severe COPD. Their effect in patients with milder airflow obstruction remains unclear. OBJECTIVE: This was an analysis of exacerbations in the Study to Understand Mortality and MorbidITy (SUMMIT) study. DESIGN: In a double-blind randomized controlled trial, once daily inhaled placebo, fluticasone furoate (FF, 100 μg), vilanterol (VI, 25 μg) or the combination (FF/VI) was administered...
October 21, 2016: American Journal of Respiratory and Critical Care Medicine
Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
Adam J N Raymakers, Natalie McCormick, Carlo A Marra, J Mark Fitzgerald, Don Sin, Larry D Lynd
Inhaled corticosteroids (ICS) are commonly prescribed to COPD patients, particularly those with more advanced stages of the disease. These patients are also at increased risk of lung cancer. A systematic review was undertaken to identify studies that examined the association between lung cancer risk and ICS therapy in COPD patients. The search strategy was created in MEDLINE and extended to EMBASE as well as other relevant databases. Both randomized controlled trials (RCTs) and observational studies were considered for inclusion...
October 19, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Junfei Feng, Xuehui Wang, Xing Li, Dejun Zhao, Jinquan Xu
BACKGROUND: Acupuncture has been suggested to treat chronic obstructive pulmonary disease (COPD) in China. However, current evidence is insufficient to draw a firm conclusion regarding the effectiveness of acupuncture in COPD. Therefore, this multicenter, randomized, sham-controlled study was designed to evaluate the efficacy of acupuncture for treating patients with COPD. METHODS: This is a two-arm, parallel group, multicenter, randomized, sham-controlled trial with concealed allocation, and participants, assessor, and analyst blinding...
October 2016: Medicine (Baltimore)
Peng Luo, Shuo Li, Yitai Chen, Yuwen Luo, Yun Li, Kai Wang, Yuxia Huang, Xin Chen
BACKGROUND: Roflumilast, a phosphodiesterase-4 inhibitor recommended by clinical guideline, is always being used in combination with at least one long-acting bronchodilator in patients with stable chronic obstructive pulmonary disease (COPD). However, there are few evidences about whether the combination of roflumilast and long-acting bronchodilators is safer and more effective in patients with moderate-to-very severe stable COPD. In our study, we investigate the effect and safety of roflumilast combined with long-acting bronchodilators on moderate-to-severe stable COPD patients...
September 2016: Journal of Thoracic Disease
Erin Davis, Carlo Marra, John-Michael Gamble, Jamie Farrell, Joe Lockyer, J Mark FitzGerald, Waseem Abu-Ashour, Charlie Gillis, John Hawboldt
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are often nonadherent with medications and have poor inhaler technique. Community pharmacists can help to improve health-related quality of life and overall outcomes in patients with COPD. We aim to measure the effectiveness of a systematic, pharmacist-driven intervention on patients with diagnosed COPD. METHODS/DESIGN: This pragmatic, parallel-group, cluster randomized controlled trial is designed to determine the effectiveness of a multifactorial, pharmacist-led intervention on medication adherence, inhaler technique, health-related quality of life, health care resource utilization including COPD exacerbations, and use of medications...
October 13, 2016: Trials
Irene Torres-Sánchez, Marie Carmen Valenza, Irene Cabrera-Martos, Isabel López-Torres, Ángela Benítez-Feliponi, Alicia Conde-Valero
The objective of this study was to determine whether an exercise intervention using a pedal exerciser is able to reduce disability in frail older patients with chronic obstructive pulmonary disease (COPD) during hospitalization due to an acute exacerbation. This study was a randomized, single-blind clinical trial. Fifty-eight frail older patients admitted to hospital due to an acute exacerbation of COPD (AECOPD) were included in this study. All patients received standard medical and pharmacological care. Patients assigned to the intervention group also received an exercise intervention...
