Impact of baseline symptoms and health status on COPD exacerbations in the FLAME study

Respiratory Research, Год журнала: 2020, Номер 21(1)

Опубликована: Апрель 22, 2020

Abstract Background COPD is a heterogeneous disease and patients may respond differently to therapies depending on baseline symptom burden. Methods This post-hoc analysis from the 52-week FLAME study investigated impact of burden in terms health status, dyspnoea, bronchitis eosinophil levels smoking status subsequent risk moderate or severe exacerbations. Health was measured by St. George’s Respiratory Questionnaire (SGRQ) score (higher ≥46.6 lower < 46.6) Assessment Test (CAT) ≥17 17); dyspnoea were assessed via an electronic diary (eDiary). Differential response once-daily indacaterol/glycopyrronium (IND/GLY) 110/50 μg versus twice-daily salmeterol/fluticasone (SFC) 50/500 assessed. Results Data 3354 analysed. The exacerbations who had less impairment (rate ratio [RR] [95% CI]): SGRQ-C, (0.88 [0.78, 0.99]); CAT, 0.85 [0.75, 0.96]) (0.79 [0.69, 0.90]) at those with more higher respectively. Compared SFC, IND/GLY led better prevention moderate-to-severe majority groups studied. Conclusion Patients greater subsequently experienced study. overall effective preventing regardless Our results suggest that future studies novel exacerbation should consider targeting baseline. Clinical trial identifier NCT01782326 .

Язык: Английский

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Blood eosinophils as predictor of outcomes in patients hospitalized for COPD exacerbations: a prospective observational study

Biomarkers, Год журнала: 2021, Номер 26(4), С. 354 - 362

Опубликована: Март 16, 2021

In the present prospective multicentre observational study, we evaluated potential role of blood eosinophils on outcomes patients hospitalized for COPD exacerbations.Consecutive >40 years with a previous diagnosis were recruited. Blood measured admission prior to initiation treatment and in three groups (<50, 50-149 ≥150 cells/μL). Patients received standard care followed up year.A total 388 included (83.5% male, mean age 72 years). higher had less dyspnoea (Borg scale), lower C-reactive protein (CRP) PaO2/FiO2 (partial pressure oxygen/fraction inhaled oxygen), discharged earlier (median 11 vs. 9 5 days <50, cells/μL, respectively). <50 cells/μL presented 30-day 1-year mortality, whereas there no differences moderate/severe exacerbations between groups. post hoc analysis, corticosteroids as per physicians' decision was associated better exacerbation prevention during follow-up cells/μL.Higher patients, further supporting their use prognostic biomarker.

Язык: Английский

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Stability of blood eosinophils in acute exacerbation of chronic obstructive pulmonary disease and its relationship to clinical outcomes: a prospective cohort study

Respiratory Research, Год журнала: 2021, Номер 22(1)

Опубликована: Ноя. 24, 2021

The clinical value of blood eosinophils and their stability in chronic obstructive pulmonary disease (COPD) remains controversial. There are limited studies on association between the acute exacerbation COPD (AECOPD) outcomes. This study aimed to evaluate hospitalized AECOPD its relationship prospective observational recruited patients with from November 2016 July 2020. eligible were divided into four groups according eosinophil counts at admission discharge: persistently < 300 cells/μl (LL), but ≥ cells/µl discharge (LH), (HL), (HH). Cox hazard analyses used changes exacerbations or mortality. In 530 included, 90 (17.0%) had a high count (BEC) 32 (35.6%) them showed decreased BEC discharge. proportions distribution for group LL, LH, HL, HH 381 (71.9%), 59 (11.1%), (6.0%), 58 (10.9%), respectively. During hospitalization, LH higher C-reactive protein level, rate intensive care unit (ICU) admission, total cost. length hospital stay was longer compared (P = 0.002, 0.017, 0.001, respectively). follow-up 12 months, associated risk moderate-to-severe LL (hazard ratio 2.00, 95% confidence interval 1.30-3.08, P 0.002). Eosinophil no significant mortality months. Sensitivity without asthma use systemic corticosteroids prior did not alter results. More attention should be paid when evaluating short-term prognosis AECOPD. A factor long-term exacerbations. during hospitalization could help predict

Язык: Английский

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Pharmacological treatment of stable COPD: need for a simplified approach

Postgraduate Medicine, Год журнала: 2019, Номер 132(2), С. 126 - 131

Опубликована: Дек. 19, 2019

Chronic obstructive pulmonary disease (COPD) is one of the most common diseases worldwide. Although different guidelines regarding therapeutic algorithms exist, widely adopted approach suggested by Global Initiative in Obstructive Lung Disease which patients are stratified according to their dyspnea severity and exacerbation history during previous year. This combined assessment COPD, takes into consideration all aforementioned characteristics COPD as well number blood eosinophils, results a proposed algorithm complex hard memorize. complexity probable causes that health care professionals not adherent when treating patients. Here, we propose simplified for treatment taking current evidence on use bronchodilators inhaled corticosteroids.

Язык: Английский

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<p>Dual Bronchodilator in the Era of Triple Therapy</p>

International Journal of COPD, Год журнала: 2020, Номер Volume 15, С. 2695 - 2705

Опубликована: Окт. 1, 2020

Abstract: Pharmacological medications used for the treatment of COPD patients have increased significantly. Long-acting bronchodilators been recognized as mainstay stable COPD, while ICS are usually added in with who experience exacerbations, despite bronchodilator treatment. In latest years, several studies published showing beneficial effect adding on dual bronchodilation suffering from more severe disease comparing triple therapy therapeutic regiments including and providing a message that this might be appropriate patients. However, not all desirable response to long-term use is associated side effects. report, we aimed provide review current knowledge importance compare its therapy, by covering wide spectrum topics. Finally, propose an algorithm performing step up down double considering evidence. Keywords: chronic obstructive pulmonary disease, bronchodilation, inhaled corticosteroids,

Язык: Английский

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