scholarly journals Post hoc Analysis of Clinical Outcomes in Placebo- and Pirfenidone-Treated Patients with IPF Stratified by BMI and Weight Loss

Respiration ◽  
2021 ◽  
pp. 1-13
Author(s):  
Stéphane Jouneau ◽  
Bruno Crestani ◽  
Ronan Thibault ◽  
Mathieu Lederlin ◽  
Laurent Vernhet ◽  
...  
Keyword(s):  
Weight Loss ◽  
Vital Capacity ◽  
Diffusing Capacity ◽  
Walk Distance ◽  
Serious Adverse Events ◽  
No Weight Loss ◽  
St George's Respiratory Questionnaire ◽  
Relative Decline ◽  
Post Hoc ◽  
Baseline Bmi

Background: Weight loss is frequently reported in patients with idiopathic pulmonary fibrosis (IPF) and may be associated with worse outcomes in these patients. Objective: The aim of this study was to investigate the relationships between body mass index (BMI) and weight loss, and outcomes over 1 year in patients with IPF. Methods: Data were included from placebo patients enrolled in ASCEND (NCT01366209) and CAPACITY (NCT00287716 and NCT00287729), and all patients in INSPIRE (NCT00075998) and RIFF Cohort A (NCT01872689). An additional analysis included data from pirfenidone-treated patients. Outcomes (annualized change in percent predicted forced vital capacity [%FVC], percent predicted carbon monoxide diffusing capacity, 6-min walk distance, St. George’s Respiratory Questionnaire total score, hospitalization, mortality, and serious adverse events) were analyzed by baseline BMI (<25 kg/m2, 25 kg/m2–<30 kg/m2, or ≥30 kg/m2) and annualized percent change in body weight (no loss, >0–<5% loss, or ≥5% loss). Results: Placebo-treated patients with a baseline BMI <25 kg/m2 or annualized weight loss may experience worse outcomes versus those with a baseline BMI ≥25 kg/m2 or no weight loss. The proportion of placebo-treated patients who experienced a relative decline of ≥10% in %FVC or death up to 1 year post-randomization was highest in patients with a baseline BMI <25 kg/m2. Pirfenidone-treated patients with an annualized weight loss ≥5% may also experience worse outcomes versus those with no weight loss. Conclusions: Patients with a baseline BMI <25 kg/m2 or annualized weight loss of >0–<5% or ≥5% may experience worse outcomes over 1 year versus those with a baseline BMI ≥25 kg/m2 or no weight loss.

651-P: Higher Doses of Dulaglutide Induce Weight Loss in Patients with Type 2 Diabetes (T2D) Regardless of Baseline BMI: Post-hoc Analysis of AWARD-11

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 651-P
Author(s):  
ENZO BONORA ◽  
JUAN P. FRIAS ◽  
RALEIGH MALIK ◽  
ANITA KWAN ◽  
SOHINI RAHA ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Post Hoc Analysis ◽  
Induce Weight Loss ◽  
Post Hoc ◽  
Baseline Bmi ◽  
Higher Doses

scholarly journals Combined pulmonary fibrosis and emphysema characteristics in a Greek cohort

2019 ◽  
Vol 5 (1) ◽  
pp. 00014-2018 ◽  
Author(s):  
Foteini Malli ◽  
Despoina Papakosta ◽  
Katerina Antoniou ◽  
Maria Dimadi ◽  
Vlassis Polychronopoulos ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Vital Capacity ◽  
Pulmonary Arterial Pressure ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Diffusing Capacity ◽  
Walk Distance ◽  
Systolic Pulmonary Arterial Pressure ◽  
Pulmonary Arterial ◽  
Worse Prognosis

