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, and Blood Institute. COPD national action plan. Washington, D.C.: U.S. Department of Health and Human Services; 2017 [accessed 2018 Jul 6]. Available from: . van Agteren JE, Hnin K, Grosser D, Carson KV, Smith BJ. Bronchoscopic lung volume reduction procedures for chronicobstructivepulmonarydisease. Cochrane Database Syst Rev. 2017;2:CD012158. - - Kaplan RM, Ries AL. Health-related quality of life in emphysema. Proc Am Thorac Soc. 2008;5:561–566. - - Vogelmeier CF, Criner GJ, Martínez FJ, Anzueto (...) similar articles Cited by 1 PubMed Central articles NS Hopkinson. Am J Respir Crit Care Med 200 (11), 1329-1331. 2019. PMID 31560561. References Wheaton AG, Cunningham TJ, Ford ES, Croft JB Centers for Disease Control and Prevention (CDC) Employment and activity limitations among adults with chronicobstructivepulmonarydisease: United States, 2013. MMWR Morb Mortal Wkly Rep. 2015;64:289–295. - - U.S. Department of Health and Human Services, National Institutes of Health and National Heart, Lung
Efficacy and safety of inhaled alpha1-antitrypsin in patients with severe alpha1-antitrypsin deficiency and frequent exacerbations of COPD Patients with inherited α1-antitrypsin (AAT) deficiency (ZZ-AATD) and severe chronicobstructivepulmonarydisease (COPD) frequently experience exacerbations. We postulated that inhalation of nebulised AAT would be an effective treatment.We randomly assigned 168 patients to receive twice-daily inhalations of 80 mg AAT solution or placebo for 50 weeks (...) in the AAT-treated group and 2.67 in the placebo group (p=0.31). More patients receiving AAT reported treatment-related treatment-emergent adverse events compared to placebo (57.5% versus 46.9%, respectively) and they were more likely to withdraw from the study. After the first year of the study, when modifications to the handling of the nebuliser were introduced, the rate of safety events in the AAT-treated group dropped to that of the placebo group.We conclude that in AATD patients with severe COPD
Comparative safety of biologic versus conventional synthetic DMARDs in rheumatoid arthritis with COPD: a real-world population study Abatacept, a biologic DMARD, was associated with respiratory adverse events in a small subgroup of RA patients with chronicobstructivepulmonarydisease (COPD) in a trial. Whether this potential risk is specific to abatacept or extends to all biologics and targeted synthetic DMARDs (tsDMARDs) is unclear. We assessed the risk of adverse respiratory events (...) associated with biologic and tsDMARDs compared with conventional synthetic DMARDs (csDMARDs) among RA patients with concomitant COPD in a large, real-world cohort.We used a prevalent new-user design to study RA patients with COPD in the US-based MarketScan databases. New users of biologic DMARDs and/or tsDMARDs were matched on time-conditional propensity scores to new users of csDMARDs. Adverse respiratory events were estimated using Cox models comparing current use of biologic/tsDMARDs with csDMARDs.The
of Canada, Richmond Hill, Ontario, Canada; j Institut Universitaire de Cardiologie et de Pneumologie de Qu ebec, Universit e Laval, Qu ebec, Quebec, Canada; k Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; l Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada ABSTRACT In this guideline update, we highlight important and new findings related to pharmacological therapy of chronicobstructivepulmonarydisease (COPD (...) corticost eroïde en inhalation (CSI)/BALA, sauf chez les patients ayant d ej a subi des exac- erbations et dont le nombre d’ eosinophiles de sang p eriph erique est elev e. Il n’y a pas lieu de recourir a la monoth erapie de CSI; lorsqu’ils sont indiqu es, les CSI doivent ^ etre utilis es uniquement KEYWORDS Chronicobstructivepulmonarydisease; COPD; guideline; pharmacotherapy; Canadian Thoracic Society; CTS CONTACT Jean Bourbeau firstname.lastname@example.org Respiratory Epidemiology and Clinical Research
