Comparative study of the efficacy and safety of theophylline and doxofylline in patients with bronchial asthma and chronic obstructive pulmonary disease

Author(s):  
Dushyant Lal ◽  
Sachin Manocha ◽  
Arunabha Ray ◽  
V.K. Vijayan ◽  
Raj Kumar

AbstractBronchial asthma and chronic obstructive pulmonary disease (COPD) are the major obstructive disorders that may contribute to the severity in individual patients. The present study was designed to compare the efficacy and safety of theophylline and doxofylline in patients with bronchial asthma and COPD.A total of 60 patients, 30 each with bronchial asthma and COPD, were enrolled for the study. Each group of 30 patients received standard treatment for asthma and COPD. Each group was again subdivided into two with 15 patients each, who received theophylline or doxofylline in addition to standard therapy, for a period of 2 months. Each patient was followed up fortnightly for the assessment of efficacy parameters using a pulmonary function test (PFT), clinical symptoms and emergency drug use, and safety was assessed by recording adverse drug reactions.Both theophylline and doxofylline produced enhancements in PFT at different time intervals in both asthma and COPD patients. The maximum beneficial effects were seen at 6 weeks for asthma patients and at 8 weeks for COPD patients for both theophylline and doxofylline.The comparative study showed that doxofylline was more effective as evidenced by improvement in PFT as well as clinical symptoms, and reduced incidence of adverse effects and emergency bronchodilator use.

2020 ◽  
Vol 24 (4) ◽  
pp. 80-86
Author(s):  
V. I. Trofimov ◽  
D. Z. Baranov

BACKGROUND: a comparative analysis of laboratory and instrumental tests at patients with bronchial obstructive diseases seems very actual due to the wide prevalence of these diseases. THE AIM: to evaluate characteristics of spirometry as well as allergic (total IgE, sputum eosinophils) and infectious (blood and sputum leucocytes, ESR, CRP, fibrinogen) inflammation markers at patients with bronchial obstructive diseases. PATIENTS AND METHODS: 104 case histories of patients with bronchial asthma, chronic obstructive pulmonary disease and overlap were analyzed including age, duration of smoking (pack-years), laboratory (clinical blood test, biochemical blood test, general sputum analysis, sputum culture) and instrumental (spirometry, body plethysmography, echocardiography) tests. Data were processed statistically with non-parametric methods. RESULTS: COPD patients were older than other groups’ patients, had the highest pack-years index. ACO patients were marked with maximal TLC and Raw, minimal FEV1, FEF25-75, FEV1/FVC. Patients with COPD had the highest inflammation markers (leucocyte count, CRP, fibrinogen). CONCLUSION: high active inflammation may cause severe lower airways possibility disorders at patients with COPD. Data related to a possible role of K. pneumoniaе in the pathogenesis of eosinophilic inflammation in lower airways are of significant interest. Patients with ACO occupy an intermediate position between asthma and COPD patients based on clinical and functional features.


Author(s):  
Babulal Bansiwal ◽  
Anees K. V. ◽  
Maneesha Jelia ◽  
Satyam Agarwal

Background: Chronic obstructive pulmonary disease is preventable and treatable disease with progressive persistent airflow limitation and enhanced chronic inflammatory response in the airways. Indian council of medical research conducted a study and found that total burden of COPD in India has more than doubled to about 14.84 million in 2011 from about 6.45 million in 1971Methods: It was an open label cross sectional study. It was conducted on patients attending the outpatient department of respiratory medicine, new medical college and hospital, Kota, over a period of one year. 100 COPD patients attending the respiratory outpatient department of GMC, Kota and fulfilling the inclusion criteria’s were included in the study. A diagnosis and severity of COPD was established by clinical symptoms and spirometric data as per GOLD guideline (ratio of FEV1 and forced vital capacity <0.7).Results: We found a significant negative correlation (Pearson correlation coefficient r = -0.664, p< 0.001) between 6 MWD and BODE index in study population.Conclusions: Thus, we concluded that the functional exercise capacity of COPD patients measured by 6MWT deteriorates linearly with severity of the disease assessed by the GOLD staging criteria. Hence we can use 6 MWT for assessing the severity of COPD in place of spirometry where the facility of spirometry is not feasible.


