scholarly journals Meta-Analysis of Clinical Efficacy and Safety of Ligustrazine in the Treatment of Idiopathic Pulmonary Fibrosis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Xiaozheng Wu ◽  
Wen Li ◽  
Zhenliang Luo ◽  
Yunzhi Chen
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Clinical Symptoms ◽  
Gas Analysis ◽  
Control Group ◽  
Efficacy And Safety ◽  
Arterial Blood Gas ◽  
Arterial Blood

Objective. To systematically review the efficacy and safety of Ligustrazine in the treatment of idiopathic pulmonary fibrosis (IPF). Methods. The electronic literature databases (PubMed, EMbase, CNKI, WanFang database, and VIP) were retrieved through a computer to find out the randomized controlled trials (RCT) of Ligustrazine in the treatment of IPF according to the inclusion/exclusion criteria screening test. Cochrane’s bias risk table was also used to evaluate the quality of the study and to extract effective data. RevMan 5.3 was used for statistical analysis. Results. A total of 7 RCTs (a total of 366 patients, including 196 in experimental and 170 in control group). Compared with the control group, Ligustrazine could improve the clinical symptoms ([OR] = 2.20, 95% CI [1.40, 3.46], P = 0.0006 ), lung function (VC % [MD] = 3.92, 95% CI [0.68, 7.17], P = 0.02 ), (TLC% [MD] = 4.94, 95% CI [0.37, 9.52], P = 0.03 ), the pulmonary diffusion function (DLCO % [MD] = 9.12, 95% CI [5.70, 12.55], P < 0.00001 ), and arterial blood gas analysis (PaO2 [MD] = 7.11, 95% CI [1.96, 12.25], P = 0.007 ) (PaCO2 [MD] = −2.42, 95% CI [−4.36, −0.49], P = 0.01 ) of IPF patients, respectively. However, FEV1/FVC % ([MD] = 9.37, 95% CI [−1.23, 19.97], P = 0.08 ) and adverse reactions ([MD] = 0.35, 95% CI [0.02, 5.36], P = 0.45 ) were not significantly improved. Conclusion. Ligustrazine has certain clinical efficacy in the treatment of IPF, but the safety of applying it and the adverse reactions need to be further analyzed and determined. It can be considered as a new alternative and complementary medicine to be promoted and recommended for use in medical units in various countries in the world and it solved the difficult problem of conventional drug treatment of IPF; therefore, more research strength can be put in the treatment of the pathological mechanism of IPF for further exploration. The study was registered under registration number CRD42020193626.

scholarly journals Progranulin And Activin A Concentrations Are Elevated In Serum From Patients With Acute Exacerbations of Idiopathic Pulmonary Fibrosis

2021 ◽  
Author(s):  
Tian Xie ◽  
Lizhen Han ◽  
Yongxing Chen ◽  
Haihong Wu
Keyword(s):  
Carbon Monoxide ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Activin A ◽  
Control Group ◽  
Diffusion Capacity ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Acute Exacerbations ◽  
Gas Measurements

Abstract Purpose To examine the serum concentrations of Progranulin (PGRN) and activin A in patients with acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) in a pilot study. Methods Twenty-one patients with AE-IPF were compared with 23 patients with stable idiopathic pulmonary fibrosis (IPF) as a control group. Serum PGRN and activin A levels, arterial blood gas measurements and lung function were determined in these two groups. Students t-test was used to compare the differences in PGRN and activin A levels between the two groups, and Spearman correlation coefficient was used to examine the relationship between serum PGRN and activin A levels with carbon monoxide diffusion capacity in patients with IPF. Results Peripheral blood PGRN and activin A levels in patients with AE-IPF were 83.7+10.0 and 14.2+1.7 ng/ml (mean+SD), respectively, higher than those in the control group 61.0+5.8, and 5.8+1.0 (p<0.001). PGRN and activin A levels were significantly negatively correlated with carbon monoxide diffusion capacity (r=-0.857 p<0.001) and r=-0.757 (p<0.001). Conclusion: PGRN and activin A may be involved in the pathogenesis of AE-IPF. They may be possible markers of activity in AE-IPF.