Effect of a Hospital-Initiated Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Patients Hospitalized With ChronicObstructivePulmonaryDisease: A Randomized Clinical Trial. Patients hospitalized for chronicobstructivepulmonarydisease (COPD) exacerbations have high rehospitalization rates and reduced quality of life.To evaluate whether a hospital-initiated program that combined transition and long-term self-management support for patients hospitalized (...) quality of life measured by the St George's Respiratory Questionnaire (SGRQ) at 6 months after discharge (score, 0 [best] to 100 [worst]; 4-point difference is clinically meaningful).Among 240 patients who were randomized (mean [SD] age, 64.9 [9.8] years; 61.7% women), 203 (85%) completed the study. The mean (SD) baseline SGRQ score was 62.3 (18.8) in the intervention group and 63.6 (17.4) in the usual care group. The mean number of COPD-related acute care events per participant at 6 months was 1.40
of Bias Appendix F. Results From Included Studies Appendix G. Results by Severity Appendix H. Adverse Events Appendix I. Inclusion and Exclusion Criteria of Included Studies Appendix J. Sensitivity Analysis Appendix K. Appendix References ES-1 Evidence Summary Background and Objectives Chronicobstructivepulmonarydisease (COPD) is a common respiratorydisease characterized by airflowlimitation and chronicrespiratory symptoms. The global prevalence is estimated to be greater than 10 percent (...) : MeiLan K. Han, M.D., M.S. University of Michigan Ann Arbor, MI Clare Hawkins, M.D. Aspire Health Care Houston, TX Cara Pasquale, M.P.H. COPD Patient Powered Research Network Washington, DC Antonello Punturieri, M.D., Ph.D. National Heart, Lung, and Blood Institute for ChronicObstructivePulmonaryDisease (COPD)/Environment Bethesda, MD Mark Steffen, M.D., M.P.H. Blue Cross and Blue Shield of Minnesota Eagan, MN James J. Stevermer, M.D., M.S.P.H. Department of Family and Community Medicine University
Current and future direct healthcare cost burden of chronicobstructivepulmonarydisease in Alberta, Canada Current and future direct healthcare cost burden of chronicobstructivepulmonarydisease in Alberta, Canada: Canadian Journal of Respiratory, Critical Care, and Sleep Medicine: Vol 0, No 0 | Search in: Journal Revue canadienne des soins respiratoires et critiques et de la médecine du sommeil 25 Views 0 CrossRef citations to date Altmetric Original Research Current and future direct (...) healthcare cost burden of chronicobstructivepulmonarydisease in Alberta, Canada , , , & Published online: 02 Jul 2019 Abstract OBJECTIVES: To examine the resource use and healthcare costs for chronicobstructivepulmonarydisease (COPD) in Alberta, Canada between 2008 and 2016 and model the future costs to 2030. METHODS: Interlinked hospitalization, ambulatory care, practitioner claims and drug databases in Alberta were used to identify COPD healthcare encounters and medications. Canadian Institution
in the medium term (over 5 years ) due to reduced all-cause mortality as well as proof of harm due to a short- term (up to 1 year postoperatively) increase in all-cause mortality. In terms of other outcomes, there were hints of benefit regarding dyspnea (as the only reported symptom of chronicobstructivepulmonarydisease [COPD]) and exacerbations as well as indications of benefit regarding improved exercise capacity and health-related quality of life. When compared to pulmonary rehabilitation (...) ? Dawid Pieper, Institute for Research in Operative Medicine, University Witten/Herdecke, Cologne, Germany ? Erich Stoelben, Lung Hospital Cologne-Merheim, Hospitals of Cologne City, Germany IQWiG thanks the external experts for their collaboration in the project. IQWiG employees ? Ulrike Paschen ? Christoph Mosch ? Stefan Sauerland ? Sibylle Sturtz ? Siw Waffenschmidt Keywords: Pneumonectomy, Bronchoscopy, PulmonaryEmphysema, Benefit Assessment Extract of final report N14-04 Version 1.0 LVR
the German original text is absolutely authoritative and legally binding. Extract IQWiG Reports – Commission No. H18-02 Targeted lung denervation using catheter ablation for chronicobstructivepulmonarydisease – Addendum to Commission H16-01 1 Extract of addendum H18-02 Version 1.0 Targeted lung denervation for COPD 27 April 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Targeted lung (...) for COPD 27 April 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - ii - IQWiG employees involved in the addendum: ? Martina Lietz ? Julia Kreis ? Fabian Lotz ? Stefan Sauerland Keywords: Catheter Ablation, PulmonaryDisease – ChronicObstructive, Assessment of Potential, Benefit Assessment Extract of addendum H18-02 Version 1.0 Targeted lung denervation for COPD 27 April 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - iii - Executive summary On 22 March 2018
