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Outcomes of high-flow versus conventional oxygen therapy in adult medical and post-surgical oncology patients: A systematic review and meta-analysis
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-02 DOI: 10.1016/j.rmed.2025.108057
Shayan Heybati , Sarah Malone , Kiyan Heybati , Jiawen Deng , Fangwen Zhou , Angelique Roy , Shubh Patel , John Muscedere , Paul Heffernan
{"title":"Outcomes of high-flow versus conventional oxygen therapy in adult medical and post-surgical oncology patients: A systematic review and meta-analysis","authors":"Shayan Heybati ,&nbsp;Sarah Malone ,&nbsp;Kiyan Heybati ,&nbsp;Jiawen Deng ,&nbsp;Fangwen Zhou ,&nbsp;Angelique Roy ,&nbsp;Shubh Patel ,&nbsp;John Muscedere ,&nbsp;Paul Heffernan","doi":"10.1016/j.rmed.2025.108057","DOIUrl":"10.1016/j.rmed.2025.108057","url":null,"abstract":"<div><h3>Background</h3><div>While the outcomes of patients with cancer have improved, the prognosis for those requiring invasive mechanical ventilation (IMV) remains poor. High-flow nasal cannula (HFNC) can be used as a management strategy to avoid IMV.</div></div><div><h3>Objectives</h3><div>To determine the efficacy and safety of HFNC compared to other non-invasive oxygenation techniques among patients with cancer.</div></div><div><h3>Methods</h3><div>This systematic review was prospectively registered and followed PRISMA guidelines. Literature searches were conducted from inception to May 17th, 2023, across MEDLINE, EMBASE, CINAHL, CENTRAL, and Web of Science. We included observational studies and randomized controlled trials enrolling adults (≥18 years of age) with an underlying cancer diagnosis that compared HFNC to at least one other form of non-invasive oxygenation.</div></div><div><h3>Results</h3><div>Seven (n = 501) medical and 4 (n = 379) post-esophagectomy studies were included. There were no significant differences in all-cause mortality (n = 573; RR 0.81; 95 % CI: 0.48 to 1.36; I<sup>2</sup> = 9 %) or invasive mechanical ventilation (IMV) (n = 540; RR 0.89; 95 % CI: 0.62 to 1.28; I<sup>2</sup> = 47 %). HFNC was associated with lower nose/mouth dryness overall (n = 398; RR 0.37; 95 % CI: 0.24 to 0.58; I<sup>2</sup> = 20 %). Across post-esophagectomy studies, HFNC was associated with shorter hospital length of stay (LOS) (n = 309; MD -88.73 h; 95 % CI: 108.94 to −68.52 h; I<sup>2</sup> = 0 %). Among medical studies, one study reported a shorter hospital LOS.</div></div><div><h3>Conclusions</h3><div>Among hospitalized patients with cancer, there were no significant differences in mortality, IMV use, ICU LOS, or skin damage. Across both cohorts, HFNC was associated with shorter hospital LOS and lower rates of nose/mouth dryness compared to other non-invasive oxygen techniques.</div></div><div><h3>Prospero registration</h3><div>CRD42022303621.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108057"},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anemia in COPD and cardiovascular mortality
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-02 DOI: 10.1016/j.rmed.2025.108084
Ana Ibarra-Macia, Eduardo Garcia-Pachon
{"title":"Anemia in COPD and cardiovascular mortality","authors":"Ana Ibarra-Macia,&nbsp;Eduardo Garcia-Pachon","doi":"10.1016/j.rmed.2025.108084","DOIUrl":"10.1016/j.rmed.2025.108084","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108084"},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of arterial stiffness as assessed by the cardio-ankle vascular index in patients with chronic obstructive pulmonary disease
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-01 DOI: 10.1016/j.rmed.2025.108078
Kyohei Oishi , Hideki Yasui , Yusuke Inoue , Hironao Hozumi , Yuzo Suzuki , Masato Karayama , Kazuki Furuhashi , Noriyuki Enomoto , Tomoyuki Fujisawa , Naoki Inui , Takafumi Suda
