Adherence to Inhaled Therapy in Patients with COPD Associated to Pneumoconiosis

Abstract Background Chronic obstructive pulmonary disease (COPD) is an important risk factor for postoperative complications and mortality. To determine the effects of perioperative combination therapy, using a long-acting muscarinic antagonist (LAMA) and a long-acting β2 agonist (LABA), on preoperative lung function, postoperative morbidity and mortality, and long-term outcome in COPD patients. Methods Between January 2005 and October 2019, 130 consecutive patients with newly diagnosed COPD underwent surgery for lung cancer. We conducted a retrospective review of their medical record to evaluate that LAMA/LABA might be an optimal regimen for patients with COPD undergoing surgery for lung cancer. All patients were received perioperative rehabilitation and divided into 3 groups according to the type of perioperative inhaled therapy and management: LAMA/LABA (n = 64), LAMA (n = 23) and rehabilitation only (no bronchodilator) (n = 43). We conducted a retrospective review of their medical records. Results Patients who received preoperative LAMA/LABA therapy showed significant improvement in lung function before surgery (p < 0.001 for both forced expiratory volume in 1 s (FEV1) and percentage of predicted forced expiratory volume in 1 s (FEV1%pred). Compared with patients who received preoperative LAMA therapy, patients with LAMA/LABA therapy had significantly improved lung function (ΔFEV1, LAMA/LABA 223.1 mL vs. LAMA 130.0 mL, ΔFEV1%pred, LAMA/LABA 10.8% vs. LAMA 6.8%; both p < 0.05). Postoperative complications were lower frequent in the LAMA/LABA group than in the LAMA group (p = 0.007). In patients with moderate to severe air flow limitation (n = 61), those who received LAMA/LABA therapy had significantly longer overall survival and disease-free survival compared with the LAMA (p = 0.049, p = 0.026) and rehabilitation-only groups (p = 0.001, p < 0.001). Perioperative LAMA/LABA therapy was also associated with lower recurrence rates (vs. LAMA p = 0.006, vs. rehabilitation-only p = 0.008). Conclusions We believe this treatment combination is optimal for patients with lung cancer and COPD.

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Advances in the development of antimicrobial peptides and proteins for inhaled therapy

Advanced Drug Delivery Reviews ◽

10.1016/j.addr.2021.114066 ◽

2021 ◽

pp. 114066

Author(s):

Yuncheng Wang ◽

Rachel Yoon Kyung Chang ◽

Warwick J Britton ◽

Hak-Kim Chan

Keyword(s):

Antimicrobial Peptides ◽

Inhaled Therapy

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Characteristics of newly diagnosed COPD patients treated with triple inhaled therapy by general practitioners: a real world Italian study

npj Primary Care Respiratory Medicine ◽

10.1038/s41533-017-0051-9 ◽

2017 ◽

Vol 27 (1) ◽

Cited By ~ 6

Author(s):

Fabiano Di Marco ◽

Pierachille Santus ◽

Silvia Terraneo ◽

Elena Peruzzi ◽

Elisa Muscianisi ◽

...

Keyword(s):

General Practitioners ◽

Real World ◽

Newly Diagnosed ◽

Italian Study ◽

Copd Patients ◽

Inhaled Therapy

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Adherence to inhaled therapy and its impact on chronic obstructive pulmonary disease (COPD)

BMC Pulmonary Medicine ◽

10.1186/s12890-018-0724-3 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 10

Author(s):

Magdalena Humenberger ◽

Andreas Horner ◽

Anna Labek ◽

Bernhard Kaiser ◽

Rupert Frechinger ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Inhaled Therapy

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Long-term combined inhaled therapy with ipratropium bromide and ambroxol of heavy smoking patients with chronic obstructive lung disease

Russian Pulmonology ◽

10.18093/0869-0189-2005-0-5-102-106 ◽

2005 ◽

pp. 102-106

Author(s):

A. R. Tatarsky ◽

E. V. Sukhanova ◽

E. V. Bobkov ◽

A. B. Kiryukhin

Keyword(s):

Ipratropium Bromide ◽

Clinical Status ◽

Control Group ◽

Chronic Obstructive ◽

Cell Content ◽

Heavy Smoking ◽

Positive Effects ◽

Copd Patients ◽

Inhaled Therapy

The study was aimed to investigate the efficiency of long-term combined inhaled therapy with ipratropium bromide and ambroxol via compressor pneumatic nebulizer in 86 COPD patients. Significant improvement in clinical status, physical tolerance and cell content (macrophages, neutrophils) of induced sputum was revealed in all the patients in comparison with a control group. Mild to moderate COPD patients had considerable improvement in FEV1. The authors concluded that the proposed treatment had resulted in the positive effects.

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Respiratory adverse event profiles in cystic fibrosis placebo subjects in short- and long-term inhaled therapy trials

Contemporary Clinical Trials ◽

10.1016/j.cct.2006.06.001 ◽

2006 ◽

Vol 27 (6) ◽

pp. 561-570 ◽

Cited By ~ 2

Author(s):

Heidi Sucharew ◽

Christopher H. Goss ◽

Steven P. Millard ◽

Bonnie W. Ramsey

Keyword(s):

Cystic Fibrosis ◽

Adverse Event ◽

Inhaled Therapy ◽

Short And Long Term

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The environmental impact of inhaled therapy: making informed treatment choices

European Respiratory Journal ◽

10.1183/13993003.02106-2021 ◽

2021 ◽

pp. 2102106

Author(s):

Ashley Woodcock ◽

Kai M. Beeh ◽

Hironori Sagara ◽

Simon Aumônier ◽

Emmanuel Addo-Yobo ◽

...

Keyword(s):

Greenhouse Gases ◽

Environmental Impacts ◽

Carbon Footprint ◽

Treatment Decision ◽

Published Data ◽

Treatment Decision Making ◽

Number Of Factors ◽

Hfc 134A ◽

Inhaled Therapy ◽

Metered Dose

When selecting the best inhaler and drug combination for a patient with respiratory disease, a number of factors should be considered. While efficacy and safety of medical treatments are always a priority, in recent years the environmental impacts of all aspects of life have become an increasingly necessary consideration and inhaled therapies are no exception. The carbon footprint of an item, individual, or organisation, is one of the most important and quantifiable environmental impacts, assessed by the amount of greenhouse gases (often expressed in terms of CO2 equivalents) generated throughout the life cycle. The two most commonly prescribed and manufactured inhaler types worldwide are pressurised metered dose inhalers (pMDIs) containing hydrofluorocarbon (HFC) propellants and dry powder inhalers (DPIs). Most of the carbon footprint of current pMDIs is a result of the propellants that they contain (HFC-134a and HFC-227ea, which are potent greenhouse gases). In comparison, the powder in DPIs is dispersed by the patient's own inhalation, meaning DPIs do not contain a propellant and have a lower carbon footprint than most pMDIs currently available. Soft mist inhalers are another propellant-free option: the device contains a spring, which provides the energy to disperse the aqueous medication. In this review, we will examine the published data on carbon footprint data for inhalers, providing an analysis of potential implications for treatment decision making and industry initiatives.

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