status”, “geographical region”, “visit”, “baseline” and the interaction terms for “baseline” and “visit” as well as for “treatment group” and “visit”. c: Institute’s calculation. CAT: COPD Assessment Test; COPD: chronicobstructivepulmonarydisease; CI: confidence interval; FF: fluticasone furoate; MD: mean difference; MMRM: mixed-effects model repeated measures; N: number of analysed patients; RCT: randomized controlled trial; SD: standard deviation; SGRQ: St. George`s Respiratory Questionnaire; SE (...) -responders. c: Patients with a reduction in SGRQ total score by = 4 points (a reduction in score indicates improvement). Patients with missing values at baseline or at the date of analysis were rated as non-responders. CAT: COPD Assessment Test; CI: confidence interval; COPD: chronicobstructivepulmonarydisease; FF: fluticasone furoate; n: number of patients with (at least one) event; N: number of analysed patients; RCT: randomized controlled trial; RR: relative risk; SGRQ: St. George`s Respiratory
Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function. While air pollutants at historical levels have been associated with cardiovascular and respiratorydiseases, it is not known whether exposure to contemporary air pollutant concentrations is associated with progression of emphysema.To assess the longitudinal association of ambient ozone (O3), fine particulate matter (PM2.5), oxides of nitrogen (NOx), and black carbon (...) exposure with change in percent emphysema assessed via computed tomographic (CT) imaging and lung function.This cohort study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) Air and Lung Studies conducted in 6 metropolitan regions of the United States, which included 6814 adults aged 45 to 84 years recruited between July 2000 and August 2002, and an additional 257 participants recruited from February 2005 to May 2007, with follow-up through November 2018.Residence-specific
Statins versus placebo for people with chronicobstructivepulmonarydisease. Chronicobstructivepulmonarydisease (COPD) is a common, preventable, and treatable respiratorydisease. COPD exacerbations are associated with worse quality of life, increased hospitalisations, and increased mortality. Currently available pharmacological interventions have variable impact on exacerbation frequency. The anti-inflammatory effects of statins may lead to decreased pulmonary and systemic inflammation (...) , resulting in fewer exacerbations of COPD. Several observational studies have shown potential benefits of statins for patients with COPD.This review aims to evaluate available evidence on benefits and harms associated with statin therapy compared with placebo as adjunct therapy for patients with COPD. Primary objectives include the following.• To determine whether statins reduce mortality rates in COPD.• To determine whether statins reduce exacerbation frequency, improve quality of life, or improve lung
2019CochraneControlled trial quality: predicted high
C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. Point-of-care testing of C-reactive protein (CRP) may be a way to reduce unnecessary use of antibiotics without harming patients who have acute exacerbations of chronicobstructivepulmonarydisease (COPD).We performed a multicenter, open-label, randomized, controlled trial involving patients with a diagnosis of COPD in their primary care clinical record who consulted a clinician at 1 of 86 general medical (...) practices in England and Wales for an acute exacerbation of COPD. The patients were assigned to receive usual care guided by CRP point-of-care testing (CRP-guided group) or usual care alone (usual-care group). The primary outcomes were patient-reported use of antibiotics for acute exacerbations of COPD within 4 weeks after randomization (to show superiority) and COPD-related health status at 2 weeks after randomization, as measured by the Clinical COPD Questionnaire, a 10-item scale with scores ranging
puffers, does three-of-kind beat a pair? Clinical Question: In ChronicObstructivePulmonaryDisease (COPD) patients on Long-Acting Muscarinic Antagonist (LAMA) and Long-Acting Beta-Agonist (LABA) dual therapy, does adding inhaled corticosteroids (ICS) improve outcomes? Bottom Line: In COPD patients with =1 exacerbation per year, triple therapy reduces the risk of future exacerbations compared to LAMA/LABA dual therapy (one less in 36 patients/year) but increases the risk of pneumonia (one more in 34 (...) . 4. Cazzola M, Rogliani P, Calzetta L, et al. Eur Respir J. 2018; 52:1801586. 5. Ferguson GT, Rabe KF, Martinez FJ, et al. Lancet Respir. 2018; 6(10):747-58. 6. Global Initiative for ChronicObstructiveLungDisease. (2019). Global strategy for the diagnosis, management, and prevention of chronicobstructivepulmonarydisease. Available at https://goldcopd.org/gold-reports/ Accessed: May 11, 2019. 7. Magnussen H, Disse B, Rodriguez-Roisin R, et al. N Engl J Med. 2014; 371: 1285- 94. 8. Chapman KR