scholarly journals Efficacy and Safety of Traditional Chinese medicine in patients with acute exacerbation of idiopathic pulmonary fibrosis: study protocol for randomized, controlled, exploratory clinical trial

2021 ◽  
Author(s):  
Hailong Zhang ◽  
Jiansheng Li ◽  
Wen Guo ◽  
Lu Wang ◽  
Dong Zhang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Acute Exacerbation ◽  
Secondary Outcome ◽  
Control Group ◽  
Efficacy And Safety ◽  
Arterial Blood

Abstract Background: At present, there is short of effective treatment for acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). The treatment of IPF with Traditional Chinese medicine (TCM) has some advantages. However, the evidence is unclear whether TCM can be recommended as an effective therapy to treat AE-IPF. The purpose of the study is to explore the efficacy and safety of TCM for patients with AE-IPF.Methods: A randomized, double-blind, placebo-controlled, exploratory clinical trial will be performed. A total of 80 patients diagnosed AE-IPF will be randomized into the intervention or control group. In addition to conventional treatment, the intervention group will be treated with Kangxianhuanji granule, and the control group will be given a placebo granule. The administration frequency is 10g each time and two times daily. After 4 weeks of treatment, the patients were followed up for 12 weeks. The primary outcomes are treatment failure rate and all-cause of mortality. Secondary outcome measures will include the length of hospitalization, overall survival, acute exacerbation rate, intubation rate, Modified British Medical Research Council (mMRC) score, and the St George's Respiratory Questionnaire idiopathic pulmonary fibrosis (SGRQ-I) score, and arterial blood gas analysis.Discussion: TCM may be beneficial in IPF. However, it has never been evaluated in patients with AE-IPF, who are incredibly prone to respiratory failure and have a high mortality rate. It is the first clinical trial to explore the efficacy and safety of TCM in the treatment of AE-IPF. This result will provide a basis for further study, which provide a high-quality evidence for the treatment of AE-IPF with TCM.Trial registration: Chinese Clinical Trial Registry, ChiCTR1900026289. Registered 29 September 2019, http://www.chictr.org.cn/index.aspx.

scholarly journals Progranulin and Activin A Concentrations are Elevated in Serum from Patients with Acute Exacerbations of Idiopathic Pulmonary Fibrosis

Lung ◽  
2021 ◽  
Vol 199 (5) ◽  
pp. 467-473
Author(s):  
Tian Xie ◽  
Lizhen Han ◽  
Yongxing Chen ◽  
Haihong Wu
Keyword(s):  
Lung Function ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Activin A ◽  
Acute Injury ◽  
Control Group ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Acute Exacerbations ◽  
Fibrotic Lung Disease

Abstract Purpose Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic lung disease of unknown cause with a variable course. Acute exacerbations of IPF (AE-IPF) is sudden accelerations of the disease or a superimposed idiopathic acute injury significantly reducing lung function. To examine the serum concentrations of Progranulin (PGRN) and activin A in patients with AE-IPF in a pilot study. Methods Twenty-one patients with AE-IPF were compared with 23 patients with stable IPF as a control group. Serum PGRN and activin A levels, arterial blood gas measurements, and lung function were determined in these two groups. Results Peripheral blood PGRN and activin A levels in patients with AE-IPF were 83.7 + 10.0 and 14.2 ± 1.7 ng/ml (mean + SD), respectively; higher than those in the control group 61.0 + 5.8 and 5.8 + 1.0 (p < 0.001). PGRN and activin A levels were significantly negatively correlated with carbon monoxide diffusion capacity r = − 0.857 (p < 0.001) and r = − 0.757 (p < 0.001). Conclusion Progranulin (PGRN) and activin A may be involved in the pathogenesis of AE-IPF. They may be possible markers of disease activity in AE-IPF.

