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Effectiveness of Fluticasone Furoate-Vilanterol for COPD in Clinical Practice. BACKGROUND: Evidence for the management of chronic obstructive pulmonary disease (COPD) comes from closely monitored efficacy trials involving groups of patients who were selected on the basis of restricted entry criteria. There is a need for randomized trials to be conducted in conditions that are closer to usual clinical practice. METHODS: In a controlled effectiveness trial conducted in 75 general practices, we (...) randomly assigned 2799 patients with COPD to a once-daily inhaled combination of fluticasone furoate at a dose of 100 μg and vilanterol at a dose of 25 μg (the fluticasone furoate-vilanterol group) or to usual care (the usual-care group). The primary outcome was the rate of moderate or severe exacerbations among patients who had had an exacerbation within 1 year before the trial. Secondary outcomes were the rates of primary care contact (contact with a general practitioner, nurse, or other health care
A validation of the National Early Warning Score to predict outcome in patients with COPD exacerbation 27553223 2016 08 24 2016 12 15 1468-3296 72 1 2017 Jan Thorax Thorax A validation of the National Early Warning Score to predict outcome in patients with COPD exacerbation. 23-30 10.1136/thoraxjnl-2016-208436 The National Early Warning Score (NEWS), proposed as a standardised track and trigger system, may perform less well in acute exacerbation of COPD (AECOPD). This study externally validated (...) The Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK. Roderick Paul J PJ Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK. eng Journal Article 2016 08 23 England Thorax 0417353 0040-6376 COPD Exacerbations 2016 02 02 2016 06 30 2016 07 18 2016 8 25 6 0 2016 8 25 6 0 2016 8 25 6 0 ppublish 27553223 thoraxjnl-2016-208436 10.1136/thoraxjnl-2016-208436
Prognostic assessment in COPD without lung function: the B-AE-D indices 27103389 2016 06 01 2017 04 23 1399-3003 47 6 2016 Jun The European respiratory journal Eur. Respir. J. Prognostic assessment in COPD without lung function: the B-AE-D indices. 1635-44 10.1183/13993003.01485-2015 Several composite markers have been proposed for risk assessment in chronic obstructive pulmonary disease (COPD). However, choice of parameters and score complexity restrict clinical applicability. Our aim (...) was to provide and validate a simplified COPD risk index independent of lung function.The PROMISE study (n=530) was used to develop a novel prognostic index. Index performance was assessed regarding 2-year COPD-related mortality and all-cause mortality. External validity was tested in stable and exacerbated COPD patients in the ProCOLD, COCOMICS and COMIC cohorts (total n=2988).Using a mixed clinical and statistical approach, body mass index (B), severe acute exacerbations of COPD frequency (AE), modified
Umeclidinium bromide/Vilanterol. Anoro for COPD. No additions to efficacy just to price 2015. DAR No 6: Umeclidinium bromide/Vilanterol. Anoro® for COPD - navarra.es Castellano | Euskara | Français | English Use the search tool! Search engine : : : : : : : : DAR No 6: Umeclidinium bromide/Vilanterol. Anoro® for COPD DAR No 6: Umeclidinium bromide/Vilanterol. Anoro® for COPD Content tools Share it No additions to efficacy, just to price Umeclidinium/vilanterol is a combination of a muscarinic
Umeclidinium bromide. Incruse for COPD. Very little efficacy 2015. DAR No 5: Umeclidinium bromide. Incruse® for COPD - navarra.es Castellano | Euskara | Français | English Use the search tool! Search engine : : : : : : : : DAR No 5: Umeclidinium bromide. Incruse® for COPD DAR No 5: Umeclidinium bromide. Incruse® for COPD Content tools Share it Very little efficacy Umeclidinium is a long acting muscarinic antagonist (LAMA) authorized for symptom relief in patients (...) with Chronic Obstructive Pulmonary Disease (COPD). They are no comparative data available with tiotropium, or with other LAMA or LABA. It has not shown to reduce the number of exacerbations. Neither does it improve quality of life or reduce the need for rescue treatment in studies lasting more than 12 weeks. There is concern on safety regarding its cardiovascular profile and the possible higher risk of pneumonia. Enviar comentario You can send us a comment or suggestion and we will respond to most frequently asked questions Competing
The inflammasome pathway in stable COPD and acute exacerbations 27730204 2018 11 13 2312-0541 2 3 2016 Jul ERJ open research ERJ Open Res The inflammasome pathway in stable COPD and acute exacerbations. 00002-2016 Chronic obstructive pulmonary disease (COPD) is characterised by pulmonary and systemic inflammation that bursts during exacerbations of the disease (ECOPD). The NLRP3 inflammasome is a key regulatory molecule of the inflammatory response. Its role in COPD is unclear. We investigated (...) the NLRP3 inflammasome status in: 1) lung tissue samples from 38 patients with stable COPD, 15 smokers with normal spirometry and 14 never-smokers; and 2) sputum and plasma samples from 56 ECOPD patients, of whom 41 could be reassessed at clinical recovery. We observed that: 1) in lung tissue samples of stable COPD patients, NLRP3 and interleukin (IL)-1β mRNA were upregulated, but both caspase-1 and ASC were mostly in inactive form, and 2) during infectious ECOPD, caspase-1, oligomeric ASC