Oxygen compared to air during exercise training in COPD with exercise-induced desaturation Almost half the patients referred to pulmonary rehabilitation with chronicobstructivepulmonarydisease (COPD) desaturate during exercise. Although oxygen supplementation may ameliorate oxygen desaturation, the effects on outcomes of exercise training have not been rigorously evaluated. This study aimed to determine whether supplemental oxygen during exercise training was more effective than medical air (...) at 5 L·min-1 during exercise training consisting of treadmill and cycle exercise, three times per week for 8 weeks. Primary outcomes were the endurance shuttle walk test (ESWT) time and ChronicRespiratoryDisease Questionnaire (CRQ)-Total score.111 participants (60 males), mean±sd age 69±7 years, with moderate to severe COPD were recruited and 97 completed (Oxygen group n=52; Air group n=45). At the end of the 8-week training programme there were no between-group differences in change in ESWT
Discriminative Accuracy of FEV1:FVC Thresholds for COPD-Related Hospitalization and Mortality. According to numerous current guidelines, the diagnosis of chronicobstructivepulmonarydisease (COPD) requires a ratio of the forced expiratory volume in the first second to the forced vital capacity (FEV1:FVC) of less than 0.70, yet this fixed threshold is based on expert opinion and remains controversial.To determine the discriminative accuracy of various FEV1:FVC fixed thresholds for predicting (...) COPD-related hospitalization and mortality.The National Heart, Lung, and Blood Institute (NHLBI) Pooled Cohorts Study harmonized and pooled data from 4 US general population-based cohorts (Atherosclerosis Risk in Communities Study; Cardiovascular Health Study; Health, Aging, and Body Composition Study; and Multi-Ethnic Study of Atherosclerosis). Participants aged 45 to 102 years were enrolled from 1987 to 2000 and received follow-up longitudinally through 2016.Presence of airflowobstruction, which
Effect of Dexamethasone on Nocturnal Oxygenation in Lowlanders With ChronicObstructivePulmonaryDisease Traveling to 3100 Meters: A Randomized Clinical Trial During mountain travel, patients with chronicobstructivepulmonarydisease (COPD) are at risk of experiencing severe hypoxemia, in particular, during sleep.To evaluate whether preventive dexamethasone treatment improves nocturnal oxygenation in lowlanders with COPD at 3100 m.A randomized, placebo-controlled, double-blind, parallel trial (...) was performed from May 1 to August 31, 2015, in 118 patients with COPD (forced expiratory volume in the first second of expiration [FEV1] >50% predicted, pulse oximetry at 760 m ≥92%) who were living at altitudes below 800 m. The study was conducted at a university hospital (760 m) and high-altitude clinic (3100 m) in Tuja-Ashu, Kyrgyz Republic. Patients underwent baseline evaluation at 760 m, were taken by bus to the clinic at 3100 m, and remained at the clinic for 2 days and nights. Participants were
CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions The role of antibiotics in acute exacerbations of chronicobstructivepulmonarydisease (COPD) is controversial and a biomarker identifying patients who benefit from antibiotics is mandatory. We performed a randomised, controlled trial in patients with acute exacerbations of COPD, comparing C-reactive protein (CRP)-guided antibiotic treatment to patient reported symptoms in accordance with the Global (...) Initiative for ChronicObstructiveLungDisease (GOLD) strategy, in order to show a reduction in antibiotic prescription.Patients hospitalised with acute exacerbations of COPD were randomised to receive antibiotics based either on the GOLD strategy or according to the CRP strategy (CRP ≥50 mg·L-1).In total, 101 patients were randomised to the CRP group and 119 to the GOLD group. Fewer patients in the CRP group were treated with antibiotics compared to the GOLD group (31.7% versus 46.2%, p=0.028; adjusted