BackgroundCombined pulmonary fibrosis and emphysema (CPFE) has recently received great attention, with studies suggesting that it presents a distinct clinical entity while others have challenged this hypothesis. This nationwide study aimed to describe a large cohort of Greek CPFE patients and to examine potential prognostic factors for survival.MethodsThis retrospective study included 97 patients with CPFE. Demographic and clinical data, pulmonary function tests, echocardiography results and bronchoalveolar lavage analysis were recorded.ResultsMost patients were male (94.8%) and 92% were current or ex-smokers. Spirometry results were abnormal (forced vital capacity (FVC) 72.9±19.9% pred and forced expiratory volume in 1 s/FVC 82.9±9.7%) with reduced diffusing capacity of the lung for carbon monoxide (DLCO) (42.3±17.4% pred). Mean systolic pulmonary arterial pressure was 41.9±19.7 mmHg and pulmonary hypertension was present in 58.8% of patients. Mean 6-min walk distance was 335.4±159.4 m. Mean emphysema score was 14.23±8.69% and mean interstitial lung disease (ILD) extent was 39.58±19.82%. Mean survival was 84 months (95% CI 72–96 months). Patients with DLCO ≥39% pred had better survival than patients with DLCO <39% pred (p=0.031). Patients with ILD extent ≥30% had worse survival than patients with ILD extent <30% (p=0.037).ConclusionsOur results indicate that CPFE patients have preserved lung volumes associated with disproportionately reduced DLCO, while reduced DLCO and increased ILD extent was associated with worse prognosis.

The effect of conductive ventilation heterogeneity on diffusing capacity measurement

2008 ◽  
Vol 104 (4) ◽  
pp. 1094-1100 ◽  
Author(s):  
Sylvia Verbanck ◽  
Daniel Schuermans ◽  
Sophie Van Malderen ◽  
Walter Vincken ◽  
Bruce Thompson
Keyword(s):  
Carbon Monoxide ◽  
Vital Capacity ◽  
Experimental Situation ◽  
Normal Subjects ◽  
Diffusing Capacity ◽  
Capacity Measurement ◽  
Alveolar Volume ◽  
Estimation Errors ◽  
Single Breath ◽  
Ventilation Heterogeneity

It has long been assumed that the ventilation heterogeneity associated with lung disease could, in itself, affect the measurement of carbon monoxide transfer factor. The aim of this study was to investigate the potential estimation errors of carbon monoxide diffusing capacity (DlCO) measurement that are specifically due to conductive ventilation heterogeneity, i.e., due to a combination of ventilation heterogeneity and flow asynchrony between lung units larger than acini. We induced conductive airway ventilation heterogeneity in 35 never-smoker normal subjects by histamine provocation and related the resulting changes in conductive ventilation heterogeneity (derived from the multiple-breath washout test) to corresponding changes in diffusing capacity, alveolar volume, and inspired vital capacity (derived from the single-breath DlCO method). Average conductive ventilation heterogeneity doubled ( P < 0.001), whereas DlCO decreased by 6% ( P < 0.001), with no correlation between individual data ( P > 0.1). Average inspired vital capacity and alveolar volume both decreased significantly by, respectively, 6 and 3%, and the individual changes in alveolar volume and in conductive ventilation heterogeneity were correlated ( r = −0.46; P = 0.006). These findings can be brought in agreement with recent modeling work, where specific ventilation heterogeneity resulting from different distributions of either inspired volume or end-expiratory lung volume have been shown to affect DlCO estimation errors in opposite ways. Even in the presence of flow asynchrony, these errors appear to largely cancel out in our experimental situation of histamine-induced conductive ventilation heterogeneity. Finally, we also predicted which alternative combination of specific ventilation heterogeneity and flow asynchrony could affect DlCO estimate in a more substantial fashion in diseased lungs, irrespective of any diffusion-dependent effects.

Nonlinear increases in diffusing capacity during exercise by seated and supine subjects

1981 ◽  
Vol 51 (4) ◽  
pp. 858-863 ◽  
Author(s):  
D. L. Stokes ◽  
N. R. MacIntyre ◽  
J. A. Nadel
Keyword(s):  
Carbon Monoxide ◽  
Oxygen Consumption ◽  
Healthy Subjects ◽  
Vital Capacity ◽  
Maximal Exercise ◽  
Sitting Position ◽  
Diffusing Capacity ◽  
Heavy Exercise ◽  
Lung Volumes ◽  
Rate Of Increase