{"title":"The role of arterial stiffness as assessed by the cardio-ankle vascular index in patients with chronic obstructive pulmonary disease","authors":"Kyohei Oishi ,&nbsp;Hideki Yasui ,&nbsp;Yusuke Inoue ,&nbsp;Hironao Hozumi ,&nbsp;Yuzo Suzuki ,&nbsp;Masato Karayama ,&nbsp;Kazuki Furuhashi ,&nbsp;Noriyuki Enomoto ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Naoki Inui ,&nbsp;Takafumi Suda","doi":"10.1016/j.rmed.2025.108078","DOIUrl":"10.1016/j.rmed.2025.108078","url":null,"abstract":"<div><h3>Background</h3><div>Arteriosclerosis and cardiovascular disease (CVD) can greatly affect the progression of chronic obstructive pulmonary disease (COPD). However, standardized methods for evaluating arteriosclerosis in COPD have not been established. The cardio-ankle vascular index (CAVI) is a reliable marker of arterial stiffness and a potential marker for assessing arteriosclerosis. This study aimed to examine the associations between the CAVI and clinical parameters and to evaluate its predictive value for clinical outcomes in COPD.</div></div><div><h3>Methods</h3><div>This retrospective, observational study included patients with COPD who underwent CAVI assessment. The relationships between CAVI and clinical parameters were analysed. The patients were stratified into two groups according to the median CAVI. We examined whether an elevated CAVI was associated with clinical outcomes and evaluated its predictive value for poor clinical outcomes, including disability (modified Rankin Scale score ≥4) or death.</div></div><div><h3>Results</h3><div>A total of 102 patients were analysed (median age: 74 years; 94.1 % men). The median CAVI was 9.4. The CAVI was positively correlated with the percentage of a low attenuation area on computed tomography and negatively correlated with FEV<sub>1</sub> and body mass index, independent of age and the smoking index. An elevated CAVI (&gt;9.4) was associated with severe exacerbations and poor clinical outcomes. A multivariate analysis identified the CAVI as an independent predictor of poor clinical outcomes, regardless of age, severity of dyspnoea, and airflow obstruction.</div></div><div><h3>Conclusion</h3><div>Arterial stiffness assessed by the CAVI is a useful marker of COPD severity and may serve as a prognostic indicator and therapeutic target for improving COPD management.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108078"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BEAT-CF (Bayesian Evidence Adaptive Treatment for people with Cystic Fibrosis): description of a prospective cohort for nested studies in cystic fibrosis
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-01 DOI: 10.1016/j.rmed.2025.108080
Parveen Fathima , Edward Pan , Julie Marsh , Nelly Newall , Tracey Meares , Charlie McLeod , Shivanthan Shanthikumar , Adam Jaffe , Andrew Tai , Nathan Ward , Sheila Sivam , Hiran Selvadurai , André Schultz , Tom Snelling
{"title":"BEAT-CF (Bayesian Evidence Adaptive Treatment for people with Cystic Fibrosis): description of a prospective cohort for nested studies in cystic fibrosis","authors":"Parveen Fathima ,&nbsp;Edward Pan ,&nbsp;Julie Marsh ,&nbsp;Nelly Newall ,&nbsp;Tracey Meares ,&nbsp;Charlie McLeod ,&nbsp;Shivanthan Shanthikumar ,&nbsp;Adam Jaffe ,&nbsp;Andrew Tai ,&nbsp;Nathan Ward ,&nbsp;Sheila Sivam ,&nbsp;Hiran Selvadurai ,&nbsp;André Schultz ,&nbsp;Tom Snelling","doi":"10.1016/j.rmed.2025.108080","DOIUrl":"10.1016/j.rmed.2025.108080","url":null,"abstract":"<div><h3>Background</h3><div>Despite recent improvements in treatment modalities for cystic fibrosis (CF), there is currently limited evidence and a lack of consensus regarding optimal treatment strategies for the different aspects of CF, including pulmonary exacerbations (PEx). We aimed to establish a prospective cohort of people with CF (pwCF) to evaluate alternative approaches to managing CF in the era of modulator therapies.</div></div><div><h3>Methods</h3><div>We prospectively enrolled children and adults with CF receiving care at specialist CF centres across Australia. Participant data were systematically collected on demography, clinical signs and symptoms, comorbidities, spirometry, participant reported outcomes, microbiology and treatments received. Here we describe the demographic, microbiological and clinical characteristics of the participants at enrolment, to understand the representativeness of the cohort for planning future nested studies.