August 11, 2016: COPD
Lone Schaadt, Robin Christensen, Lars Erik Kristensen, Marius Henriksen
INTRODUCTION: Intensity of exercise is believed to be a key determinant of response to chronic obstructive pulmonary disease (COPD) rehabilitation. We hypothesized that a higher intensity of exercise, in combination with physiotherapist-led instructions and education in management of breathlessness, would lead to better self-management, possibly delaying calls to the emergency service and preventing hospitalization. OBJECTIVE: We aimed to test this hypothesis in a subsequent randomized trial, and in order to test study processes and estimate hospitalization rates, we did a small preliminary prospective cohort study on severe COPD patients referred to outpatient rehabilitation...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Nikolas Bernhard, Robert Bals, Sebastian Fähndrich
Alpha-1-antitrypsin deficiency is a genetic risk factor for the development of chronic obstructive airway disease (COPD) and liver cirrhosis. The disease is widely underdiagnosed. The hallmarks of therapy are smoking cessation, prevention from environmental dust exposure and augmentation therapy. Findings from the recently published prospective, placebo-controlled and randomized RAPID trial proved effectiveness of AAT augmentation therapy for slowing progression of emphysema, measured by CT lung density. CT lung density may be more sensitive than forced exspiratory volume in one second (FEV1) or monoxid diffusion capacity (DLCO)...
September 2016: Deutsche Medizinische Wochenschrift
Feng-Sen Li, Yan-Li Zhang, Zheng Li, Dan Xu, Chun-Yan Liao, Huan Ma, Li Gong, Jun Su, Qi Sun, Qian Xu, Zhen Gao, Ling Wang, Jing Jing, Jing Wang, Min Jiang, Ge Tian, Bilal Hasan
In traditional Chinese medicine (TCM), the Yiqigubiao pill is commonly used to enhance physical fitness. The current clinical trial was designed to evaluate the efficacy and safety of the Yiqigubiao pill as an adjuvant therapy for patients with stable chronic obstructive pulmonary disease (COPD). The current trial was a randomized, double-blind, placebo-controlled superiority trial. The participants were recruited from outpatients at the Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University (Ürümqi, China) between February and September 2012...
October 2016: Experimental and Therapeutic Medicine
Janine Dretzke, David Moore, Chirag Dave, Rahul Mukherjee, Malcolm J Price, Sue Bayliss, Xiaoying Wu, Rachel E Jordan, Alice M Turner
INTRODUCTION: Noninvasive ventilation (NIV) improves survival among patients with hypercapnic respiratory failure in hospital, but evidence for its use in domiciliary settings is limited. A patient's underlying risk of having an exacerbation may affect any potential benefit that can be gained from domiciliary NIV. This is the first comprehensive systematic review to stratify patients based on a proxy for exacerbation risk: patients in a stable state and those immediately post-exacerbation hospitalization...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Irene Braithwaite, Mathew Williams, Sharon Power, Janine Pilcher, Mark Weatherall, Amanda Baines, Jackie Moynihan, Rodger Kempsford, Richard Beasley
BACKGROUND: Fluticasone furoate (FF)/vilanterol (VI) is a once-daily maintenance treatment for asthma and chronic obstructive pulmonary disease. The duration of bronchodilation beyond 24 h has not been determined previously. METHODS: Adults aged 18-65 (n = 32), with asthma and reversibility to salbutamol (≥15% and ≥200 mL increase in forced expiratory volume in 1 s [FEV1]) participated in a double-blind, placebo-controlled, crossover study. Patients were admitted to a clinical trials unit for 72 h, and inhaled, in random order, placebo or FF/VI 100/25 mcg via ELLIPTA dry powder inhaler on two occasions 7-14 days apart...
October 2016: Respiratory Medicine
Dannuey M Cardoso, Guilherme A F Fregonezi, Renan T Jost, Ricardo Gass, Cristine L Alberton, Isabella M Albuquerque, Dulciane N Paiva, Sérgio S M Barreto
Objective: To investigate the acute effects of EPAP on the activity of sternocleidomastoid (SCM), parasternal muscles and ventilatory parameters in COPD patients. Method: Twenty-four patients with COPD were studied using surface electromyography (sEMG) and a ventilometer. Patients were randomly assigned to EPAP 10 cmH2O-EPAP10 or 15 cmH2O-EPAP15 for 20 minutes. Results: The parasternal muscle sEMG activity increased during EPAP10 and EPAP15; however, a greater and significant increase was observed with EPAP10 (mean between-group difference: 12...
September 16, 2016: Brazilian Journal of Physical Therapy
Stefan Markun, Thomas Rosemann, Kaba Dalla-Lana, Claudia Steurer-Stey
BACKGROUND: Recruiting patients for research in primary care is difficult with diseases that tend to remain underdiagnosed, such as chronic obstructive pulmonary disease (COPD). Researchers may consider introducing case finding into patient recruitment, but the impact on recruitment yield is largely unknown. OBJECTIVES: To assess the impact of case finding on recruitment yield and population characteristics in primary care-based COPD research. METHODS: For a cluster randomized controlled trial of COPD in primary care, an opportunistic case finding strategy was introduced into patient recruitment, in addition to recruiting patients with previously diagnosed COPD...