2021 ◽  
Vol 12 ◽  
Author(s):  
Anaëlle Muggeo ◽  
Jeanne-Marie Perotin ◽  
Audrey Brisebarre ◽  
Sandra Dury ◽  
Valérian Dormoy ◽  
...  

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by airflow limitation. This chronic respiratory disease represents the third leading cause of death worldwide. Alteration of the airway microbiota has been reported to be associated with exacerbation frequency in COPD, but its role on the symptoms in patients at stable state is still incompletely described. This study aimed to determine whether bacteria isolated in sputum can be associated with the clinical features of COPD patients within stable state. Our study highlights, for the first time, that altered microbiota with Enterobacterales is associated with pejorative clinical symptoms in stable COPD patients. The airway microbiota of 38 patients was analyzed using an extended culture approach and mass spectrometry identification. Cluster analysis by principal coordinate analysis of the bacterial communities showed that the patients could be classified into three distinct clusters in our cohort. The clusters showed no differences in proportions of the phylum, but one of them was associated with a high prevalence of Enterobacterales (71.4% in cluster 1 vs. 0% in cluster 3), loss of microbiota diversity, and higher bacterial load (107 vs. 105 CFU/ml, respectively) and characterized by predominant cough and impact on mental health. These novel findings, supported by further studies, could lead to modifying the processing of COPD sputum in the everyday practice of clinical microbiology laboratories.


2018 ◽  
Vol 96 (3) ◽  
pp. 257-261
Author(s):  
Anna G. Romanovskikh ◽  
Yu. G. Belotserkovskaya ◽  
I. P. Smirnov

Chronic obstructive pulmonary disease (COPD) is an urgent problem of modern healthcare. One of the most frequent approaches to the therapy of the COPD remains the appointment of inhaled corticosteroids (ICSs) and long-acting β2-agonists (LABAs) in fixed-dose combinations. At the same time, the role and place of fixed-dose combinations (ICS/LABA) in COPD therapy is currently being actively discussed. The presented article describes the efficacy and safety of fixed-dose combinations (ICS/LABA) in COPD patients, modern approaches to the appointment of ICS/LABA.


Author(s):  
Vineet Mahajan ◽  
Himanshu Sareen ◽  
Surya Kant ◽  
Jyoti Bajpai ◽  
Apoorva Narain ◽  
...  

Background: Psychiatric co morbidities tend to occur quite frequently in patients of chronic respiratory diseases mainly bronchial asthma and Chronic Obstructive Pulmonary Disease (COPD) but still it is highly under diagnosed. Aim and objective of the study was to find out the prevalence of psychiatric co morbidities in asthma and COPD and to correlate them with disease severity according to Global Initiative against Obstructive Lung Disease (GOLD) and Global Initiative against Asthma (GINA) guidelines.Methods: Study was conducted in Department of TB and Chest in association with Department of Psychiatry of Punjab Institute of Medical Sciences, a secondary care medical college in north India. A total 204 patients, 68 of bronchial asthma, 68 0f COPD and 68 were controls included in the study. Diagnosis and severity of respiratory diseases was assessed by spirometry. Evaluation of psychiatric co morbidities was done using the MINI international neuropsychiatric interview questionnaire.Results: The frequency of psychiatric co morbidities in COPD patients was significantly higher (32.4%) compared to patients of bronchial asthma (20.6%). The most common co morbidity in both arms was generalized anxiety disorder (17.6% in COPD patients and 10.3% in patients of bronchial asthma.Conclusions: COPD patients have a higher frequency of psychiatric co morbidities compared to bronchial asthma patients and control population. These should be properly screened and treated. 


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


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