Effect of triple therapy in patients with asthma-COPD overlap 

Effect of triple therapy in patients with asthma-COPD overlap
. Int J Clin Pharmacol Ther. 2019 Jun 24;: Authors: Ishiura Y, Fujimura M, Ohkura N, Hara J, Kasahara K, Ishii N, Tamaki T, Shimizu T, Nomura S Abstract OBJECTIVE: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is of increasing interest because ACO patients have significantly worse outcomes, leading to greater social and economic burdens compared with asthma or COPD alone. Some guidelines for ACO recommend triple therapy with inhaled corticosteroids, long-acting β2 agonists, and long-acting muscarinic antagonists. However, this approach is based on extrapolating data from patients with asthma or COPD alone. Therapeutic studies for ACO have not previously been conducted. MATERIALS AND METHODS: A 12-week, randomized, open-label cross-over pilot study was conducted in 17 ACO patients to evaluate the effect of umeclidinium (UMEC) 62.5 µg once-daily added to fluticasone furoate/vilanterol (FF/VI) 200/25 µg once-daily. A 4-week run-in, a first and a second 4-week treatment period were included. Respiratory function, respiratory impedance, fractional exhaled nitric oxide, COPD assessment test, and asthma control test scores were evaluated 0, 4, and 8 weeks after randomization. RESULTS: Mean values of post-bronchodilator forced expiratory volume in 1 second as a percentage of the predicted value (%FEV1), after UMEC was added to FF/VI, were signifi...
Source: International Journal of Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research

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Publication date: Available online 18 September 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Marcia Vervloet, Liset van Dijk, Peter Spreeuwenberg, David Price, Alison Chisholm, Eric Van Ganse, Hilary Pinnock, Cynthia S. Rand, Michelle N. Eakin, Tjard Schermer, Patrick C. Souverein, Alexandra L. Dima, Respiratory Effectiveness Group’s Adherence Working GroupAbstractBackgroundLow inhaled corticosteroids (ICS) adherence is associated with increased asthma burden. This relationship is likely bidirectional, and may vary across adherence stages (initiation, implementation, persistence)....
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Asthma and chronic obstructive pulmonary disease (COPD) are markedly different airway diseases, but sometimes they overlap, with some asthmatic patients showing some features of COPD (fixed airway obstruction, mixed neutrophilic/eosinophilic airway inflammation, and relatively poor response to corticosteroids) and some patients with COPD having features of asthma (atopy, history of asthma, greater airway reversibility, increased blood and sputum eosinophil counts, and a clinical response to corticosteroids).
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Editorial Source Type: research
Conclusions: The ACO cohort with statin use exhibited the lower risk of hepatic, renal, and heart failure than any other cohort, regardless of age, sex, comorbidities, or ICS or OS use. Regarding the combined use of statins and ICS, the risks of hepatic failure were lower. For the combined use of statins and OS, the hepatic, renal and heart failure were less frequent.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Abstract Vilanterol trifenatate is a novel chiral long-acting β2-agonist developed. Vilanterol combined with inhaled corticosteroids can treat COPD and asthma. A simple liquid chromatographic method is developed for the quantitative determination of R-vilanterol and S-vilanterol (impurity S). HPLC separation was achieved on Chiralpak ID (250 × 4.6 mm; particle size 5 μm) column using hexane-ethanol-ethanolamine (75:25:0.1, v/v/v) as mobile phase at a flow rate of 1.0 mL/min. The resolution is greater than 3.3. Ethanolamine in the mobile phase is vital to enhance chromatograph...
Source: Chirality - Category: Molecular Biology Authors: Tags: Chirality Source Type: research
Authors: Högman M, Thornadtsson A, Bröms K, Janson C, Lisspers K, Ställberg B, Hedenström H, Malinovschi A Abstract Exhaled nitric oxide (FENO) is a marker of type-2 inflammation in asthma and is used in its management. However, smokers and ex-smokers have lower FENO values, and the clinical use of FENO values in COPD patients is unclear. Therefore, we investigated if FENO had a relationship to different COPD characteristics in smoking and ex-smoking subjects. Patients with COPD (n = 533, 58% females) were investigated while in stable condition. Measurements of FENO50, blood cell c...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research
Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity and mortality worldwide, and its prevalence is increasing. Airway inflammation is a consistent feature of COPD and is implicated in the pathogenesis and progression of COPD, but anti-inflammatory therapy is not first-line treatment. The inflammation has many guises and phenotyping this heterogeneity has revealed different patterns. Neutrophil-associated COPD with activation of the inflammasome, T1 and T17 immunity is the most common phenotype with eosinophil-associated T2-mediated immunity in a minority and autoimmunity observed in more severe...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Series Source Type: research
Clinical management of asthma and chronic obstructive pulmonary disease (COPD) has primarily relied on the use of beta 2 adrenergic receptor agonists (bronchodilators) and corticosteroids, and more recently, monoclonal antibody therapies (biologics) targeting specific cytokines and their functions. Although these approaches provide relief from exacerbations, questions remain on their long-term efficacy and safety. Furthermore, current therapeutics do not address progressive airway remodeling (AR), a key pathological feature of severe obstructive lung disease. Strikingly, agonists of the bitter taste receptors (TAS2Rs) deli...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Conclusions: Asthma and COPD patients using DuoResp Spiromax reported moderate-to-high medication adherence, were very satisfied with their inhaler and found it easy to use. PMID: 31293211 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
Abstract Corticosteroid insensitive airway inflammation is one of major barrier to effective managements of chronic airway diseases, such as obstructive pulmonary airway disease (COPD) and severe asthma. The role of nonreceptor tyrosine kinase Src is important in airway inflammation in mice models of atopic asthma and COPD. Thus, in this study, we determined the effects of Src inhibitor, dasatinib, on airway inflammation induced by repeated intranasal exposure to lipopolysaccharide (LPS). Male mice (A/J strain, 5 weeks old) were intranasally exposed to LPS twice daily for 3 days, and dasatinib was intranasally tre...
Source: Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan - Category: Drugs & Pharmacology Authors: Tags: Yakugaku Zasshi Source Type: research
Authors: Oshagbemi OA, Franssen FME, van Kraaij S, Braeken DCW, Wouters EFM, Maitland-van der Zee AH, Driessen JHM, de Vries F Abstract Although recently introduced in the pharmacological treatment algorithm of chronic obstructive pulmonary disease (COPD), there is a need for more data supporting the use of blood eosinophil counts as a biomarker to guide inhaled corticosteroids (ICS) therapy. The aim of this study was to evaluate the risk of moderate and/or severe exacerbations and all-cause mortality in a large primary care population after withdrawal of ICS compared to continued users stratified by elevated blood...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research
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