Respiratory medicine
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Respiratory medicine · Dec 2014
Randomized Controlled Trial Multicenter StudyEfficacy and safety of umeclidinium/vilanterol 62.5/25 mcg and tiotropium 18 mcg in chronic obstructive pulmonary disease: results of a 24-week, randomized, controlled trial.
Combinations of inhaled long-acting bronchodilator therapies such as muscarinic antagonists and β2-agonists may be more effective than monotherapy in the treatment of chronic obstructive pulmonary disease (COPD). ⋯ UMEC/VI was associated with statistically significant and clinically meaningful improvements in lung function versus TIO. UMEC/VI was well tolerated. UMEC/VI 62.5/25 mcg could provide an effective new treatment option for patients with moderate-to-very severe COPD.
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Respiratory medicine · Dec 2014
Randomized Controlled Trial Comparative StudyCost-effectiveness of the LABA/LAMA dual bronchodilator indacaterol/glycopyrronium in a Swedish healthcare setting.
Indacaterol/glycopyrronium (IND/GLY) is a once-daily inhaled fixed-dose combination of indacaterol (IND), a long-acting β2-adrenergic agonist (LABA), and glycopyrronium (GLY), a long-acting muscarinic antagonist (LAMA) for use as maintenance treatment to relieve symptoms of chronic obstructive pulmonary disease (COPD) in adults. ⋯ IND/GLY is cost-minimising vs IND + GLY and dominates SFC in the maintenance treatment of COPD patients in Sweden. Encouraging dual bronchodilator therapy over an ICS-containing combination results in lower total costs and better outcomes compared to combination therapy including fluticasone in moderate-to-severe COPD patients with low exacerbation risk.
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Respiratory medicine · Dec 2014
Randomized Controlled TrialRandomized trial of non-invasive ventilation combined with exercise training in patients with chronic hypercapnic failure due to chronic obstructive pulmonary disease.
Non-invasive ventilation and exercise training might prove beneficial in the management of COPD patients. ⋯ The combination of ventilation and exercise training had greater benefits than the separate treatments: improvements were observed in both blood gases and the levels of more biomarkers decreased. In addition, submaximal exercise capacity increased in all groups. The improvements seen in BODE index, perception of dyspnoea and quality of life were similar in all groups.
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Respiratory medicine · Dec 2014
Observational StudySemiquantitative cough strength score and associated outcomes in noninvasive positive pressure ventilation patients with acute exacerbation of chronic obstructive pulmonary disease.
Weak cough may result in the failure of noninvasive positive pressure ventilation (NPPV) in patients with AECOPD. However, no detailed descriptions have yet been published for the measurement of cough strength and associated outcomes in AECOPD patients. ⋯ AECOPD patients with weak cough had a high risk of NPPV failure. SCSS, APACHE II scores, and total proteins were predictors of NPPV failure. Combined, these factors increased the power to predict NPPV failure.
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Respiratory medicine · Dec 2014
Association of lung function with coronary heart disease and cardiovascular disease outcomes in elderly: the Rancho Bernardo study.
Lung function is inversely associated with coronary heart disease (CHD) and cardiovascular disease (CVD). We evaluated the prospective association of reduced lung function by spirometry and CHD or CVD events in older community-dwelling adults. ⋯ FEV1 and FVC are inversely associated with risk of future CHD and CVD events in older community-dwelling adults and may add to CVD risk stratification in the elderly.