</div></div><div><h3>Results</h3><div>Between October 14, 2020 and December 31, 2023, 927 pwCF were enrolled across eleven Australian CF centres. Of these, 51% (n=472) were male, 77% (n=709) were &lt;18 years old, 90% (n=831) had a highest ppFEV<sub>1</sub> (percent predicted forced expiratory volume exhaled in the first second) of ≥70% in the preceding year, and 35% (n=322) reported detection of <em>Pseudomonas aeruginosa</em> in their airway specimens.</div></div><div><h3>Conclusions</h3><div>We have established a contemporary cohort of pwCF with granular clinical and treatment data for PEx. This cohort will enable future nested studies focused on PEx management and other aspects of CF care. Understanding the baseline characteristics of these participants, as presented here, is critical for interpreting subsequent outcomes and for identifying factors that may influence disease progression and response to therapies.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108080"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between depression, anxiety and long-term healthcare resource utilization in patients with pulmonary embolism
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-01 DOI: 10.1016/j.rmed.2025.108079
Inge Kirchberger , Simone Fischer , Thomas M. Berghaus , Jakob Linseisen , Christine Meisinger
{"title":"Association between depression, anxiety and long-term healthcare resource utilization in patients with pulmonary embolism","authors":"Inge Kirchberger ,&nbsp;Simone Fischer ,&nbsp;Thomas M. Berghaus ,&nbsp;Jakob Linseisen ,&nbsp;Christine Meisinger","doi":"10.1016/j.rmed.2025.108079","DOIUrl":"10.1016/j.rmed.2025.108079","url":null,"abstract":"<div><h3>Background</h3><div>To date, the utilization of healthcare resources for complications associated with acute pulmonary embolism (PE) have received no attention. This study aimed to explore healthcare utilization and its association with depression and anxiety up to 2 years after in-patient treatment for PE.</div></div><div><h3>Methods</h3><div>Data from the German ‘Lungenembolie Augsburg (LEA)' cohort study was used. Baseline characteristics of the adult patients with PE were collected through an interview during hospital stay and via chart review. Participants completed postal questionnaires 3, 6, 12, and 24 months after their PE event containing questions on healthcare utilization. Depression and anxiety were assessed using the Hospital Anxiety and Depression scale (HADS-D). Negative binomial mixed models were used to investigate the associations between depression and anxiety scores (exposures) and the number of hospitalizations, hospital outpatient clinic visits, general practitioner consultations and medical specialist visits with outcomes adjusted for potential confounders.</div></div><div><h3>Results</h3><div>Out of 569 patients (55 % male, mean age 63.0 ± 14.5 years), 18.3 % had at least mild symptoms of depression and 21.3 % had at least mild symptoms of anxiety at the initial hospitalization. During the first 3 months after hospital discharge, 28.1 % of the patients had at least one hospital readmission. Higher HADS-D depression scores were significantly associated with more hospitalizations (p = 0.0063), hospital outpatient clinic visits (p = 0.0009) and visits to general practitioners (p = 0.0434). Higher HADS-D anxiety scores were significantly associated with more hospitalizations (p = 0.0413) and visits to medical experts (p = 0.0268).</div></div><div><h3>Conclusions</h3><div>Depression and anxiety were significantly associated with increased healthcare utilization in patients with PE.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108079"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Age-related changes of inflammatory cytokines in nasal secretion of patients with chronic rhinosinusitis
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-01 DOI: 10.1016/j.rmed.2025.108082
Fang Chen , Chaosheng Yu , Tao Zhang , Congxiang Shen , Yonghe Li , Hongzheng Zhang
