Oral Corticosteroid-Related Healthcare Resource Utilization and Associated Costs in Patients with COPD DOI Creative Commons
Gary Tse, Cono Ariti, Mona Bafadhel

и другие.

Advances in Therapy, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 19, 2024

Oral corticosteroids (OCS) are used to manage chronic obstructive pulmonary disease (COPD) exacerbations but associated with adverse outcomes that may increase healthcare resource utilization and costs. We compared attendance/costs OCS-related in patients who ever OCS versus those never examined associations between cumulative exposure attendance/costs. This direct matched observational cohort study the UK Clinical Practice Research Datalink GOLD database (data range 1987–2019). Patients a COPD diagnosis on/after April 1, 2003, Hospital Episode Statistics linkage were included. Emergency room, specialist or primary care outpatient, inpatient attendance analyzed. Costs, estimated using Health Social Care 2019 National Service Reference Costs 2019–2020 reports, adjusted for sex, age, exacerbation number, inhaler type 12 months before index date. The had higher annualized disease-specific (excluding respiratory) total non-OCS (adjusted incidence rate ratio [aIRR] 95% confidence intervals [CIs]) ranging from 37% (1.37 [1.31, 1.43]) emergency room attendances 149% (2.49 [2.36, 2.63]) consultations. Disease-specific increased positive dose–response relationship most categories < 0.5 g reference dose. For 1.0 dose category, greatest increases occurred consultations (aIRR [95% CI] 1.38 [1.32, 1.44]). ≥ 10 observed 2.83 [2.66, 3.00]), non-elective long stays (≥ 2 days; 2.54 [2.15, 2.99]), short (≤ 1 day; 2.51 [2.12, 2.98]). Similar findings all-cause Among COPD, costs, relationship. A graphical abstract is available this article. Many people living have "flare-ups", exacerbations, at which time their symptoms suddenly worsen. To treat doctors prescribe steroid tablets (oral short). However, repeated use negative health effects, leading hospital visits systems Using anonymized patient records England, we costs system related effects of planned (elective) non-planned (non-elective) stays, visits, appointments OCS. also explored how amount by grouped into 53,299 pairs so every was one (e.g., same age sex), treatment followed over approximately 6 years. found received than did not, appointments. In OCS, generally greater when more used, These results show lead burden incurring

Язык: Английский

Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial DOI Creative Commons
Sanjay Ramakrishnan, Richard Russell,

Hafiz Taha Mahmood

и другие.

The Lancet Respiratory Medicine, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 1, 2024

Язык: Английский

Процитировано

11
Chronic Obstructive Pulmonary Disease and Type 2 Diabetes Mellitus: Complex Interactions and Clinical Implications DOI Open Access
Lucreția Anghel, Anamaria Ciubară,

Diana Pătraș

и другие.

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(6), С. 1809 - 1809

Опубликована: Март 7, 2025

Chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2DM) are highly prevalent chronic conditions, frequently coexisting due to their shared pathophysiological mechanisms risk factors. Epidemiological studies estimate that up 30% of COPD patients have comorbid T2DM, contributing worsened progression, more hospitalizations, higher mortality rates. Systemic inflammation in contributes insulin resistance by increasing pro-inflammatory cytokines (TNF-α, IL-6, CRP), which impair glucose metabolism beta-cell function. Conversely, hyperglycemia T2DM exacerbates oxidative stress, leading endothelial dysfunction, reduced lung function, impaired repair mechanisms. A comprehensive narrative review was conducted evaluate the interplay between examining mechanisms, clinical consequences, management strategies. The co-occurrence accelerates development, elevates hospitalization rates, deteriorates overall prognosis. Pharmacological interactions complicate illness treatment, requiring a multidisciplinary therapy strategy. Recent data underscore need integrate palliative care, facilitate decision-making, provide psychological support enhance patient outcomes. Efficient COPD-T2DM comorbidity necessitates customized, interdisciplinary strategy targets both respiratory metabolic health. Preliminary prognostic dialogues, holistic lifestyle modifications can improve quality life results.

Язык: Английский

Процитировано

1
Update on the pharmacological treatment of chronic obstructive pulmonary disease DOI Creative Commons

Madeleine R. Jacques,

Brooks Kuhn, Timothy E. Albertson

и другие.

Expert Opinion on Pharmacotherapy, Год журнала: 2024, Номер unknown, С. 1 - 20

Опубликована: Сен. 29, 2024

Chronic obstructive pulmonary disease (COPD) is a common syndrome associated with smoking and environmental exposures coupled genetic susceptibility. Recent major advancements in the treatment of COPD patients have become available.

Язык: Английский

Процитировано

4
Cumulative Dispensing of Oral Corticosteroids Over 12 Months in People with COPD DOI Creative Commons
Angela T. Burge, Narelle S. Cox, Simone Dal Corso

и другие.

International Journal of COPD, Год журнала: 2025, Номер Volume 20, С. 149 - 158

Опубликована: Янв. 1, 2025

Oral corticosteroids (OCS) are recommended for the treatment of exacerbations in people with COPD; however, high cumulative lifetime doses (≥1000mg prednisolone-equivalent) associated adverse health effects. This issue is well defined asthma but less understood COPD. The aim this study was to examine OCS dispensed COPD over 12 months. a secondary analysis data from two randomised controlled trials involving followed up months following pulmonary rehabilitation. Clinical and administrative (respiratory-related hospital admissions emergency presentations, maintenance medications) were examined determine dose relative 1000mg threshold relationship clinical features. Of 232 participants (126 females, age mean 68 ± SD 9 years, FEV1 53 22% predicted), 48% (n = 112) at least once Sixty-two (26%) ≥1000mg. Participants more likely have had respiratory admission (OR 4.1, 95% CI 2.3 8.7) greater breathlessness (modified Medical Research Council scale ≥2, OR 2.5, 1.3 5.0); no disease severity or medications demonstrated. One four unsafe period only Further work needed magnitude strategies address exposure OCS.

