Respiratory medicine
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Respiratory medicine · Oct 2014
Randomized Controlled TrialPooled safety analysis of the fixed-dose combination of indacaterol and glycopyrronium (QVA149), its monocomponents, and tiotropium versus placebo in COPD patients.
To further assess the safety profile of the fixed-dose combination of indacaterol and glycopyrronium (QVA149) and its monocomponents; we investigated the impact of individual patient-level factors and time by integrating the patient-level safety data from the QVA149 clinical programme with relevant information from the independent indacaterol and glycopyrronium safety databases. ⋯ There was no increase in the risk for the investigated safety endpoints for the fixed-dose combination QVA149, and it had a comparable safety profile as its monocomponents and tiotropium versus placebo.
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Respiratory medicine · Oct 2014
Phenotypic and genetic heterogeneity among subjects with mild airflow obstruction in COPDGene.
Chronic obstructive pulmonary disease (COPD) is characterized by marked phenotypic heterogeneity. Most previous studies have focused on COPD subjects with FEV1 < 80% predicted. We investigated the clinical and genetic heterogeneity in subjects with mild airflow limitation in spirometry grade 1 defined by the Global Initiative for chronic Obstructive Lung Disease (GOLD 1). ⋯ Our results indicate that GOLD 1 subjects show substantial clinical heterogeneity, which is at least partially related to genetic heterogeneity.
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Respiratory medicine · Oct 2014
Lung cancer in patients with idiopathic pulmonary fibrosis: clinical characteristics and impact on survival.
Idiopathic pulmonary fibrosis (IPF) is reportedly associated with an increased risk of lung cancer. However, few studies have explored whether IPF affects the long-term survival of lung cancer patients. The primary goal of this study was to evaluate the characteristics of lung cancer in IPF patients and impact of IPF on lung cancer survival. ⋯ Squamous cell carcinoma was the most common type of lung cancer in IPF patients. IPF reduced the survival of surgically treated lung cancer patients regardless of age, sex, histologic type, and/or lung cancer stage.
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Respiratory medicine · Sep 2014
Randomized Controlled Trial Multicenter StudyTiotropium in asthmatic adolescents symptomatic despite inhaled corticosteroids: a randomised dose-ranging study.
Tiotropium, a once-daily long-acting anticholinergic agent, has been shown to be an efficacious and safe add-on treatment for adults with symptomatic asthma, despite treatment with inhaled corticosteroids (ICS). A large proportion of asthmatic adolescents have symptomatic disease despite a wide range of therapeutic options. We investigated the efficacy and safety of three doses of tiotropium, administered in the evening (via Respimat(®) SoftMist™ inhaler), versus placebo in asthmatic adolescents symptomatic despite ICS treatment. ⋯ This first study of tiotropium in adolescents with symptomatic asthma demonstrates that tiotropium is well tolerated and efficacious as add-on to maintenance treatment with ICS. ClinicalTrials.gov identifier; NCT01122680.
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Respiratory medicine · Sep 2014
Randomized Controlled Trial Multicenter StudyRepeated dyspnea score and percent FEV1 are modest predictors of hospitalization/relapse in patients with acute asthma exacerbation.
(1) Compare ideal cut-off points for DS and %FEV1 at 1 and 3 h to predict hospitalization/relapse in subjects with moderate to severe asthma exacerbation (2) Develop a multivariate regression model using DS, %FEV1, demographic, and clinical variables to predict hospitalization/relapse. ⋯ The 3-h score for %FEV1 and DS performed better than scores at any other time point and better than either parameter over time. The 3-h DS had the greatest association with the composite outcome. Neither test was a strong enough predictor to be used solely for this purpose.