Only severe COPD is associated with being underweight: results from a population survey 27730201 2018 11 13 2312-0541 2 3 2016 Jul ERJ open research ERJ Open Res Only severe COPD is associated with being underweight : results from a population survey. 00051-2015 Low body mass index (BMI) and malnutrition in chronic obstructive pulmonary disease (COPD) are associated with a poor prognosis. The prevalence of underweight, as well as overweight, in severity grades of COPD is sparsely investigated (...) in studies of the general population and the associated patterns of risk factors are not well established. The aim of the present study was to determine the association between severity grades of airflow limitation in COPD, and both underweight and obesity when corrected for possible confounding factors. The study is based on pooled data from the OLIN (Obstructive Lung Disease in Northern Sweden) studies. Complete records with lung function, BMI and structured interview data were available from 3942
Inflammatory bowel disease and risk of mortality in COPD 26869671 2016 05 02 2016 05 02 1399-3003 47 5 2016 May The European respiratory journal Eur. Respir. J. Inflammatory bowel disease and risk of mortality in COPD. 1357-64 10.1183/13993003.01945-2015 Patients with chronic obstructive pulmonary disease (COPD) have higher incidence and prevalence of other chronic inflammatory diseases, including inflammatory bowel disease (IBD). We assessed whether IBD onset increases mortality risk (...) in patients with COPD or asthma-associated COPD.Two population-based cohorts of COPD and asthma-COPD subjects were identified using the administrative health databases in Québec, Canada, 1990-2007. Death records were retrieved from the death certificate registry. Cox proportional hazards models were used to assess the impact of newly developed IBD on mortality risk.The COPD and asthma-COPD cohorts included 273 208 and 26 575 patients, respectively, of which 697 and 119 developed IBD. IBD increased the
Functional characterisation of bone marrow-derived mesenchymal stromal cells from COPD patients 27730190 2018 11 13 2312-0541 2 2 2016 Apr ERJ open research ERJ Open Res Functional characterisation of bone marrow-derived mesenchymal stromal cells from COPD patients. 00045-2015 Autologous bone marrow-derived mesenchymal stromal cells (BM-MSCs) are evaluated for clinical use in chronic obstructive pulmonary disease (COPD) patients, but it is unclear whether COPD affects BM-MSCs. To investigate (...) this, BM-MSCs from nine COPD patients and nine non-COPD age-matched controls were compared with regard to immunophenotype, growth and differentiation potential, and migration capacity. Other functional assays included the response to pro-inflammatory stimuli and inducers of the nuclear factor (erythroid derived 2)-like 2 antioxidant response element (Nrf2-ARE) pathway, and effects on NCI-H292 airway epithelial cells. No significant differences were observed in terms of morphology, proliferation
Indacaterol-Glycopyrronium versus Salmeterol-Fluticasone for COPD. BACKGROUND: Most guidelines recommend either a long-acting beta-agonist (LABA) plus an inhaled glucocorticoid or a long-acting muscarinic antagonist (LAMA) as the first-choice treatment for patients with chronic obstructive pulmonary disease (COPD) who have a high risk of exacerbations. The role of treatment with a LABA-LAMA regimen in these patients is unclear. METHODS: We conducted a 52-week, randomized, double-blind, double (...) -dummy, noninferiority trial. Patients who had COPD with a history of at least one exacerbation during the previous year were randomly assigned to receive, by inhalation, either the LABA indacaterol (110 μg) plus the LAMA glycopyrronium (50 μg) once daily or the LABA salmeterol (50 μg) plus the inhaled glucocorticoid fluticasone (500 μg) twice daily. The primary outcome was the annual rate of all COPD exacerbations. RESULTS: A total of 1680 patients were assigned to the indacaterol-glycopyrronium
Measurement duration impacts variability but not impedance measured by the forced oscillation technique in healthy, asthma and COPD subjects 27730194 2018 11 13 2312-0541 2 2 2016 Apr ERJ open research ERJ Open Res Measurement duration impacts variability but not impedance measured by the forced oscillation technique in healthy, asthma and COPD subjects. 00094-2015 The forced oscillation technique (FOT) is gaining clinical acceptance, facilitated by more commercial devices and clinical data (...) . However, the effects of variations in testing protocols used in FOT data acquisition are unknown. We describe the effect of duration of data acquisition on FOT results in subjects with asthma, chronic obstructive pulmonary disease (COPD) and healthy controls. FOT data were acquired from 20 healthy, 22 asthmatic and 18 COPD subjects for 60 s in triplicate. The first 16, 30 and 60 s of each measurement were analysed to obtain total, inspiratory and expiratory resistance of respiratory system ( R rs
