Testing bronchodilator responsiveness

The recent paper in the European Respiratory Journal by Janson et al. [1] on testing bronchodilator responsiveness suggests that it has no value in distinguishing asthma from COPD. The authors correctly state that "there are many different ways of defining bronchodilator reversibility." However, they do not then mention any of them other than using the change in forced expiratory volume in 1 s (FEV1) standardised by the start value. This can lead to a sex and size bias in assessing bronchodilator response [2]. One method, that was recommended by the European Respiratory Society many years ago [3], standardises the change in FEV1 by the subject's predicted value and not their start value. Using this method it has been found that a change in FEV1 of 8% of predicted or more due to a bronchodilator was associated with a survival advantage [2]. This approach avoided all the pitfalls around the clinical diagnosis of COPD versus asthma. Previously it has been found that a change in FEV1 of 4% of predicted in COPD patients was associated with subjects being able to appreciate that their breathlessness was improved [4].
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Articles: Correspondence Source Type: research

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Authors: Tangirala NC, O'Conor R, Wolf MS, Wisnivesky JP, Federman AD Abstract Regular use of inhaled corticosteroids (ICS) is the standard of care for patients with persistent asthma and chronic obstructive pulmonary disease (COPD). Adherence to ICS is measured using the 10-item Medication Adherence Report Scale (MARS), a self-reported medication adherence assessment. However, data on the validity of this measure are limited. Data were obtained from two cohort studies that examined the association of health literacy with self-management behaviors among adults ages 65 and older with asthma and adults ages 40 and ol...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research
This study describes the long-term comorbidity profile and treatment burden among people with HIV-1 infection.Methods: This retrospective study included Medicaid claims data from patients with ≥1 antiretroviral (ARV) claim between 2016 and 2017 (most recent claim defined the index date), ≥1 HIV diagnosis within 1 year before index, age ≥18 years at first HIV diagnosis and
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Condition:   Chronic Obstructive Respiratory Diseases Intervention:   Other: Therapeutic strategy Sponsor:   Olivier Michel Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
;rez López Sánchez There is a high prevalence of comorbidities among patients with chronic obstructive pulmonary disease (COPD). Comorbidities are likely common in patients with any COPD degree and are associated with increased mortality. The aim of this study was to determine the prevalence of thirty-one different COPD comorbidities and to evaluate the association between physical activity (PA) levels in people with COPD residing in Spain. Cross-sectional data from the Spanish National Health Survey 2017 were analysed. A total of 601 adults (52.2% females) with COPD aged 15 to 69 participated in this ...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Publication date: Available online 15 January 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Yong Suk Jo, Yong Il Hwang, Kwang Ha Yoo, Tae-Hyung Kim, Myung Goo Lee, Sang Haak Lee, Kyeong-Cheol Shin, Kwang Ho In, Hyoung Kyu Yoon, Chin Kook Rhee, Korean Asthma Research Group &KOCOSS cohortAbstractBackgroundFew reports have investigated the efficacy of using inhaled corticosteroid (ICS)-containing inhalers to treat patients with asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO).ObjectiveTo investigate the effect of ICS treatment on patients with ACO using five sets ...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
AbstractBackgroundPrevious studies have suggested an increased risk of asthma related to indoor dampness problems, but their role in the etiology of Asthma-COPD Overlap Syndrome has not been studied. We utilized a population-based incident case –control study to assess potential effect of indoor dampness and molds at home and at work on development of ACOS.MethodsWe recruited systematically all new cases of asthma diagnosed during a 2.5-year study period (1997 –2000) and randomly selected controls from the source population of adults 21–63 years old and representing 500,000 persons-years in the Pirka...
Source: Clinical and Translational Allergy - Category: Allergy & Immunology Source Type: research
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Source: WebMD Health - Category: Consumer Health News Source Type: news
Conclusion: We present a simple study where the patients are screened for obstructive lung disease with a handheld spirometry and a questionnaire on respiratory symptoms. Number needed to screen is low at 3.4-4.5. In all, 10 new cases of obstructive lung disease were diagnosed. This study illustrates that screening for COPD and asthma is feasible even in a psychiatric population. PMID: 31928298 [PubMed - as supplied by publisher]
Source: Nordic Journal of Psychiatry - Category: Psychiatry Tags: Nord J Psychiatry Source Type: research
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Source: Drugs.com - Daily MedNews - Category: General Medicine Source Type: news
Abstract Patients treated for drug addiction have high asthma and COPD prevalence rates. The relative contributions of cigarette smoking, smoking intensity and possible smoking of other substances has not been described. We aimed to describe the prevalence and determinants of asthma and COPD in patients prescribed methadone as opioid substitution therapy (OST). In a cross-sectional study of an anonymised patient-level primary care dataset of UK inner-city general practices (n = 46), 321,395 patients aged ≥18 years were identified. A total of 676 (0.21%) had a record of a methadone ever issued in p...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: NPJ Prim Care Respir Med Source Type: research
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