Spirometric changes during exacerbations of COPD: a post hoc analysis of the WISDOM trial

Published on Dec 13, 2018in Respiratory Research5.631
· DOI :10.1186/S12931-018-0944-3
Henrik Watz38
Estimated H-index: 38
 , Kay Tetzlaff25
Estimated H-index: 25
 (University of Tübingen)+ 5 AuthorsPeter M.A. Calverley88
Estimated H-index: 88
Sources
Abstract
Background Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss of lung function and poor outcomes for patients. However, there are limited data on the time course of changes in forced expiratory volume in 1 s (FEV1) preceding the first reported symptom and after the start of an exacerbation.
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References22
Newest
Nov 1, 2017·American Journal of Respiratory and Critical Care Medicine21.41
#1Peter M.A. CalverleyH-Index: 88
#2Kay Tetzlaff (University of Tübingen)H-Index: 25
Last. Henrik WatzH-Index: 38
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Jul 1, 2017·Respiratory Medicine3.42
#1David M.G. Halpin (RD&E: Royal Devon and Exeter Hospital)H-Index: 30
#2Marc Decramer (Katholieke Universiteit Leuven)H-Index: 103
Last. Donald P. Tashkin (UCLA: University of California, Los Angeles)H-Index: 109
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Abstract Background COPD exacerbations are associated with accelerated lung function decline, but whether they are causal is unknown. We evaluated the effect of a single exacerbation on rate of lung function change using data from the 4-year Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT ® ) trial. Methods Retrospective analysis of annual rates of decline in FEV 1 and FVC before and after a single (and the only) moderate-to-severe exacerbation in patients during UP...
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Mar 1, 2017·American Journal of Respiratory and Critical Care Medicine21.41
#1C Vogelmeier (University of Marburg)
#2Gerard J. Criner (TU: Temple University)H-Index: 11
Last. Marc Decramer (Katholieke Universiteit Leuven)H-Index: 11
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This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 report focuses primarily on the revised and novel parts of the document. The most significant changes include: (1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and...
Source
Aug 24, 2016·American Journal of Respiratory and Critical Care Medicine21.41
#1Mark T. Dransfield (UAB: University of Alabama at Birmingham)H-Index: 65
#2Ken M. Kunisaki (UMN: University of Minnesota)H-Index: 16
Last. Barry J. Make (University of Colorado Denver)H-Index: 69
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Rationale: Acute exacerbations of chronic obstructive pulmonary disease (COPD) increase the risk of death and drive healthcare costs, but whether they accelerate loss of lung function remains controversial. Whether exacerbations in subjects with mild COPD or similar acute respiratory events in smokers without airflow obstruction affect lung function decline is unknown.Objectives: To determine the association between acute exacerbations of COPD (and acute respiratory events in smokers without COP...
Source
Aug 22, 2016·International Journal of Chronic Obstructive Pulmonary Disease3.35
#1Roberto Rodriguez-Roisin (University of Barcelona)H-Index: 40
#2Kay Tetzlaff (University of Tübingen)H-Index: 25
Last. Peter M.A. CalverleyH-Index: 88
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The WISDOM study ({"type":"clinical-trial","attrs":{"text":"NCT00975195","term_id":"NCT00975195"}}NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measur...
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May 1, 2016·The Lancet Respiratory Medicine30.70
#1Henrik WatzH-Index: 38
#2Kay Tetzlaff (University of Tübingen)H-Index: 25
Last. Peter M.A. CalverleyH-Index: 88
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Summary Background Blood eosinophil counts might predict response to inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) and a history of exacerbations. We used data from the WISDOM trial to assess whether patients with COPD with higher blood eosinophil counts would be more likely to have exacerbations if ICS treatment was withdrawn. Methods WISDOM was a 12-month, randomised, parallel-group trial in which patients received 18 μg tiotropium, 100 μg salmeter...
Source
Apr 29, 2016·American Journal of Respiratory and Critical Care Medicine21.41
#1Signe Vedel-Krogh (UCPH: University of Copenhagen)H-Index: 9
#2Sune F. Nielsen (UCPH: University of Copenhagen)H-Index: 35
Last. Børge G. Nordestgaard (UCPH: University of Copenhagen)H-Index: 165
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Rationale: Whether high blood eosinophils are associated with chronic obstructive pulmonary disease (COPD) exacerbations among individuals with COPD in the general population is largely unknown.Objectives: To test the hypothesis that high blood eosinophils predict COPD exacerbations.Methods: Among 81,668 individuals in the Copenhagen General Population Study, we examined 7,225 with COPD based on spirometry. We recorded blood eosinophils at baseline and future COPD exacerbations longitudinally, d...
