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Therapeutic Advances in Respiratory Disease

Anthony D D'Urzo, Dave Singh, James F Donohue, Kenneth R Chapman
Aclidinium bromide/formoterol fumarate (AB/FF) 400/12 µg is a twice-daily long-acting muscarinic receptor antagonist and long-acting β2 agonist (LAMA/LABA) dual-bronchodilator maintenance therapy used to relieve symptoms and reduce future risk of exacerbations in adults with chronic obstructive pulmonary disease (COPD). To date, there have been several clinical studies and post hoc analyses of AB/FF, assessing treatment outcomes in patients with moderate-to-severe COPD. These studies have looked at a range of outcomes, including lung function parameters, patient-reported symptom scores, quality-of-life measures assessing impaired health and perceived well-being, and the frequency, duration, and severity of exacerbations...
January 2019: Therapeutic Advances in Respiratory Disease
Soo Jin Na, Jae-Seung Jung, Sang-Bum Hong, Woo Hyun Cho, Sang-Min Lee, Young-Jae Cho, Sunghoon Park, So-My Koo, Seung Yong Park, Youjin Chang, Byung Ju Kang, Jung-Hyun Kim, Jin Young Oh, So Hee Park, Jung-Wan Yoo, Yun Su Sim, Kyeongman Jeon
BACKGROUND: There are limited data regarding prolonged extracorporeal membrane oxygenation (ECMO) support, despite increase in ECMO use and duration in patients with respiratory failure. The objective of this study was to investigate the outcomes of severe acute respiratory failure patients supported with prolonged ECMO for more than 28 days. METHODS: Between January 2012 and December 2015, all consecutive adult patients with severe acute respiratory failure who underwent ECMO for respiratory support at 16 tertiary or university-affiliated hospitals in South Korea were enrolled retrospectively...
January 2019: Therapeutic Advances in Respiratory Disease
Bingxin Guo, Yichun Bai, Yana Ma, Cong Liu, Song Wang, Runzhen Zhao, Jiaxing Dong, Hong-Long Ji
Smoke-inhalation-induced acute lung injury (SI-ALI) is a leading cause of morbidity and mortality in victims of fire tragedies. SI-ALI contributes to an estimated 30% of burn-caused patient deaths, and recently, more attention has been paid to the specific interventions for this devastating respiratory illness. In the last decade, much progress has been made in the understanding of SI-ALI patho-mechanisms and in the development of new therapeutic strategies in both preclinical and clinical studies. This article reviews the recent progress in the treatment of SI-ALI, based on pathophysiology, thermal damage, airway obstruction, the nuclear-factor kappa-B signaling pathway, and oxidative stress...
January 2019: Therapeutic Advances in Respiratory Disease
Giorgio Lorenzo Colombo, Sergio Di Matteo, Chiara Martinotti, Martina Oselin, Maria Chiara Valentino, Giacomo Matteo Bruno, Claudia Pitotti, Francesco Menzella
BACKGROUND: Asthma is a highly prevalent chronic inflammatory airways disease, with a considerable impact on quality of life (QoL). To express the effects of asthma on patients' subjective experience, patient-reported outcomes (PROs) represent an important instrument. The asthma QoL questionnaire (AQLQ) is one of the main PROs among these. MATERIALS AND METHODS: To identify long-term asthma-related QoL outcomes associated with omalizumab therapy in patients with moderate-to-severe asthma, we developed a systematic review according to the PRISMA guidelines...
January 2019: Therapeutic Advances in Respiratory Disease
Sherstin T Lommatzsch, Jennifer L Taylor-Cousar
Years of tremendous study have dawned a new era for the treatment of cystic fibrosis (CF). For years CF care was rooted in the management of organ dysfunction resulting from the mal-effects of absent anion transport through the CF transmembrane regulator (CFTR) protein. CFTR, an adenosine triphosphate binding anion channel, has multiple functions, but primarily regulates the movement of chloride anions, thiocyanate and bicarbonate across luminal cell membranes. Additional roles include effects on other electrolyte channels such as the epithelial sodium channel (ENaC) and on pulmonary innate immunity...
January 2019: Therapeutic Advances in Respiratory Disease
Paolo Solidoro, Filippo Patrucco, Francesca de Blasio, Luisa Brussino, Michela Bellocchia, Davide Dassetto, Emanuele Pivetta, Annamaria Riccio, Enrico Heffler, Walter Canonica, Giovanni Rolla, Caterina Bucca
BACKGROUND: Omalizumab may modulate airway remodeling in severe asthma. Using forced expiratory volume in 1 second (FEV1 ) as a surrogate of airway remodeling, we aimed to investigate if an omalizumab add-on in severe allergic asthma may lead to a persistent reversal of airway obstruction and to evaluate the potential biomarkers of airway obstruction reversibility. METHODS: Data were collected before (T0) and after omalizumab add-on for 1 year (T1, 32 patients), 2 years (T2, 26 patients) and 4 years (T4, 13 patients)...
