Comparison of LAMA/LABA vs. ICS/LABA in high risk COPD patients: Pre-specified analysis on lung function and health status from the IMPACT trial

2019 ◽  
Author(s):  
DA Lipson ◽  
F Barnhart ◽  
I Boucot ◽  
C Crim ◽  
N Brealey ◽  
...  
Author(s):  
David A Lipson ◽  
Frank Barnhart ◽  
Isabelle Boucot ◽  
Courtney Crim ◽  
Noushin Brealey ◽  
...  

Author(s):  
Madonna Ferrone ◽  
◽  
Marcello G. Masciantonio ◽  
Natalie Malus ◽  
Larry Stitt ◽  
...  

2014 ◽  
Vol 9 ◽  
Author(s):  
Roberto W. Dal Negro ◽  
Luca Bonadiman ◽  
Paola Turco

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality at global level even if still underestimated. The insufficient use of specific tools for an objective definition and staging, the inadequate awareness of COPD, but also a difficult patient-to-doctor communication, can contribute to the poor management of COPD. A very simple, short and sensitive questionnaire (the “COPD Assessment Test” - CAT questionnaire) is now available for assessing the impact of COPD on the patient’s health. The present study was designed to provide such evidence using data generated throughout Italy. Methods: The Italian validated version of the CAT questionnaire was distributed to 681 consecutive COPD patients of different severity (males = 480), well matched for age, gender, smoking habit, geographical distribution, BMI, dyspnoea score and educational level. The CAT score variability was investigated vs all anagraphic, and clinical variables, and spirometric indices of lung function (regression). No Italian data are available to our knowledge on the CAT use, neither in General Medicine, nor in the specialist setting. Results: Data of this study confirmed that the CAT questionnaire is a sensitive, simple, and quick tool for assessing the respiratory status of COPD patients. The CAT score proved not conditioned by the patient’s age, gender, body size, geographical origin, and educational level. It was inversely correlated with the spirometric values, even if not uniquely linked to them. Conclusions: The CAT score does not represent a surrogate measurement of lung function: it is an instrument which focuses on different areas of respiratory health in COPD patients, thus providing an useful and objective tool for the long-term clinical and therapeutic monitoring of COPD patients in the specialist outpatient setting.


Author(s):  
Lizarazu Maulidil Li Kharis ◽  
Andjar Pudji ◽  
Priyambada Cahya Nugraha

Chronic obstructive pulmonary disease (COPD) is a disease whose prevalence tends to increase annually, with the World Health Organization (WHO) data predicting in 2020 the disease is the cause of the third-highest mortality worldwide. The assessment of the recurrence of COPD patients is very important, as it will accelerate the decline of lung function and health status. The purpose of this research is to design a spirometer by utilizing the MPXV7002DP sensor and equipped with a graphical display as well as lung health status on the Nextion TFT LCD.  A portable Spirometer design has been done using the MPXV7002DP pressure sensor out as a transducer with a display on the Nextion TFT LCD. The design aims to determine the health of lung function by knowing the volume of lung Forced Vital Capacity (FVC), Forced Expired Volume in one second (FEV1), and Vital Capacity (VC). The working principle of this tool is to process the pressure from the results of the user blowing to the sensor through a mouthpiece which is designed based on Venturimeter law, the data will be processed by the Arduino microcontroller 2560 to be displayed on the LCD TFT and Nextion stored in SD card memory. The result of module validation data against a Spirometer 3L calibrator Benchmarking tool was obtained 1.58% VC error. The value is still below the 5% error tolerance limit so that the VC parameters in the secure module is used.


2019 ◽  
Author(s):  
DA Lipson ◽  
F Barnhart ◽  
I Boucot ◽  
C Crim ◽  
N Brealey ◽  
...  
Keyword(s):  

2020 ◽  
Vol 55 (5) ◽  
pp. 1901921 ◽  
Author(s):  
David M.G. Halpin ◽  
Mark T. Dransfield ◽  
MeiLan K. Han ◽  
C. Elaine Jones ◽  
Sally Kilbride ◽  
...  