Source
Aug 15, 2015·American Journal of Respiratory and Critical Care Medicine21.41
#1Salman Siddiqui (NIHR: National Institute for Health Research)H-Index: 35
#2Alessandro Guasconi (Chiesi Farmaceutici S.p.A.)H-Index: 6
Last. Dave SinghH-Index: 80
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To the Editor: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition (1). The identification of COPD phenotypes may allow stratified treatment approaches that modulate discrete disease mechanisms. Peripheral blood eosinophilia is both a common and repeatable finding in COPD (2). In addition, the presence of a blood/sputum eosinophilia is associated with a significant proportion of COPD exacerbations (3, 4) and a favorable response to systemic steroids (5). However, the role o...
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Oct 1, 2014·The New England Journal of Medicine91.25
#1Helgo MagnussenH-Index: 68
#2Bernd DisseH-Index: 18
Last. Pascal ChanezH-Index: 88
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In this 12-month, double-blind, parallel-group study, 2485 patients with a history of exacerbation of COPD received triple therapy consisting of tiotropium (at a dose of 18 μg once daily), salmeterol (50 μg twice daily), and the inhaled glucocorticoid fluticasone propionate (500 μg twice daily) during a 6-week run-in period. Patients were then randomly assigned to continued triple therapy or withdrawal of fluticasone in three steps over a 12-week period. The primary end point was the time to the...
Source
Apr 1, 2014·Respiratory Medicine3.42
#1Helgo MagnussenH-Index: 68
#2Henrik WatzH-Index: 38
Last. Bernd Disse (Boehringer Ingelheim)H-Index: 18
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Summary Long-acting bronchodilators in combination with inhaled corticosteroids (ICS) are recommended to decrease the risk of recurrent exacerbations in patients with Global initiative for chronic Obstructive Lung Disease (GOLD) stage 3–4 chronic obstructive pulmonary disease (COPD). There is increasing concern about the clinical benefit and long-term safety of ICS use in COPD patients. The WISDOM (Withdrawal of Inhaled Steroids During Optimised bronchodilator Management) study (NCT00975195) aim...
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Non-invasive at-home monitoring of lung and lung airways health enables the early detection and tracking of respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD). Various proposed approaches estimate the respiratory rate and extract the respiratory waveform from an electrocardiogram (ECG) signal as a way to discreetly monitor lung health. Unfortunately, these approaches fail to accurately capture the respiratory cycle phase features, resulting in a non-specific, incom...
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Impressive advances in inhalation therapy for patients with asthma and chronic obstructive pulmonary disease (COPD) have occurred in recent years. However, important gaps in care remain, particularly relating to poor adherence to inhaled therapies. Digital inhaler health platforms which incorporate digital inhalers to monitor time and date of dosing are an effective disease and medication management tool, promoting collaborative care between clinicians and patients, and providing more in-depth u...
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Jul 1, 2021·Journal of Thoracic Disease2.90
#1Sha Liu (University of South China)H-Index: 1
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Purpose null This study evaluated the safety and efficacy of inhaled nemiralisib, a phosphoinositide 3-kinase δ (PI3Kδ) inhibitor, in patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD). null Methods null In this double-blind, placebo-controlled study, 126 patients (40-80 years with a post-bronchodilator forced expiratory volume in 1 sec (FEV1) ≤80% of predicted (previously documented)) were randomized 1:1 to once daily inhaled nemiralisib (1 mg) or placebo for 84...
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Although the pathophysiology of chronic obstructive pulmonary disease (COPD) is multifactorial, central airway collapse is reported to have a great impact on symptom severity. In COPD patients, positive pressure formed by hyperinflated lungs compressing the tracheal wall and negative changes in intratracheal static pressure due to rapid expiratory flow velocity at the beginning of expiration collapse the trachea. This phenomenon can be explained by fluid dynamics theory. Our hypothesis is that v...
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Background/Aims The sit-to-stand test is a quick and cost-effective measure of exercise tolerance and lower body strength. The literature focuses on its use in stable patients with chronic obstruct...
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Non-invasive at-home monitoring of lung and lung airways health enables the early detection and tracking of respiratory diseases like asthma and chronic obstructive pulmonary disease (COPD). Various proposed approaches estimate the respiratory rate and extract the respiratory waveform from an electrocardiogram (ECG) signal as a way to discreetly monitor lung health. Unfortunately, these approaches fail to accurately capture the respiratory cycle phase features, resulting in a non-specific, incom...
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Objective: To develop an algorithm that can infer the severity level of a COPD patient's airflow limitation from tidal breathing data that is collected by a wearable device. Methods: Data was collected from 25 single visit adult volunteers with a confirmed or suspected diagnosis of chronic obstructive pulmonary disease (COPD). The ground truth airflow limitation severity of each subject was determined by applying the Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging criteria ...
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