Measurement properties of an asthma symptom and rescue medication use diary

2014 ◽  
Vol 52 (1) ◽  
pp. 88-97 ◽  
Author(s):  
Marci Clark ◽  
Susan Martin ◽  
Henrik Svedsater ◽  
Peter Dale ◽  
Loretta Jacques
Keyword(s):  
Rescue Medication ◽  
Asthma Symptom ◽  
Medication Use ◽  
Measurement Properties

scholarly journals Early and sustained symptom improvement with umeclidinium/vilanterol versus monotherapy in COPD: a post hoc analysis of the EMAX randomised controlled trial

2020 ◽  
Vol 14 ◽  
pp. 175346662092694
Author(s):  
Edward M Kerwin ◽  
Isabelle H Boucot ◽  
Claus F Vogelmeier ◽  
Francois Maltais ◽  
Ian P Naya ◽  
...  
Keyword(s):  
Rescue Medication ◽  
Controlled Trial ◽  
Medication Use ◽  
Symptom Improvement ◽  
Chronic Obstructive ◽  
Electronic Diary ◽  
Double Blind ◽  
Clinical Trial Registration ◽  
Bronchodilator Therapy ◽  
Post Hoc

Background: In chronic obstructive pulmonary disease (COPD), both the time needed for patients to gain symptom improvement with long-acting bronchodilator therapy and whether an early response is predictive of a sustained response is unknown. This study aimed to investigate how quickly meaningful symptom responses are seen in patients with COPD with bronchodilator therapy and whether these responses are sustained. Methods: Early MAXimisation of bronchodilation for improving COPD stability (EMAX) was a 24-week, double-blind, double-dummy, parallel-group trial that randomised patients to umeclidinium/vilanterol (UMEC/VI), umeclidinium or salmeterol. Daily Evaluating Respiratory Symptoms in COPD (E-RS:COPD) score and rescue salbutamol use were captured via an electronic diary and analysed initially in 4-weekly periods. Post hoc analyses assessed change from baseline in daily E-RS:COPD score and rescue medication use weekly (Weeks 1–8), and association between E-RS:COPD responder status at Weeks 1–4 and later time points. Results: In the intent-to-treat population ( n = 2425), reductions from baseline in E-RS:COPD scores and rescue medication use were apparent from Day 2 with all treatments. Treatment differences for UMEC/VI versus either monotherapy plateaued by Week 4–8 and were sustained at Weeks 21–24; improvements were consistently greater with UMEC/VI. For all treatments, most patients (60–85%) retained their Weeks 1–4 E-RS:COPD responder/non-responder status at Weeks 21−24. Among patients receiving UMEC/VI who were E-RS:COPD responders at Weeks 1–4, 70% were responders at Weeks 21–24. Conclusion: Patients with symptomatic COPD had greater potential for early symptom improvements with UMEC/VI versus either monotherapy. This benefit was generally maintained for 24 weeks. Early monitoring of treatment response can provide clinicians with an early indication of a patient’s likely longer-term response to prescribed bronchodilator treatment and will facilitate appropriate early adjustments in care. Clinical Trial Registration: NCT03034915, 2016-002513-22 (EudraCT Number). The reviews of this paper are available via the supplemental material section.

scholarly journals Rescue medication use as a patient-reported outcome in COPD: a systematic review and regression analysis

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Yogesh Suresh Punekar ◽  
Sheetal Sharma ◽  
Ankit Pahwa ◽  
Jitender Takyar ◽  
Ian Naya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Regression Analysis ◽  
Rescue Medication ◽  
Medication Use ◽  
Patient Reported Outcome ◽  
Patient Reported

scholarly journals Obesity as a susceptibility factor to indoor particulate matter health effects in COPD