September 29, 2016: Respiration; International Review of Thoracic Diseases
Anne E Holland, Ajay Mahal, Catherine J Hill, Annemarie L Lee, Angela T Burge, Narelle S Cox, Rosemary Moore, Caroline Nicolson, Paul O'Halloran, Aroub Lahham, Rebecca Gillies, Christine F McDonald
BACKGROUND: Pulmonary rehabilitation is a cornerstone of care for COPD but uptake of traditional centre-based programmes is poor. We assessed whether home-based pulmonary rehabilitation, delivered using minimal resources, had equivalent outcomes to centre-based pulmonary rehabilitation. METHODS: A randomised controlled equivalence trial with 12 months follow-up. Participants with stable COPD were randomly assigned to receive 8 weeks of pulmonary rehabilitation by either the standard outpatient centre-based model, or a new home-based model including one home visit and seven once-weekly telephone calls from a physiotherapist...
September 26, 2016: Thorax
Palmira Bernocchi, Simonetta Scalvini, Tiziana Galli, Mara Paneroni, Doriana Baratti, Ottavia Turla, Maria Teresa La Rovere, Maurizio Volterrani, Michele Vitacca
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist, significantly reducing patients' quality of life and increasing morbidity and mortality. For either single disease, a multidisciplinary disease-management approach supported by telecommunication technologies offers the best outcome in terms of prolonged survival and reduced hospital readmissions. However, no data exist in patients with combined COPD/CHF. We planned a randomized controlled trial to investigate the feasibility and efficacy of an integrated, home-based, medical/nursing intervention plus a rehabilitation program versus conventional care in patients with coexisting COPD/CHF...
2016: Trials
Adriane B Cardim, Patrícia Em Marinho, Jasiel F Nascimento, Helen Kb Fuzari, Armèle Dornelas de Andrade
Whole-body vibration (WBV) is considered a type of physical activity based on the assumption that it results in an increase in muscle strength and performance and, therefore, may be a promising way to exercise patients with COPD. A comprehensive database search (PubMed/MEDLINE, LILACS, CINAHL, Web of Science, Scopus, and COCHRANE Library) for randomized trials, including original articles, that compared WBV groups versus control groups was conducted and studies were selected for comparison. The effect of WBV treatment was compared for minimum clinically important differences...
September 20, 2016: Respiratory Care
Zainab Ahmadi, Josefin Sundh, Anna Bornefalk-Hermansson, Magnus Ekström
Long-term oxygen therapy (LTOT) ≥ 15 h/day improves survival in hypoxemic chronic obstructive pulmonary disease (COPD). LTOT 24 h/day is often recommended but may pose an unnecessary burden with no clear survival benefit compared with LTOT 15 h/day. The aim was to test the hypothesis that LTOT 24 h/day decreases all-cause, respiratory, and cardiovascular mortality compared to LTOT 15 h/day in hypoxemic COPD. This was a prospective, observational, population-based study of COPD patients starting LTOT between October 1, 2005 and June 30, 2009 in Sweden...
2016: PloS One
Eva Broendum, Charlotte Suppli Ulrik, Thorbjorn Gregersen, Ejvind Frausing Hansen, Allan Green, Thomas Ringbaek
The aim of this analysis is to investigate reasons why patients with chronic obstructive pulmonary disease decline to participate in a controlled trial of telemedicine. Patients with previous chronic obstructive pulmonary disease exacerbations were invited to participate in a 6-month randomized telemedicine trial. For eligible patients, reasons for refusal were registered. Of 560 eligible patients, 279 (50%) declined to participate in the trial, 257 (92%) reported a reason: 53 (20.6%) technical concerns, 164 (63...
September 16, 2016: Health Informatics Journal
M J Connolly, A M Yohannes
Respiratory diseases are common in older people. However, the impact of comorbid depression in older patients with chronic obstructive pulmonary disease (COPD) and asthma has not been fully explored. This narrative review examines the impact of comorbid depression and its management in COPD and asthma in older adults. The causes of depression in patients with COPD and asthma are multifactorial and include physical, physiological and behavioural factors. Depression is associated with hospital readmission in older adults with asthma and COPD...
October 2016: Maturitas
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