{"title":"Age-related changes of inflammatory cytokines in nasal secretion of patients with chronic rhinosinusitis","authors":"Fang Chen ,&nbsp;Chaosheng Yu ,&nbsp;Tao Zhang ,&nbsp;Congxiang Shen ,&nbsp;Yonghe Li ,&nbsp;Hongzheng Zhang","doi":"10.1016/j.rmed.2025.108082","DOIUrl":"10.1016/j.rmed.2025.108082","url":null,"abstract":"<div><h3>Background</h3><div>Patient-specific factors are highly involved in chronic rhinosinusitis (CRS) 's course and treatment response. However, the effects of aging on the pathophysiology of CRS remain unclear. This study aimed to evaluate the age-related changes in nasal secretion inflammatory characteristics in patients with CRS.</div></div><div><h3>Methods</h3><div>The levels of 12 inflammatory cytokines in nasal mucus samples obtained from 31 patients diagnosed with CRS were measured via enzyme-linked immunosorbent assays. The associations between age and inflammatory cytokine levels were determined by Spearman correlation coefficient analysis. In addition, the relationships between inflammatory markers and demographic evaluation variables such as the Sino-Nasal Outcome Test-22 (SNOT-22) score and disease duration were examined to determine whether the levels of inflammatory cytokines influence the assessment of disease severity in CRS patients.</div></div><div><h3>Results</h3><div>Compared to younger patients with CRS, aged CRS patients exhibited a significant reduction in IL-6 levels (p &lt; 0.01), while levels of IL-10 (p &lt; 0.01), IL-13 (p &lt; 0.01), and Eotaxin (p &lt; 0.05) were markedly elevated. Notably, the Eotaxin level demonstrated a significant decline with age among CRS patients younger than 60 years old (r = −0.79, p &lt; 0.001). Furthermore, the increased mucus TNF-α level was significantly correlated with the prolongation of the disease course in aged CRS patients, with a clinically relevant difference of 7.78 months (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>We have revealed age-specific changes in the inflammatory characteristics of CRS patients, providing new and interesting findings for the development of personalized treatment methods tailored to this high-risk population.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108082"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to "Evaluation of the benefits of respirator breathing and vomiting training and dynamic core training on improving respiratory muscle strength" [Respir. Med. 240 (2025) 108029].
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-01 DOI: 10.1016/j.rmed.2025.108060
Ran He, Lin Ren
{"title":"Corrigendum to \"Evaluation of the benefits of respirator breathing and vomiting training and dynamic core training on improving respiratory muscle strength\" [Respir. Med. 240 (2025) 108029].","authors":"Ran He, Lin Ren","doi":"10.1016/j.rmed.2025.108060","DOIUrl":"10.1016/j.rmed.2025.108060","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108060"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetically determined α-Klotho levels and causal association with aging-related lung diseases
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-04-01 DOI: 10.1016/j.rmed.2025.108081
Chen Jin, Ruiying Jin, Dingyu Liu, Yuwen Li
{"title":"Genetically determined α-Klotho levels and causal association with aging-related lung diseases","authors":"Chen Jin,&nbsp;Ruiying Jin,&nbsp;Dingyu Liu,&nbsp;Yuwen Li","doi":"10.1016/j.rmed.2025.108081","DOIUrl":"10.1016/j.rmed.2025.108081","url":null,"abstract":"<div><h3>Background</h3><div>Abnormal α-Klotho (KL) levels play an essential role in the pathogenesis of aging-related lung diseases. However, the correlation between circulating KL levels and aging-related lung diseases has not been determined. This study aimed to determine whether circulating KL levels causally affect aging-related lung diseases using Mendelian randomization (MR).</div></div><div><h3>Methods</h3><div>Five KL-associated Single-nucleotide polymorphisms (SNPs) were analyzed using two-sample MR to assess their effects on three aging-related lung diseases: idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), and lung cancer.