IMPACT, a 52-week, randomised, double-blind trial, assessed the efficacy and safety of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy versus FF/VI or UMEC/VI in patients with symptomatic COPD and a history of exacerbations.Subgroup analyses assessed whether the efficacy of FF/UMEC/VI versus FF/VI or UMEC/VI and UMEC/VI versus FF/VI varies according to prior exacerbation history, and the combined effects of exacerbation history and blood eosinophil counts. Three subgroups were defined: single moderate (1 moderate/no severe; n=3056 (30%)), frequent moderate (≥2 moderate/no severe; n=4628 (45%)) and severe (≥1 severe/any moderate; n=2671 (26%)). End-points included annual on-treatment moderate/severe exacerbation rate (pre-specified), lung function and health status (both post-hoc).Moderate/severe exacerbation rates (reduction % (95% CI)) were reduced in the FF/UMEC/VI group versus FF/VI (single moderate 20% (10–29), frequent moderate 11% (2–19), severe 17% (7–26)) and versus UMEC/VI (single moderate 18% (5–29), frequent moderate 29% (21–37), severe 26% (14–35)). Moderate/severe exacerbation rates were reduced in the FF/VI group versus UMEC/VI in the frequent moderate subgroup; a numerical reduction was observed in the severe subgroup (single moderate 2% (−12–18), frequent moderate 21% (11–29), severe 11% (−3–22)). Moderate/severe exacerbation rates were lower in the FF/VI group compared with UMEC/VI in patients with higher eosinophil counts. FF/UMEC/VI improved lung function and health status versus both dual therapies irrespective of exacerbation subgroup. UMEC/VI improved lung function versus FF/VI in all subgroups.Triple therapy was more effective than dual regardless of exacerbation history, consistent with results in the intent-to-treat population. Comparisons between dual therapies were influenced by prior exacerbation history and eosinophil counts.


Author(s):  
David A Lipson ◽  
Frank Barnhart ◽  
Isabelle Boucot ◽  
Courtney Crim ◽  
Noushin Brealey ◽  
...  
Keyword(s):  

2021 ◽  
Author(s):  
Jef Serré ◽  
Ajime Tom Tanjeko ◽  
Carolien Mathyssen ◽  
Tobias Heigl ◽  
Dana Paulina Cook ◽  
...  

Abstract Background: In chronic obstructive pulmonary disease (COPD), exacerbations cause acute inflammatory flare-ups and increase the risk for hospitalization and mortality. Exacerbations are common in all disease stages and are often caused by bacterial infections e.g., non-typeable Heamophilus influenzae (NTHi). Accumulating evidence also associates vitamin D deficiency with the severity of COPD and exacerbation frequency. However, it is still unclear whether vitamin D deficiency when combined with cigarette smoking would worsen and prolong exacerbations caused by repeated infections with the same bacterial strain. Methods: vitamin D sufficient (VDS) and deficient (VDD) mice were exposed to nose-only cigarette smoke (CS) for 14 weeks and oropharyngeally instilled with NTHi at week 6, 10 and 14. Three days after the last instillation, mice were assessed for lung function, remodeling, inflammation and immunity. The impact of VDD and CS on inflammatory cells and immunoglobulin (Ig) production was also assessed in non-infected animals while serum Ig production against NTHi and dsDNA was measured in COPD patients before and 1 year after supplementation with Vitamin D3. Results: VDD enhanced NTHi eradication, independently of CS and complete eradiation was reflected by decreased anti-NTHi Ig’s within the lung. In addition, VDD led to an increase in total lung capacity (TLC), lung compliance (Cchord), MMP12/TIMP1 ratio with a rise in serum Ig titers and anti-dsDNA Ig’s. Interestingly, in non-infected animals, VDD exacerbated the CS-induced anti-NTHi Ig’s, anti-dsDNA Ig’s and inflammatory cells within the lung. In COPD patients, serum Ig production was not affected by vitamin D status but anti-NTHi IgG increased after vitamin D3 supplementation in Vitamin D insufficient patients before treatment. Conclusion: During repeated infections, VDD facilitated NTHi eradication and resolution of local lung inflammation through production of anti-NTHi Ig, independently of CS but it also produced autoantibodies. In COPD patients, vitamin D supplementation might be protective against NTHi infections in vitamin D insufficient patient. Future research is needed to decipher the protective or self-destructive effects of VDD on adaptive immunity.Trail registration: ClinicalTrails, NCT00666367. Registered 23 April 2008, https://www.clinicaltrials.gov/ct2/show/study/NCT00666367


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