scholarly journals Study of effectiveness of antiviral drugs (umifenovir, triazavirin) against acute respiratory viral infections

2018 ◽  
Vol 99 (2) ◽  
pp. 215-223 ◽  
Author(s):  
E P Tikhonova ◽  
T Yu Kuz'mina ◽  
N V Andronova ◽  
O A Tyushevskaya ◽  
T A Elistratova ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Clinical Efficacy ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Antiviral Drug ◽  
Antiviral Drugs ◽  
Control Group ◽  
Efficacy And Safety ◽  
Respiratory Viral Infections ◽  
Adaptive Reactions

Aim. Comparative study of clinical efficacy and safety of antiviral drug triazavirin and umifenovir in the treatment of patients with acute respiratory viral infections and influenza. Methods. The study included 100 patients aged 18 to 65 years diagnosed with moderate acute respiratory viral infection. Group 1 included 34 patients receiving umifenovir 200 mg 4 times a day for 5 days, and comparison group included 32 patients who received triazavirin 1 capsule (250 mg) 3 times a day for 5 days. Group 3 (control group) included 34 patients not treated with antiviral therapy. Efficacy and safety of the studied antiviral drugs were evaluated based on clinical symptoms in the disease course and were confirmed by adaptive reactions of the organism. Results. Among patients receiving triazavirin, recovery time and fever, headache and catarrhal syndrome resolution time were less than among patients who received umifenovir. On triazavirin treatment with favorable tolerability, symptomatic medications (antipyretics) were discontinued, and the duration of their use was less, than in patients receiving umifenovir. Evaluation of clinical efficacy of umifenovir and triazavirin for the treatment of acute respiratory viral infections and influenza demonstrated that the drugs effectively reverse the main symptoms of the disease (p <0.05), reduce complications incidence (18.1±2.1% vs. 55.9±3.2%, p <0.05) and contribute to the stabilization of adaptive reactions of the organism in contrast to the results of patients not receiving etiotropic therapy (6.9±2.9% vs. 12.8±2.7, p <0.05). During the use of umifenovir by day 4 and during the use of triazavirin by day 3 intoxication and catarrhal syndromes had been reversed, while in case of the absence of antiviral therapy, 55.8% of patients had continuing intoxication and catarrhal symptoms. Conclusion. The results of the study allow defining umifenovir and triazavirin as the first line of defense against acute respiratory viral infections with good efficacy and tolerability of the drugs.

scholarly journals FDA-approved Antitussive Dextromethorphan Enhances Antifibrotic Effectiveness of Pirfenidone in Bleomycin-induced Mice and Patients with Idiopathic Pulmonary Fibrosis

2021 ◽  
Author(s):  
Nana Liu ◽  
Yubao Wang ◽  
Jie Huang ◽  
Yunze Du ◽  
Luqing Wei ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Efficacy And Safety ◽  
Open Label ◽  
Double Blind ◽  
Randomized Controlled ◽  
Model Study ◽  
One Year

Abstract Background: We aimed to investigate whether dextromethorphan (DM), an antitussive agent, could improve the antifibrotic efficacy of pirfenidone in treating idiopathic pulmonary fibrosis, a fatal interstitial lung disease characterized by progressive and irreversible respiratory failure.Methods: A bleomycin-induced mouse pulmonary fibrosis model study and an open-label randomized clinical trial were performed to evaluate the effectiveness of pirfenidone combined with DM.Results: In the animal study, pirfenidone combined with DM protected the mice against bleomycin-induced pulmonary fibrosis with better capabilities than pirfenidone or DM alone, as indicated by lung histologic analysis and hydroxyproline levels. In the clinical study, pirfenidone plus DM markedly mitigated pulmonary function (FEV1 and FVC) decline and ameliorated chest HRCT imaging scores (ground glass opacities and reticulation) of patients with IPF compared with pirfenidone alone at one year after administration. There were no significant differences in adverse reactions between the pirfenidone-DM group and the pirfenidone group.Conclusions: Pirfenidone plus DM may be a better strategy to modify IPF than pirfenidone alone. The efficacy and safety of the combination of pirfenidone and DM for patients with IPF warrants further verification by a double-blind randomized controlled trial (RCT).