January 2019: Therapeutic Advances in Respiratory Disease
Eric Derom, Guy G Brusselle, Guy F Joos
Long-acting bronchodilators are the cornerstone of pharmacologic treatment of chronic obstructive pulmonary disease (COPD). Spiolto® or Stiolto® is a fixed-dose combination (FDC) containing two long-acting bronchodilators, the long-acting muscarinic receptor antagonist tiotropium (TIO) and the long-acting β2-adrenoceptor agonist olodaterol (OLO), formulated in the Respimat® Soft Mist™ inhaler. A total of 13 large, multicentre studies of up to 52 weeks' duration have documented its efficacy in more than 15,000 patients with COPD...
January 2019: Therapeutic Advances in Respiratory Disease
Kristin B Highland, Michael Hull, Janis Pruett, Caitlin Elliott, Yuen Tsang, William Drake
INTRODUCTION: Since its introduction to the market in 2016, selexipag has been an alternative oral therapy among both treatment-naïve patients and those with mono or dual therapy failure; however, limited information is available regarding the presentation and management of patients with pulmonary arterial hypertension (PAH) prior to selexipag initiation. This study examined treatment patterns, healthcare utilization, and costs in the 12 months prior to and the 6 months following selexipag initiation...
January 2019: Therapeutic Advances in Respiratory Disease
Mark R Bowling, Erik E Folch, Sandeep J Khandhar, Jordan Kazakov, William S Krimsky, Gregory P LeMense, Philip A Linden, Boris A Murillo, Michael A Nead, Michael A Pritchett, Catalina V Teba, Christopher W Towe, Terence Williams, Carlos J Anciano
BACKGROUND: Fiducial markers (FMs) help direct stereotactic body radiation therapy (SBRT) and localization for surgical resection in lung cancer management. We report the safety, accuracy, and practice patterns of FM placement utilizing electromagnetic navigation bronchoscopy (ENB). METHODS: NAVIGATE is a global, prospective, multicenter, observational cohort study of ENB using the superDimension™ navigation system. This prospectively collected subgroup analysis presents the patient demographics, procedural characteristics, and 1-month outcomes in patients undergoing ENB-guided FM placement...
January 2019: Therapeutic Advances in Respiratory Disease
Hayoung Choi, Beomsu Shin, Hongseok Yoo, Gee Young Suh, Jong Ho Cho, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim, Kyeongman Jeon
BACKGROUND: Acute lung injury (ALI) is the most serious pulmonary complication after lung resection. Although the beneficial effects of low-dose corticosteroids have been demonstrated in patients with postoperative ALI, there are limited data on optimal corticosteroid treatment. METHODS: We retrospectively analyzed 58 patients who were diagnosed with ALI among 7593 patients who underwent lung cancer surgery between January 2009 and December 2016. RESULTS: Of the 58 patients, 42 (72%) received corticosteroid treatment within 72 h (early treatment group) and 16 (28%) received corticosteroid treatment more than 72 h after ALI occurred (late treatment group)...
January 2019: Therapeutic Advances in Respiratory Disease
Li-Han Hsu, An-Chen Feng, Thomas C Soong, Jen-Sheng Ko, Nei-Min Chu, Yung-Feng Lin, Shu-Huei Kao
BACKGROUND: Pleurodesis is often used to prevent the re-accumulation of a malignant pleural effusion (MPE). Intrapleural urokinase (IPUK) therapy facilitates lung re-expansion for patients with loculated MPE or a trapped lung that allows subsequent pleurodesis. MPE management has been traditionally regarded as a symptomatic treatment. We tried to evaluate their impact on patient survival. METHODS: There were 314 consecutive patients with symptomatic MPE that underwent minocycline pleurodesis with ( n = 109) and without ( n = 205) the antecedent IPUK therapy between September 2005 and August 2015, who were recruited for the pleurodesis outcome and survival analysis...
January 2019: Therapeutic Advances in Respiratory Disease
Tobias Gessler
Inhaled iloprost is a well-established medication to treat pulmonary arterial hypertension (PAH), a serious and potentially fatal disease of the pulmonary resistance vessels. The therapeutic administration of iloprost requires six to nine inhalations per day, due to the short biological half-life of this prostacyclin analogue. The I-NebTM AADTM , introduced in 2006, is the most commonly used nebulizer for delivering iloprost, requiring at least 6.5 min for an inhaled dose of 5 µg. In order to reduce inhalation time, a portable nebulizer based on modern-device technology was developed...
January 2019: Therapeutic Advances in Respiratory Disease
Markus Polke, Matthias Rötting, Nilab Sarmand, Johannes Krisam, Ralf Eberhardt, Felix J F Herth, Daniela Gompelmann
BACKGROUND: Endoscopic and surgical interventions may be beneficial for selected patients with emphysema. Rates of treatment failure decrease when the predictors for successful therapy are known. The aim of the study was to evaluate the number of patients with severe emphysema who were not eligible for any intervention, and the reasons for their exclusion. METHODS: The study was a retrospective analysis of 231 consecutive patients with advanced emphysema who were considered for interventional therapy in 2016 at the Thoraxklinik, Heidelberg, Germany...