Increasing burden of COPD in rural India: an example why India warrants primary healthcare reforms 27730188 2018 11 13 2312-0541 2 2 2016 Apr ERJ open research ERJ Open Res Increasing burden of COPD in rural India: an example why India warrants primary healthcare reforms. 00032-2016 Battle against COPD: time to reinforce the primary healthcare units of rural areas of India to combat lung diseases http://ow.ly/ZAwge. Kalkana Toshita T Dept of Pneumology, Allergy and Asthma Research Centre
Economic surveillance for chronic obstructive pulmonary disease (COPD) in Alberta Economic Report Economic surveillance for chronic obstructive pulmonary disease (COPD) in Alberta REVISED, August 2016 INSTITUTE OF HEALTH ECONOMICS The Institute of Health Economics (IHE) is an independent, not-for-profit organization that performs research in health economics and synthesizes evidence in health technology assessment to assist health policy making and best medical practices. IHE BOARD OF DIRECTORS (...) Access, AstraZeneca Ms. Jennifer Chan – VP, Policy & Communications, Merck Canada Ms. Tanya Lederer – Director, External Relations, GlaxoSmithKline Inc. IHE Mr. Doug Gilpin – Chair, Audit & Finance Committee Dr. Egon Jonsson – Executive Director & CEO, Institute of Health Economics Ms. Allison Hagen – Director of Finance, Operations & Administration, Institute of Health Economics Economic Report Economic surveillance for chronic obstructive pulmonary disease (COPD) in Alberta Contributing authors
Home health monitoring compared with usual care for patients with moderate to severe COPD evidence note In response to an enquiry from Quality and Efficiency Support Team, Scottish Government Number 60 March 2016 What is the clinical effectiveness, cost effectiveness and safety of home health monitoring compared with usual care for patients with moderate to severe chronic obstructive pulmonary disease? What is an evidence note Evidence notes are rapid reviews of published secondary clinical (...) recommendations for NHSScotland, however the Scottish Health Technologies Group (SHTG) produce an Advice Statement to accompany all evidence reviews. Definitions Chronic obstructive pulmonary disease: is a lung disease characterised by chronic airflow obstruction that is not fully reversible and usually progressive 1 . Exacerbation: characterised by the rapid and sustained worsening of respiratory symptoms beyond normal daily variations 1 . Bronchitis: inflammation that narrows the bronchi (the tubes carrying
Home health monitoring compared with usual care for patients with moderate to severe COPD File name: 2016-003 AS COPD v1.0.doc Version: 1.0 Date: 21 March 2016 Produced by: SHTG Page: 1 Review date: March 2018 Advice Statement 003/2016 March 2016 What is the clinical effectiveness, cost effectiveness, safety and patient satisfaction of home health monitoring compared with usual care for patients with moderate to severe chronic obstructive pulmonary disease? This advice has been produced (...) following completion of evidence note 60 by Healthcare Improvement Scotland, in response to an enquiry from the Quality and Efficiency Support Team Background In 2012/2013, practice team information data estimated that about 20 women and 18 men per 1,000 patients, across all ages, consulted a general practitioner or practice nurse at least once due to chronic obstructive pulmonary disease (COPD). The Scottish Government’s national telehealth and telecare delivery plan includes an objective to expand
Physical activity assessed in routine care predicts mortality after a COPD hospitalisation 27730174 2018 11 13 2312-0541 2 1 2016 Jan ERJ open research ERJ Open Res Physical activity assessed in routine care predicts mortality after a COPD hospitalisation. 00062-2015 The independent relationship between physical inactivity and risk of death after an index chronic obstructive pulmonary disease (COPD) hospitalisation is unknown. We conducted a retrospective cohort study in a large integrated (...) healthcare system. Patients were included if they were hospitalised for COPD between January 1, 2011 and December 31, 2011. All-cause mortality in the 12 months after discharge was the primary outcome. Physical activity, expressed as self-reported minutes of moderate to vigorous physical activity (MVPA), was routinely assessed at outpatient visits prior to hospitalisation. 1727 (73%) patients were inactive (0 min of MVPA per week), 412 (17%) were insufficiently active (1-149 min of MVPA per week) and 231
Understanding variation in length of hospital stay for COPD exacerbation: European COPD audit 27730166 2018 11 13 2312-0541 2 1 2016 Jan ERJ open research ERJ Open Res Understanding variation in length of hospital stay for COPD exacerbation: European COPD audit. 00034-2015 Chronic obstructive pulmonary disease (COPD) care across Europe has high heterogeneity with respect to cost and the services available. Variations in length of stay (LOS) may be attributed to patient characteristics, resource (...) and organisational characteristics, and/or the so-called hospital cluster effect. The European COPD Audit in 13 countries included data from 16 018 hospitalised patients. The recorded variables included information on patient and disease characteristics, and resources available. Variables associated with LOS were evaluated by a multivariate, multilevel analysis. Mean±sd LOS was 8.7±8.3 days (median 7 days, interquartile range 4-11 days). Crude variability between countries was reduced after accounting