scholarly journals Residual Lung Function Impairment Is Associated with Hyperventilation in Patients Recovered from Hospitalised COVID-19: A Cross-Sectional Study

2021 ◽  
Vol 10 (5) ◽  
pp. 1036
Author(s):  
Ernesto Crisafulli ◽  
Daniele Gabbiani ◽  
Giulia Magnani ◽  
Gianluigi Dorelli ◽  
Fabiana Busti ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Lung Function ◽  
Clinical Symptoms ◽  
Gas Analysis ◽  
Cross Sectional ◽  
Arterial Blood Gas ◽  
Persistent Symptoms ◽  
Arterial Blood ◽  
Function Impairment ◽  
Lung Function Impairment

Patients who have recovered from COVID-19 show persistent symptoms and lung function alterations with a restrictive ventilatory pattern. Few data are available evaluating an extended period of COVID-19 clinical progression. The RESPICOVID study has been designed to evaluate patients’ pulmonary damage previously hospitalised for interstitial pneumonia due to COVID-19. We focused on the arterial blood gas (ABG) analysis variables due to the initial observation that some patients had hypocapnia (arterial partial carbon dioxide pressure-PaCO2 ≤ 35 mmHg). Therefore, we aimed to characterise patients with hypocapnia compared to patients with normocapnia (PaCO2 > 35 mmHg). Data concerning demographic and anthropometric variables, clinical symptoms, hospitalisation, lung function and gas-analysis were collected. Our study comprised 81 patients, of whom 19 (24%) had hypocapnia as compared to the remaining (n = 62, 76%), and defined by lower levels of PaCO2, serum bicarbonate (HCO3−), carbon monoxide diffusion capacity (DLCO), and carbon monoxide transfer coefficient (KCO) with an increased level of pH and arterial partial oxygen pressure (PaO2). KCO was directly correlated with PaCO2 and inversely with pH. In our preliminary report, hypocapnia is associated with a residual lung function impairment in diffusing capacity. We focus on ABG analysis’s informativeness in the follow-up of post-COVID patients.

Respiratory Muscle Strength and its use in COVID-19 pandemic: Role of Lung Function tests (Preprint)

2020 ◽  
Author(s):  
Dr. Anita Agrawal ◽  
Vivek Nalgilkar
Keyword(s):  
Respiratory Muscle ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Muscle Performance ◽  
Control Group ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Significant Difference

