Respiratory medicine
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Respiratory medicine · Aug 2010
Randomized Controlled Trial Multicenter Study Comparative StudyEfficacy and safety of ipratropium bromide/albuterol delivered via Respimat inhaler versus MDI.
We compared the efficacy and safety of ipratropium bromide/albuterol delivered via Respimat inhaler, a novel propellant-free inhaler, versus chlorofluorocarbon (CFC)-metered dose inhaler (MDI) and ipratropium Respimat inhaler in patients with COPD. This was a multinational, randomized, double-blind, double-dummy, 12-week, parallel-group, active-controlled study. Patients with moderate to severe COPD were randomized to ipratropium bromide/albuterol (20/100mcg) Respimat inhaler, ipratropium bromide/albuterol MDI [36mcg/206mcg (Combivent Inhalation Aerosol MDI)], or ipratropium bromide (20mcg) Respimat inhaler. ⋯ Ipratropium bromide/albuterol Respimat inhaler had comparable efficacy to ipratropium bromide/albuterol MDI for FEV(1) area under the curve at 0-6h (AUC(0-6)), superior efficacy to ipratropium Respimat inhaler for FEV(1) AUC(0-4) and comparable efficacy to ipratropium Respimat inhaler for FEV(1) AUC(4-6). All active treatments were well tolerated. This study demonstrates that ipratropium bromide/albuterol 20/100mcg inhaler administered four times daily for 12 weeks had equivalent bronchodilator efficacy and comparable safety to ipratropium bromide/albuterol 36mcg/206mcg MDI, and significantly improved lung function compared with the mono-component ipratropium bromide 20 mcg Respimat inhaler. [Clinical Trial Identifier Number: NCT00400153].
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Respiratory medicine · Aug 2010
ReviewStatins in community acquired pneumonia: Evidence from experimental and clinical studies.
Statins are widely used to lower cholesterol and prevent complications of cardiovascular disease. The non-lipid lowering (pleiotropic) effects of statins may also have applications to the management of infections. These include effects on endothelial function, inflammation and coagulation pathways. ⋯ Experimental and animal studies suggest statins attenuate acute lung injury by modulating neutrophil function, reducing pro-inflammatory cytokine release and reducing vascular leak. Statins reduce endothelial dysfunction and have anti-thrombotic effects that improve outcome from pneumonia and sepsis in animal models. Clinical studies have provided conflicting results, but many suggest that statins may have a role in preventing pneumonia, or improving prognosis in hospitalised patients with community-acquired pneumonia.
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Respiratory medicine · Aug 2010
Relationship of emphysema and airway disease assessed by CT to exercise capacity in COPD.
To assess the association of emphysema and airway disease assessed by volumetric computed tomography (CT) with exercise capacity in subjects with chronic obstructive pulmonary disease (COPD). ⋯ These results suggest that the extent of emphysema but not airway disease measured by volumetric CT contributes independently to exercise limitation in subjects with COPD.