To study the effects of exercise on pulmonary diffusing capacity, we measured the lungs' diffusing capacity for carbon monoxide (DLCO) during exhalation from 30 to 45% exhaled vital capacity in eight healthy subjects at rest and during exercise while both sitting and supine. We found that DLCO at these lung volumes in resting subjects was 26.3 +/- 3.2% (mean +/- SE) higher in the supine than in the sitting position (P less than 0.001). We also found that, in both positions, DLCO at these lung volumes increased significantly (P less than 0.001) with increasing exercise and approached similar values at maximal exercise. The pattern of increase in DLCO with an increase in oxygen consumption in both positions was curvilinear in that the rate of increase in DLCO during mild exercise was greater than the rate of increase in DLCO during heavy exercise (P = 0.02). Furthermore, in the supine position during exercise, it appeared that DLCO reached a physiological maximum.

scholarly journals Efficacy of early antifibrotic treatment for idiopathic pulmonary fibrosis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keishi Sugino ◽  
Hirotaka Ono ◽  
Natsumi Watanabe ◽  
Masahiro Ando ◽  
Eiyasu Tsuboi ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Disease Progression ◽  
Vital Capacity ◽  
Early Stage ◽  
Japanese Patients ◽  
Oxygen Desaturation ◽  
Stage I ◽  
Relative Decline ◽  
Antifibrotic Drugs

Abstract Background Although antifibrotic drugs, including nintedanib and pirfenidone, slow the progression of idiopathic pulmonary fibrosis (IPF), there is little data about the timing of start of antifibrotic treatment in real-world clinical practice. The present study aimed to clarify the efficacy of nintedanib and pirfenidone in patients with early-stage IPF. Methods We compared survival and disease progression between patients with IPF with Japanese Respiratory Society (JRS) disease severity system stage I with and without oxygen desaturation on the 6-min walk test (6MWT) and increased the gender–age–physiology (GAP) staging. We examined the efficacy of antifibrotic drugs in patients with early-stage IPF. Results The severity of stage I IPF (n = 179) according to the JRS criteria consisted of the following GAP staging criteria: stage I, 111 cases; stage II, 58 cases; stage III, 10 cases. The duration from the initial visit to disease progression and survival time was significantly shorter in JRS stage I patients with oxygen desaturation on the 6MWT or with increased GAP staging (unfavorable group) compared with patients without those factors. In the unfavorable group, the relative decline in percentage predicted forced vital capacity (%FVC) over 6 months was significantly lower in patients undergoing antifibrotic treatment compared with non-treated patients. Conclusion Antifibrotic drugs have a beneficial effect on the decline in %FVC in Japanese patients with early-stage IPF who have oxygen desaturation on the 6MWT or increased GAP staging.

Pulmonary function in men after oxygen breathing at 3.0 ATA for 3.5 h

1991 ◽  
Vol 71 (3) ◽  
pp. 878-885 ◽  
Author(s):  
J. M. Clark ◽  
R. M. Jackson ◽  
C. J. Lambertsen ◽  
R. Gelfand ◽  
W. D. Hiller ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Large Change ◽  
Forced Expiratory Volume ◽  
Diffusing Capacity ◽  
Mild Degree ◽  
Oxygen Breathing ◽  
Multiple Organs ◽  
Expiratory Flow

As a pulmonary component of Predictive Studies V, designed to determine O2 tolerance of multiple organs and systems in humans at 3.0–1.5 ATA, pulmonary function was evaluated at 1.0 ATA in 13 healthy men before and after O2 exposure at 3.0 ATA for 3.5 h. Measurements included flow-volume loops, spirometry, and airway resistance (Raw) (n = 12); CO diffusing capacity (n = 11); closing volumes (n = 6); and air vs. HeO2 forced vital capacity maneuvers (n = 5). Chest discomfort, cough, and dyspnea were experienced during exposure in mild degree by most subjects. Mean forced expiratory volume in 1 s (FEV1) and forced expiratory flow at 25–75% of vital capacity (FEF25–75) were significantly reduced postexposure by 5.9 and 11.8%, respectively, whereas forced vital capacity was not significantly changed. The average difference in maximum midexpiratory flow rates at 50% vital capacity on air and HeO2 was significantly reduced postexposure by 18%. Raw and CO diffusing capacity were not changed postexposure. The relatively large change in FEF25–75 compared with FEV1, the reduction in density dependence of flow, and the normal Raw postexposure are all consistent with flow limitation in peripheral airways as a major cause of the observed reduction in expiratory flow. Postexposure pulmonary function changes in one subject who convulsed at 3.0 h of exposure are compared with corresponding average changes in 12 subjects who did not convulse.

