International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Review Meta AnalysisMepolizumab in the treatment of eosinophilic chronic obstructive pulmonary disease.
Despite maximal medical therapy, a subset of patients with chronic obstructive pulmonary disease continue to suffer acute exacerbations. It is also clear that a subset of this population has elevated blood eosinophils. ⋯ Mepolizumab, a humanized monoclonal antibody against interleukin-5 (IL-5), may have a therapeutic effect in a subgroup of patients with COPD and eosinophilic airway inflammation. In this review, we discuss the biologic rationale for mepolizumab targeting IL-5 in eosinophilic COPD as well as the results of recently published clinical trials.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Multicenter Study Comparative Study Observational StudyComparative analysis of medical expenditure with nebulized budesonide versus systemic corticosteroids in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease in China.
Purpose: Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and is a leading cause of disability in China. Acute exacerbations of COPD (AECOPD) are a leading cause of hospitalizations, and account for a substantial proportion of medical expenditure. Corticosteroids are commonly used to manage AECOPD in hospitalized patients, so our objective was to analyze the total medical expenditure associated with nebulized budesonide (nBUD) vs. systemic corticosteroids (SCS) in this population. ⋯ Conclusion: AECOPD is a leading cause of hospitalization in China, which places substantial burden on the healthcare system. This post-hoc analysis suggests that nBUD regimens are associated with lower medical expenditure than SCS regimens in hospitalized patients with AECOPD, and may reduce the financial burden of COPD. However, prospective studies evaluating the effectiveness of nBUD therapies are warranted.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Meta AnalysisThe effects of single inhaler triple therapy vs single inhaler dual therapy or separate triple therapy for the management of chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials.
This study aims to compare the effects of single inhaler triple therapy comprised of inhaled corticosteroids (ICSs), long-acting β2-agonists (LABAs), and long-acting muscarinic receptor antagonists (LAMAs) with dual therapies comprised of either LABA/LAMA, ICS/LABA or separate ICS/LABA plus LAMA triple therapy. ⋯ The use of single inhaler triple therapy for COPD patients can result in lower rates of moderate or severe exacerbations of COPD as well as improved lung function and quality of life compared with dual therapy with LABA/LAMA or ICS/LABA.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Metabolic Syndrome in Early Chronic Obstructive Pulmonary Disease: Gender Differences and Impact on Exacerbation and Medical Costs.
Metabolic syndrome (MetS) is a well-known comorbidity of chronic obstructive pulmonary disease (COPD). However, their interrelationship, particularly in early COPD, remains unclear. Therefore, we aimed to assess the prevalence and clinical characteristics of MetS in patients with early COPD, and to explore the impact of MetS on the frequency of COPD exacerbations and associated medical costs. ⋯ MetS is more prevalent in women with early COPD. MetS increased the frequency of exacerbations and the medical costs in women with early COPD.
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Int J Chron Obstruct Pulmon Dis · Jan 2019
Randomized Controlled Trial Multicenter Study Comparative StudyNasal high-flow versus noninvasive ventilation in patients with chronic hypercapnic COPD.
Despite the encouraging results of noninvasive ventilation (NIV) in chronic hypercapnic COPD patients, it is also evident that some patients do not tolerate NIV or do not benefit from it. We conducted a study in which COPD patients with stable, chronic hypercapnia were treated with NIV and nasal high-flow (NHF) to compare effectiveness. ⋯ NHF may constitute an alternative to NIV in COPD patients with stable chronic hypercapnia, eg, those not tolerating or rejecting NIV with respect to pCO2 reduction and improvement in QoL.