January 2019: Therapeutic Advances in Respiratory Disease
Jaime L Rubin, Lasair O'Callaghan, Christopher Pelligra, Michael W Konstan, Alexandra Ward, Jack K Ishak, Conor Chandler, Theodore G Liou
BACKGROUND: Lumacaftor/ivacaftor combination therapy is efficacious and generally safe for patients with cystic fibrosis (CF) homozygous for the F508del-CF transmembrane conductance regulator (CFTR) mutation. However, long-term survival benefits of lumacaftor/ivacaftor (LUM/IVA) cannot yet be quantified. Simulation models can provide predictions about long-term health outcomes. In this study, we aimed to project long-term health outcomes of LUM/IVA plus standard care (SC) in patients with CF homozygous for F508del-CFTR...
January 2019: Therapeutic Advances in Respiratory Disease
Chul Park, Soo Jin Na, Chi Ryang Chung, Yang Hyun Cho, Gee Young Suh, Kyeongman Jeon
BACKGROUND: Bacterial pneumonia is a major cause of acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) support. However, it is unknown whether the type of pneumonia, community-acquired pneumonia (CAP) versus hospital-acquired pneumonia (HAP), should be considered when predicting outcomes for ARDS patients treated with ECMO. METHODS: We divided a sample of adult patients receiving ECMO for acute respiratory distress syndrome caused by bacterial pneumonia between January 2012 and December 2016 into CAP ( n = 21) and HAP ( n = 35) groups and compared clinical and bacteriological characteristics and outcomes...
January 2019: Therapeutic Advances in Respiratory Disease
Daniel Dusser, Francine M Ducharme
Given the high proportion of patients with asthma who remain uncontrolled despite controller treatment, there remains a need for the development of more effective treatment options with a proven safety and tolerability profile. Recently, asthma guidelines have evolved to incorporate new therapies, including long-acting muscarinic antagonists (LAMAs) and biologics. Here we focus on the safety profile of tiotropium, a LAMA, using data from the large-scale UniTinA-asthma® clinical trial program, which investigated the use of tiotropium in over 6000 patients with asthma who remained symptomatic despite receiving inhaled corticosteroids (ICS) maintenance therapy, with or without other adjunct therapies...
January 2019: Therapeutic Advances in Respiratory Disease
Weiquan Liang, Peicun Hu, Wenliang Guo, Zhuquan Su, Jingxian Li, Shiyue Li
BACKGROUND: Balloon dilation is a primary treatment for nonmalignant tracheobronchial stenosis, but often requires multiple treatment sessions to maintain therapeutic efficacy. No guideline is available to suggest the appropriate maximum number of treatment sessions. This study aimed to investigate the relationship between the number of balloon dilation sessions and its long-term therapeutic effectiveness in Chinese patients with nonmalignant central airway stenosis. METHODS: A total of 111 patients with nonmalignant central airway stenosis treated with flexible bronchoscopic balloon dilation from January 2005 to September 2012 were included...
January 2019: Therapeutic Advances in Respiratory Disease
Pascale Tomasini, Julie Egea, Maxime Souquet-Bressand, Laurent Greillier, Fabrice Barlesi
Molecular profiling of metastatic nonsquamous non-small cell lung cancer (NSCLC) is required to guide the treatment strategy. Anaplastic lymphoma kinase ( ALK) gene rearrangements are found in approximately 5% of lung adenocarcinomas and are associated with specific clinical features including a high risk of brain metastases. Crizotinib was the first ALK inhibitor developed and it demonstrated improved outcomes in patients with ALK-positive advanced NSCLC in comparison with chemotherapy. However, despite an initial response, all ALK-positive NSCLC patients develop acquired resistance to crizotinib...
January 2019: Therapeutic Advances in Respiratory Disease
Catharina Belge, Marion Delcroix
Macitentan (10 mg once daily orally), a dual endothelin receptor antagonist (ERA) developed by modifying the structure of bosentan to increase the efficacity and safety, is approved for the treatment of pulmonary arterial hypertension (PAH). The pivotal SERAPHIN trial, (a landmark trial in the history of PAH trials because of the large number of included patients, the long-term follow up and the first trial with morbidity/mortality as the primary endpoint) showed a reduction of the risk of a morbidity or mortality event by 45% over the treatment time compared with placebo...
January 2019: Therapeutic Advances in Respiratory Disease
Warangkana Keeratichananont, Apichat Kaewdech, Suriya Keeratichananont
BACKGROUND: Autologous blood is a novel, high-efficacy sclerosant for treatment of malignant pleural effusion (MPE), similar to tetracycline. There has been no comparative data between autologous blood and a worldwide sclerosant like talc. We aimed to compare the effectiveness of autologous blood versus talc pleurodesis. METHODS: A prospective study was conducted at Songklanagarind Hospital, Songkhla, Thailand. A total of 123 symptomatic MPE cases were randomized to receive autologous blood pleurodesis (ABP) versus pleurodesis with talc slurry...
January 2018: Therapeutic Advances in Respiratory Disease
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