BACKGROUND There is a concern that pulmonary function testing could represent a potential way for COVID 19 transmission due to the congregation of patients with lung disease and because of the potential for coughing and droplet formation surrounding pulmonary function testing procedures There remain many unknowns facts about the possibility of transmission and the data are in evolution; however, the risks of transmission may be significant, and likely to vary based on the prevalence of the virus in the community and the age and severity of lung disease. Pulmonary functions routinely used for screening the COVID 19 patients are pulse oximeter and arterial blood gas analysis techniques. In addition to these two, the impaired respiratory muscle performance can also be tested. It is an underappreciated factor contributing to poor outcomes unfolding during the coronavirus pandemic. While impaired respiratory muscle performance is considered to be rare, it is more frequently encountered in patients with poorer health. The primary aim of this study is to discuss the potential role of respiratory muscle performance from the perspective of the coronavirus pandemic. We have done studies on COPD patients where the impaired respiratory muscle performance is reduced and when we compare that with control group, we realize that this is a good test to identify for COVID 19 patients. OBJECTIVE The purpose of this paper is to discuss the potential role of testing respiratory muscle performance. It can be utilised for screening large population during COVID-19 pandemic. METHODS This work was done at a Premier Medical Institute of Mumbai, which is a tertiary care centre catering to a large number of patients from all over Mumbai and also other parts of the state of Maharashtra. After proper diagnosis from the Chest Physician and labelled as COPD patient, the MIP measurements was conducted. Spirometry was done during the routine procedure. RESULTS In total, 90 subjects with a mean age of 60.3 ± 14.76 years and percentage of forced expiratory volume in 1 second (FEV1) of 89.67+9.92 L were recruited. MIP was significantly higher in control group than COPD. (z=-12.5). The analysis of variance (ANOVA) showed significant difference for maximal inspiratory pressure (p=0.003) between different stages of COPD. The MIP results showed that there was a statistically significant difference between mild and very severe (p=0.0019) as well as between moderate and very severe (p=0.002). The MIP results showed that there was a statistically significant difference between mild and very severe (p=0.0019) as well as between moderate and very severe (p=0.002). A significant positive correlation among maximal static pressure and FEV1 % (r= 0.5) was also observed. MIP thus is an effective technique to measure reduced performance of respiratory muscle strength. CONCLUSIONS In addition to pulse oximeter and arterial blood gas analysis, MIP can be the test of choice to test the impaired respiratory muscle performance in COVID 19 patients. Screening for respiratory muscle impairment in patients with dyspnea or characteristics associated increased risk of severe respiratory complication due to viral infection may be advantageous.

scholarly journals The effects and safety of pirfenidone in the treatment of idiopathic pulmonary fibrosis: a meta-analysis and systematic review

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Chenchen Zang ◽  
Yan Zheng ◽  
Yanqing Wang ◽  
Lisha Li
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Vital Capacity ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Control Group ◽  
High Quality ◽  
Free Survival ◽  
Randomized Controlled

Abstract Background It is necessary to systematically evaluate the efficacy and adverse reactions of pirfenidone in the treatment of patients with idiopathic pulmonary fibrosis (IPF). Methods Pubmed et al. databases were searched up to March 15, 2021 for randomized controlled trials (RCT) of pirfenidone in the treatment of IPF. Two authors collected and compared the indicators including progression-free survival (PFS), vital capacity (VC), forced vital capacity (FVC), and adverse reactions. RevMan 5.3 software and Stata 15.0 software were used for meta-analysis. Results A total of 8 reports with 9 RCTs involving 1824 IPF patients were included. Meta-analysis results showed that compared with the control group, pirfenidone could prolong the PFS phase of IPF patients (HR = 0.65, 95% CI 0.55 ~ 0.76, P < 0.001), slow down the VC of IPF patients (SMD = 0.43, 95% CI 0.21 ~ 0.66, P < 0.001), and decrease FVC (SMD = 0.31, 95% CI 0.14 ~ 0.48, P < 0.001). The main adverse reactions of pirfenidone were gastrointestinal reactions, photosensitivity and skin rashes. Conclusion Pirfenidone is beneficial to prolong the PFS of IPF patients, improve lung function, and it is safe for clinical use. However, more high-quality RCTs are still needed to provide reliable evidence for the treatment of IPF.

scholarly journals A Study on the Efficacy and Safety of a New Endoscopic Nasal Mask for Intravenous Anaesthesia With Respiratory Retention: a Randomized Controlled Trial

2021 ◽  
Author(s):  
Bin Yu ◽  
Mengying Wang ◽  
Xinyu Cheng ◽  
Haiyue Ma ◽  
Shuqi Xie
Keyword(s):  
Blood Gas Analysis ◽  
Day Surgery ◽  
Assisted Ventilation ◽  
Gas Analysis ◽  
Control Group ◽  
Nasal Mask ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Experimental Group

