Respiratory medicine
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Respiratory medicine · Mar 2003
Randomized Controlled Trial Multicenter Study Clinical TrialCost-effectiveness of fluticasone propionate in the treatment of chronic obstructive pulmonary disease: a double-blind randomized, placebo-controlled trial.
Chronic obstructive pulmonary disease (COPD) is a debilitating disease and places a large financial burden on health-care systems and society. We prospectively evaluated the cost-effectiveness offluticasone propionate (FP) treatment in patients with moderate-to-severe COPD, who were symptomatic on regular bronchodilator therapy. ⋯ Treatment with FP was associated with statistically significant clinical benefits in patients with moderate-to-severe COPD currently symptomatic on regular bronchodilator therapy. As the differences in direct and total costs compared with placebo were small and non-significant, this treatment can be considered cost-effective in this patient population.
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Respiratory medicine · Mar 2003
Randomized Controlled Trial Multicenter Study Clinical TrialThe salmeterol/fluticasone combination is more effective than fluticasone plus oral montelukast in asthma.
The aim of this study was to compare the efficacy and safety of salmeterol/fluticasone propionate combination product (SFC) with fluticasone propionate (FP) plus oral montelukast (M) over 12 weeks in symptomatic asthma patients. The study was a multinational, randomised, double-blind, double-dummy, parallel-group design in patients aged > or = 15 years. After a 4-week run-in during which all patients received FP 100 microg twice daily, patients were randomised to inhaled SFC (50/100 microg) twice daily or inhaled FP 100 microg twice daily and oral M 10 mg once daily. ⋯ Patients in the SFC group were also significantly more likely to have a rescue-free day. Both treatments were equally well tolerated. Combination therapy with FP plus salmeterol (SFC) produced significantly greater improvements in lung function and asthma control than the addition of montelukastto FP.
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Respiratory medicine · Mar 2003
Multicenter StudyEconomic analysis of the Confronting COPD survey: an overview of results.
An economic analysis of data from a large-scale international survey, Confronting COPD in North America and Europe, was conducted in seven countries (Canada, France, Italy, The Netherlands, Spain, the U. K and the U. SA.), to investigate the burden of chronic obstructive pulmonary disease (COPD). ⋯ The survey also demonstrated that the societal costs of COPD were 4-17 times higher in patients with severe COPD than in patients with mild COPD. Patients with comorbid conditions (accounting for 30-57% of patients in each country) were also particularly costly to society. These results suggest that a high priority should be given to interventions aimed at delaying the progression of disease, preventing exacerbations and reducing the risk of comorbidities, in order to alleviate the clinical and economic burden of COPD in North America and Europe.
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Respiratory medicine · Mar 2003
Peak inspiratory flow through diskus and turbuhaler, measured by means of a peak inspiratory flow meter (In-Check DIAL).
With a handheld peak inspiratory flow (PIF) meter (In-Check DIAL), the internal resistance of the Diskus (DKR) and the Turbuhaler (THR) can be simulated by means of calibrated resistances. This study investigated whether patients with asthma or chronic obstructive pulmonary disease could generate a PIF which is optimal for the Diskus (DK) (30 l/min) and theTurbuhaler (TH) (60 l/min). Peak expiratory flow (PEF) and maximal inspiratory pressure (MIP) were also assessed. ⋯ Analysis showed that the female gender and an exacerbation appeared to be independent predictors of the inability to generate an adequate PIF via the THR. Twelve per cent of patients (25% of females) could not generate the optimal inspiratory flow via the THR. When in doubt whether the patient can generate an adequate inspiration, measurement with the In-Check DIAL is recommended.