Язык: Английский

Процитировано

0
Management of Non-communicable Diseases in Primary Care DOI
Cheuk To Chung,

Sharen Lee,

Jeffrey Shi Kai Chan

и другие.

Quality of life in Asia, Год журнала: 2025, Номер unknown, С. 239 - 257

Опубликована: Янв. 1, 2025

Язык: Английский

Процитировано

0
Mechanisms of osteoporosis associated with chronic obstructive pulmonary disease DOI
Daisuke Inoue, Daisuke Inoue

Journal of Bone and Mineral Metabolism, Год журнала: 2024, Номер 42(4), С. 428 - 437

Опубликована: Июль 1, 2024

Язык: Английский

Процитировано

1
Budesonide/Glycopyrrolate/Formoterol for the Management of COPD in a UK Primary Care Population: Real-World Use and Early Medication Success DOI Creative Commons
Hana Müllerová, Jeffrey Shi Kai Chan,

Heath Heatley

и другие.

International Journal of COPD, Год журнала: 2024, Номер Volume 19, С. 1153 - 1166

Опубликована: Май 1, 2024

Real-life research is needed to evaluate the effectiveness of budesonide/glycopyrrolate/formoterol (BGF) in routine COPD primary care management. We assessed frequency medication success among patients with who initiated BGF using real-world data.

Язык: Английский

Процитировано

0
The influence of glucocorticoids on the bone tissue in patients with chronic obstructive pulmonary disease DOI Creative Commons
N.P. Masik, O.I. Masik, Tetiana Y. Niushko

и другие.

PAIN JOINTS SPINE, Год журнала: 2024, Номер 14(2), С. 90 - 95

Опубликована: Авг. 13, 2024

Background. According to the GOLD guidelines, glucocorticoids (GCs) are recommended for exacerbations of chronic obstructive pulmonary disease (COPD). Bone mineral density (BMD) can be reduced in case use therapeutic doses GCs. The aim study was determine influence GCs on BMD and frequency osteoporosis patients with COPD depending prescribed therapy. Materials methods. We examined 202 (group E) acute phase. Group I consisted 129 taking basic dual treatment, group II — 73 triple therapy inhaled During exacerbations, systemic were at cumulative dose 352.94 ± 30.51 mg/year. bone state using an ultrasound densitometer SONOST-2000. A Speed Sound (SOS), Broadband Ultrasound Attenuation (BUA), Stiffness index (SI), T- Z-scores determined. Results. Decreases SI, BUA, Z- scores established 43.51 % from 83.56 (p < 0.05). In group, SI lower by 9.54 %, BUA 14.35 SOS 14.57 score 6.9 25.86 %; subjects 3: 40.27 3.25 17.9 4: 19.9 77.8 5.6 compared group. Conclusions. Glucocorticoid-induced diagnosed 10.71 20.55 Its depended stage COPD: 3 22.22 patients, 4 50.0 subjects.

Язык: Английский

Процитировано

0
The Saudi Thoracic Society Evidence-based guidelines for the diagnosis and management of chronic obstructive pulmonary disease DOI Creative Commons

Hamdan Al-Jahdali,

Riyad Al‐Lehebi, Hani Lababidi

и другие.

Annals of Thoracic Medicine, Год журнала: 2024, Номер 20(1), С. 1 - 35

Опубликована: Сен. 24, 2024

The Saudi Thoracic Society (STS) developed an updated evidence-based guideline for diagnosing and managing chronic obstructive pulmonary disease (COPD) in Arabia. This aims to provide a comprehensive unbiased review of current evidence assessing, diagnosing, treating COPD. While epidemiological data on COPD Arabia are limited, the STS panel believes that prevalence is increasing due rising rates tobacco smoking. key objectives guidelines facilitate accurate diagnosis COPD, identify risk exacerbations, recommendations relieving reducing symptoms stable patients during exacerbations. A unique aspect this its simplified, practical approach classifying into three classes based symptom severity using Assessment Test exacerbations hospitalizations. provides reader with executive summary recommended treatments best available also addresses other major aspects management comorbidities. primarily intended use by internists general practitioners

Язык: Английский

Процитировано

0
NK cells in the lung: novel insight and future challenge in the airway diseases DOI Creative Commons

Tommaso Pianigiani,

Irene Paggi, Grace E. Cooper

и другие.

ERJ Open Research, Год журнала: 2024, Номер 11(2), С. 00683 - 2024

Опубликована: Окт. 10, 2024

Natural killer (NK) cells are innate lymphoid which present in the lung as circulating and resident cells. They key players both airway surveillance crosstalk with (COPD) pathogenesis, they seem to contribute development of bronchiectasis. In asthma, NK cell dysfunction was observed mainly severe forms, it can lead a biased type-2 immune response failure resolution eosinophilic inflammation that characterise allergic phenotypes. Moreover, aberrant functions may interfere antimicrobial contributing frequency severity virus-induced exacerbations. COPD, exhibit increased cytotoxicity against epithelium tissue destruction emphysema. This be exacerbated by viral infections cigarette smoke exposure through NKG2D-dependent detection cellular stress. Lastly, bronchiectasis, might promote neutrophil survival following stimulation proinflammatory cytokines apoptosis. Systemic steroid treatment seemingly compromises activity, while biologic benralizumab could enhance proliferation, maturation activation. narrative review gives an overview diseases focusing on pathophysiological clinical implications. Together, our findings emphasise pleiotropic role underscoring their possible implications therapeutical approaches.

Язык: Английский

Процитировано

0