Abstract Background: General anaesthesia is the most common choice for day surgery, and a laryngeal mask airway is the most commonly used airway management method in general anaesthesia. Many of the complications of laryngeal mask airways are not conducive to a rapid recovery and discharge. The main purpose of this study was to verify the effectiveness and safety of a new endoscopic nasal mask for anaesthesia for a short surgery.Methods: This is a randomized controlled study of 96 patients who were scheduled to undergo hysteroscopy, breast mass resection or great saphenous vein lesion resection. They were randomly divided into two groups. After entering the operating room, 48 patients in the control group were treated with LMA-assisted ventilation, and 48 patients in the experimental group were subjected to assisted ventilation with the new endoscopic nasal mask. Both groups were given dexmedetomidine combined with sufentanil, propofol, dexamethasone, parecoxib sodium, dezocine and ramosetron to complete the intravenous general anaesthesia.The main observation indexes included the occurrence of hypoxemia (SpO2<90%) after anaesthesia induction; the occurrence of hypercapnia (PetCO2>50 mmHg) due to respiratory depression and changes in the PaO2 and PaCO2 values in the arterial blood gas analysis (ABG) results.Results: The occurrence of hypoxemia (SPO2<90%) in the experimental group and the control group was not significantly different (P>0.05). The occurrence of hypercapnia (PetCO2>50 mmHg) in the experimental group was significantly reduced compared to that in the control group (P<0.05), and the difference was statistically significant. According to the results of the preoperative and postoperative arterial blood gas analysis, there was no statistically significant difference in PaO2 and PaCO2 between the two groups (P>0.05). Conclusion: Both methods are safe and effective for anaesthesia during a short operation. The new endoscopic nasal mask can quickly and effectively provide effective ventilation . It is convenient for anaesthesia airway management for clinical short day surgery.Trial registration: Trial Registration: www.chictr.org.cn; registration no.: ChiCTR2000032548; date of registration: 3rd May 2020

scholarly journals Equine multinodular pulmonary fibrosis (EMPF): Five case reports

2013 ◽  
Vol 61 (3) ◽  
pp. 319-332 ◽  
Author(s):  
Bianca Schwarz ◽  
Andrea Klang ◽  
Barbora Bezdekova ◽  
Sára Sárdi ◽  
Orsolya Kutasi ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Bronchoalveolar Lavage ◽  
Case Reports ◽  
Clinical Signs ◽  
Case Series ◽  
Blood Gas Analysis ◽  
Endoscopic Examination ◽  
Gas Analysis ◽  
Arterial Blood Gas ◽  
Arterial Blood

Equine multinodular pulmonary fibrosis (EMPF), a progressive fibrosing interstitial lung disease has been associated with gammaherpesviruses. This case series describes five horses with EMPF. Three of the horses (two in Hungary, one in the Czech Republic) were diagnosed with EMPF ante mortem. They presented with typical clinical signs of EMPF including dyspnoea and weight loss. Arterial blood gas analysis revealed hypoxaemia. Blood work showed signs of inflammation like neutrophilia and hyperfibrinogenaemia. An endoscopic examination of the respiratory tract including cytology and culture of tracheobronchial secretion and bronchoalveolar lavage were performed, revealing secondary bacterial infection in one case. A suspected diagnosis of EMPF was made on the basis of a positive EHV-5 PCR from bronchoalveolar lavage and the findings of thoracic radiographs and ultrasound examination. In one case the diagnosis was confirmed by lung biopsy. All horses died or had to be euthanised despite treatment. Two horses (from Austria) were diagnosed with EMPF post mortem. They not only had EMPF but also concurrent other diseases which seemed to be associated with immunosuppression. Three horses showed the discrete form and two horses the diffuse form of EMPF. EHV-5 DNA was identified in lung tissue of all horses by PCR.

Sign in / Sign up

Export Citation Format

Share Document