2015 ◽  
Vol 45 (5) ◽  
pp. 1248-1257 ◽  
Author(s):  
Meredith C. McCormack ◽  
Andrew J. Belli ◽  
Deepak A. Kaji ◽  
Elizabeth C. Matsui ◽  
Emily P. Brigham ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Particulate Matter ◽  
Pulmonary Disease ◽  
Rescue Medication ◽  
Medication Use ◽  
Disease Stage ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Indoor Particulate Matter ◽  
The Impact

Our goal was to investigate whether obesity increases susceptibility to the adverse effects of indoor particulate matter on respiratory morbidity among individuals with chronic obstructive pulmonary disease (COPD).Participants with COPD were studied at baseline, 3 and 6 months. Obesity was defined as a body mass index ≥30 kg·m−2. At each time point, indoor air was sampled for 5–7 days and particulate matter (PM) with an aerodynamic size ≤2.5 μm (PM2.5) and 2.5–10 μm (PM2.5–10) was measured. Respiratory symptoms, health status, rescue medication use, exacerbations, blood biomarkers and exhaled nitric oxide were assessed simultaneously.Of the 84 participants enrolled, 56% were obese and all were former smokers with moderate-to-severe COPD. Obese participants tended to have less severe disease as assessed by Global Initiative for Chronic Obstructive Pulmonary Disease stage and fewer pack-years of smoking. There was evidence that obesity modified the effects of indoor PM on COPD respiratory outcomes. Increases in PM2.5 and PM2.5–10 were associated with greater increases in nocturnal symptoms, dyspnoea and rescue medication use among obese versus non-obese participants. The impact of indoor PM on exacerbations, respiratory status and wheeze also tended to be greater among obese versus non-obese participants, as were differences in airway and systemic inflammatory responses to indoor PM.We found evidence that obesity was associated with exaggerated responses to indoor fine and coarse PM exposure among individuals with COPD.

scholarly journals 24-h Nitrogen dioxide concentration is associated with cooking behaviors and an increase in rescue medication use in children with asthma

2017 ◽  
Vol 159 ◽  
pp. 118-123 ◽  
Author(s):  
Laura M. Paulin ◽  
D.’Ann L. Williams ◽  
Roger Peng ◽  
Gregory B. Diette ◽  
Meredith C. McCormack ◽  
...  
Keyword(s):  
Nitrogen Dioxide ◽  
Rescue Medication ◽  
Medication Use ◽  
Children With Asthma

scholarly journals Efficacy of indacaterol/glycopyrronium versus salmeterol/fluticasone in current and ex-smokers: a pooled analysis of IGNITE trials

2020 ◽  
pp. 00816-2020
Author(s):  
David M.G. Halpin ◽  
Claus F. Vogelmeier ◽  
Karen Mezzi ◽  
Pritam Gupta ◽  
Konstantinos Kostikas ◽  
...  
Keyword(s):  
Rescue Medication ◽  
Inhaled Corticosteroids ◽  
Smoking Status ◽  
Medication Use ◽  
Pooled Analysis ◽  
Forced Expiratory Volume ◽  
Limited Information ◽  
Asthmatic Patients ◽  
St George's Respiratory Questionnaire ◽  
The Difference