scholarly journals Action of ethylene on postharvest of summer squash ‘Menina Brasileira’

Revista CERES ◽  
2017 ◽  
Vol 64 (4) ◽  
pp. 360-367
Author(s):  
Fernanda Ferreira de Araújo ◽  
Lucas Cavalcante da Costa ◽  
Tania Pires da Silva ◽  
Mário Puiatti ◽  
Fernando Luiz Finger
Keyword(s):  
Weight Loss ◽  
Chlorophyll Content ◽  
Electrolyte Leakage ◽  
Soluble Sugars ◽  
Control Treatment ◽  
Ethylene Concentration ◽  
Malondialdehyde Content ◽  
Summer Squash ◽  
No Weight Loss ◽  
Exogenous Ethylene

ABSTRACT The purpose of this study was to evaluate the sensitivity and the physiological responses of summer squash ‘Menina Brasileira’ to ethylene. Immature fruits were harvested and placed in 20 L sealed buckets, in which ethylene was applied at concentrations of 0.1, 1.0, 10, 100, and 1000 μL L-1 for 24 h. Fruits were placed in buckets with no ethylene as a control treatment. Thereafter, the fruits were taken out of the buckets and maintained on bench, wherein on days 0, 2, 4, 6, and 8, they were evaluated regarding the accumulated fresh weight loss, soluble sugars, reducing and non-reducing sugars, starch, total chlorophyll, content of malondialdehyde, and electrolyte leakage. Fruits of summer squash ‘Menina Brasileira’ showed sensitivity to exogenous ethylene with no weight loss stimulation. Additionally, the fruits exhibited small changes in nutritional quality attributes and changes in the external fruit appearance, including decreased chlorophyll content as well as damage to cell membrane characterized by increase in malondialdehyde content and electrolyte leakage. These changes were stimulated by increasing exogenous ethylene concentration.

scholarly journals Alterations in Food Reward Regarding Bariatric Surgery Type and Weight Loss Outcomes: An Exploratory Study

2022 ◽  
Author(s):  
Erika Guyot ◽  
Julie-Anne Nazare ◽  
Pauline Oustric ◽  
Maud Robert ◽  
Emmanuel Disse ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Exploratory Study ◽  
Food Reward ◽  
Food Preferences ◽  
P Value ◽  
Cross Sectional ◽  
Weight Loss Outcomes ◽  
Post Hoc ◽  
Type Of Surgery

Changes in food preferences after bariatric surgery may alter its effectiveness as a treatment for obesity. We aimed to compare food reward for a comprehensive variety of food categories between patients who received a sleeve gastrectomy (SG) or a Roux-en-Y gastric bypass (RYGB) and to explore whether food reward differs according to weight loss. In this cross-sectional exploratory study, food reward was assessed using the Leeds Food Preference Questionnaire (LFPQ). We assessed liking and wanting of eleven food categories. Comparisons were done regarding type of surgery and Total Weight Loss (TWL; based on tercile distribution). Fifty-six patients (30 SG and 26 RYGB) were included (women: 70%; age: 44.0 (11.1) y). Regarding the type of surgery, scores were not significantly different between SG and RYGB, except for &lsquo;non-dairy products &ndash; without color&rsquo; explicit liking (p = 0.04). Regarding TWL outcomes, explicit liking, explicit wanting and implicit wanting, scores were significantly higher for Good responders than Low responders for &lsquo;No meat &ndash; High fat&rsquo; (post-hoc corrected p-value: 0.04, 0.03 and 0.04, respectively). Together, our results failed to identify major differences in liking and wanting regarding the type of surgery and tended to indicate that higher weight loss might be related to a higher reward for high protein-content food. Rather to focus only on palatable foods, future studies should also consider a broader range of food items, including protein reward.

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