The pharmacological management of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS).

The pharmacological management of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). Expert Opin Pharmacother. 2020 Feb;21(2):213-231 Authors: Albertson TE, Chenoweth JA, Pearson SJ, Murin S Abstract Introduction: Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS) is a disease phenotype that shares T helper lymphocyte cell Th1/neutrophilic/non-Type-2 Inflammation pathways thought to be key in COPD and Th2/eosinophilic/Type-2 inflammatory pathways of asthma. The pharmacology of treating ACOS is challenging in severe circumstances.Areas covered: This review evaluates the stepwise treatment of ACOS using pharmacological treatments used in both COPD and asthma. The most common medications involve the same inhalers used to treat COPD and asthma patients. Advanced stepwise therapies for ACOS patients are based on patient characteristics and biomarkers. Very few clinical trials exist that focus specifically on ACOS patients.Expert opinion: After inhalers, advanced therapies including phosphodiesterase inhibitors, macrolides, N-acetylcysteine and statin therapy for those ACOS patients with a COPD appearance and exacerbations are available. In atopic ACOS patients with exacerbations, advanced asthma therapies (leukotriene receptor antagonists and synthesis blocking agents.) are used. ACOS patients with elevated blood eosinophil/IgE levels are considered for immunotherapy or therapeutic monoclonal antibodies blocking specific Th...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

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Publication date: Available online 13 February 2020Source: Pharmacology &TherapeuticsAuthor(s): Kylie B.R. Belchamber, Louise E. DonnellyAbstractChronic pulmonary conditions now account for 1 in 15 deaths in the US and mortality is increasing. Chronic obstructive pulmonary disease (COPD) is due to become the 3rd largest cause of mortality by 2030 and mortality from other respiratory conditions such as asthma, idiopathic pulmonary fibrosis and cystic fibrosis are not reducing. There is an urgent need for novel therapies to address this problem as many of the current strategies targeting inflammation are not sufficient. ...
Source: Pharmacology and Therapeutics - Category: Drugs & Pharmacology Source Type: research
Background: Although some studies have evaluated the association of the receptor for advanced glycation end products (RAGE) genetic variation with asthma and COPD, the results are still inconsistent. We here aimed to investigate the association of multiple variants in RAGE gene with the risk for asthma and COPD, alone and in combination, in a population-based Han Chinese cohort.Methods: Five variants in RAGE gene (rs1800625, rs1800624, rs2070600, rs184003 and rs2071288) were genotyped using the TaqMan assay among 347 patients with asthma or COPD and 527 age and sex-matched controls. Data were analyzed using Haplo.stats pro...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Genes and environment Source Type: research
Conditions:   Hypertension;   Diabetes;   Obesity;   COPD;   CHF;   High Cholesterol;   Asthma;   Chronic Pain;   Multiple Sclerosis;   Depression;   Anxiety;   Heart Diseases;   Stroke Interventions:   Behavioral: HeRe We Arts;   Behavioral: HeRe We Ed Sponsors:   The Cleveland Clinic;   National Endowment for the Arts;   Cuyahoga Arts and Culture Recruiting
Source: - Category: Research Source Type: clinical trials
AbstractBackgroundFunctional limitations may be more common in middle-aged adults than previously recognized. However, there are few published data on the prevalence of activity limitations, and their association with multimorbidity, among adults 50 to 64  years old.ObjectiveTo describe the prevalence of activity limitations and the association with multimorbidity in middle-aged adults.DesignCross-sectional analysis of US population-based National Health and Nutrition Examination Survey (NHANES) 2011 –2016.ParticipantsThe total number of community-dwelling NHANES participants aged 50 –64 years old is ...
Source: Journal of General Internal Medicine - Category: Internal Medicine 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
CONCLUSIONS: Contrary to expectation, the combination of poor mental functioning and chronic disease diagnosis did not have a strong synergistic effect on cost. Mental and general medical conditions appear to have independent effects on health care costs. PMID: 31378194 [PubMed - as supplied by publisher]
Source: Psychiatric Services - Category: Psychiatry Tags: Psychiatr Serv Source Type: research
Conclusion: Challenges with using and changing inhalers has meant this market has not followed other high-volume drug classes following patent loss. This is starting to change, with the situation monitored to enhance efficient prescribing alongside continued good quality care. PMID: 31189394 [PubMed - as supplied by publisher]
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
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