Inhaled corticosteroids have proven to be less effective in smoking asthmatic patients; however, there is limited information on the efficacy of inhaled corticosteroid-containing regimens in COPD patients who continue smoking. We evaluate the differential efficacy of once-daily indacaterol/glycopyrronium 110/50 µg compared with twice-daily salmeterol/fluticasone 50/500 µg in current smokers and ex-smokers, with COPD.A pooled analysis of data from ILLUMINATE, LANTERN and FLAME studies, was conducted to assess the efficacy of indacaterol/glycopyrronium compared with salmeterol/fluticasone in current smokers and ex-smokers, with COPD. Efficacy was assessed in terms of improvements in trough forced expiratory volume in 1 s (FEV1), transition dyspnoea index (TDI) focal score, St George's Respiratory Questionnaire (SGRQ) total score, reduced rescue medication use and exacerbation prevention at 26 weeks after the start of the therapy.In total, 1769 (38%) current smokers and 2848 (62%) ex-smokers were included. Patients treated with indacaterol/glycopyrronium experienced greater improvements in trough FEV1versus salmeterol/fluticasone in both current and ex-smokers (least squares mean treatment difference, 105 mL and 78 mL, respectively). Improvements in TDI focal score, SGRQ total score and reduction in rescue medication use were also greater with indacaterol/glycopyrronium versus salmeterol/fluticasone in current and ex-smokers. Further, indacaterol/glycopyrronium reduced all exacerbations (moderate/severe) compared with salmeterol/fluticasone, irrespective of smoking status. The difference in efficacy in favour of indacaterol/glycopyrronium was more prominent in current smokers in most cases.Indacaterol/glycopyrronium demonstrated greater efficacy versus salmeterol/fluticasone and the differences were generally more prominent in current smokers suggesting smoking may reduce the effects of salmeterol/fluticasone.

scholarly journals Efficacy of umeclidinium/vilanterol according to the degree of reversibility of airflow limitation at screening: a post hoc analysis of the EMAX trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Claus F. Vogelmeier ◽  
Paul W. Jones ◽  
Edward M. Kerwin ◽  
Isabelle H. Boucot ◽  
François Maltais ◽  
...  
Keyword(s):  
Lung Function ◽  
Rescue Medication ◽  
Inhaled Corticosteroids ◽  
Full Range ◽  
Medication Use ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Double Blind ◽  
Once Daily ◽  
Post Hoc

Abstract Background In patients with chronic obstructive pulmonary disease (COPD), the relationship between short-term bronchodilator reversibility and longer-term response to bronchodilators is unclear. Here, we investigated whether the efficacy of long-acting bronchodilators is associated with reversibility of airflow limitation in patients with COPD with a low exacerbation risk not receiving inhaled corticosteroids. Methods The double-blind, double-dummy EMAX trial randomised patients to umeclidinium/vilanterol 62.5/25 µg once daily, umeclidinium 62.5 µg once daily, or salmeterol 50 µg twice daily. Bronchodilator reversibility to salbutamol was measured once at screening and defined as an increase in forced expiratory volume in 1 s (FEV1) of ≥ 12% and ≥ 200 mL 10−30 min post salbutamol. Post hoc, fractional polynomial (FP) modelling was conducted using the degree of reversibility (mL) at screening as a continuous variable to investigate its relationship to mean change from baseline in trough FEV1 and self-administered computerised-Transition Dyspnoea Index (SAC-TDI) at Week 24, Evaluating Respiratory Symptoms-COPD (E-RS) at Weeks 21–24, and rescue medication use (puffs/day) over Weeks 1–24. Analyses were conducted across the full range of reversibility (−850–896 mL); however, results are presented for the range −100–400 mL because there were few participants with values outside this range. Results The mean (standard deviation) reversibility was 130 mL (156) and the median was 113 mL; 625/2425 (26%) patients were reversible. There was a trend towards greater improvements in trough FEV1, SAC-TDI, E-RS and rescue medication use with umeclidinium/vilanterol with higher reversibility. Improvements in trough FEV1 and reductions in rescue medication use were greater with umeclidinium/vilanterol compared with either monotherapy across the range of reversibility. Greater improvements in SAC-TDI and E-RS total scores were observed with umeclidinium/vilanterol versus monotherapy in the middle of the reversibility range. Conclusions FP analyses suggest that patients with higher levels of reversibility have greater improvements in lung function and symptoms in response to bronchodilators. Improvements in lung function and rescue medication use were greater with umeclidinium/vilanterol versus monotherapy across the full range of reversibility, suggesting that the dual bronchodilator umeclidinium/vilanterol may be an appropriate treatment for patients with symptomatic COPD, regardless of their level of reversibility.

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