</div></div><div><h3>Results</h3><div>Based on a main casual effects model with MR analyses by the inverse variance weighted (IVW) method including multiplicative random-effects model (IVW-mre) and fixed-effects inverse variance-weighted model (IVW-fe), genetically predicted circulating KL levels were negatively related with risk of IPF (Odds ratio (OR<sub>IVW-mre</sub>), 0.999, 95 % CI, 0.999–1.000, <em>P</em> <sub>IVW-mre</sub> = 0.008; OR <sub>IVW-fe</sub>, 0.999, 95 % CI, 0.999–1.000, <em>P</em><sub>IVW-fe</sub> = 0.042). Inversely, the circulating levels of KL displayed no clear association with COPD and lung cancer. No pleiotropy was detected.</div></div><div><h3>Conclusions</h3><div>Genetically predicted circulating KL was causally associated with a lower risk of IPF, suggesting a protective effect in preventing IPF risk. Therefore, KL may be a promising target for the prevention and therapeutic intervention in patients with IPF.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108081"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations of small airway dysfunction assessed by impulse oscillometry with lung function decline and exacerbations in participants with chronic obstructive pulmonary disease: A prospective cohort study in China
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-03-31 DOI: 10.1016/j.rmed.2025.108075
Lifei Lu , Fan Wu , Gaoying Tang , Qi Wan , Zhishan Deng , Jieqi Peng , Cuiqiong Dai , Kunning Zhou , Xiaohui Wu , Shuqing Yu , Yongqing Huang , Changli Yang , Shengtang Chen , Pixin Ran , Yumin Zhou
{"title":"Associations of small airway dysfunction assessed by impulse oscillometry with lung function decline and exacerbations in participants with chronic obstructive pulmonary disease: A prospective cohort study in China","authors":"Lifei Lu ,&nbsp;Fan Wu ,&nbsp;Gaoying Tang ,&nbsp;Qi Wan ,&nbsp;Zhishan Deng ,&nbsp;Jieqi Peng ,&nbsp;Cuiqiong Dai ,&nbsp;Kunning Zhou ,&nbsp;Xiaohui Wu ,&nbsp;Shuqing Yu ,&nbsp;Yongqing Huang ,&nbsp;Changli Yang ,&nbsp;Shengtang Chen ,&nbsp;Pixin Ran ,&nbsp;Yumin Zhou","doi":"10.1016/j.rmed.2025.108075","DOIUrl":"10.1016/j.rmed.2025.108075","url":null,"abstract":"<div><h3>Introduction</h3><div>Small airway dysfunction (SAD) assessed by impulse oscillometry (IOS) was common in patients with chronic obstructive pulmonary disease (COPD). However, little is known about the associations between IOS-defined small airway dysfunction (SAD) and the long-term prognosis of COPD. This study aimed to explore the associations between IOS-defined SAD, lung function decline and exacerbations in patients with COPD.</div></div><div><h3>Methods</h3><div>We analyzed baseline and 2-year follow-up data from the prospective cohort study in China. We defined SAD using IOS parameters Z-score greater than the 1.645 or less than −1.645. Subsequently, these patients were divided into three groups based on the different criteria defined SAD using IOS (normal group [none IOS parameters abnormalities], inconsistent SAD [any IOS parameters abnormalities, but not all], consistent SAD [all of IOS parameters abnormalities]). Negative binomial regression was conducted to analyze the associations between SAD and exacerbations, while a multivariable linear regression model was utilized to identify associations between SAD and lung function decline.</div></div><div><h3>Results</h3><div>833 patients with COPD were enrolled in our study. SAD (defined by X5, AX, and Fres z-score) was associated with a faster decline in lung function and higher risk of exacerbation. Meanwhile, for inconsistent diagnosis of SAD, we observed that patients with consistent SAD and inconsistent SAD experienced a faster decline in FEV<sub>1</sub> and higher risk of exacerbations than those with normal group.</div></div><div><h3>Conclusions</h3><div>IOS-defined SAD was associated with worse outcomes in patients with COPD, and further clinical trials are needed to clarify whether early intervention to reduce the severity of small airway lesions can delay the progress of COPD.</div></div><div><h3>Trial registration</h3><div>Chinese Clinical Trial Registry, ChiCTR1900024643. Registered on 19 July 2019.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108075"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of Indacaterol vs Tiotropium in COPD patients due to biomass exposure in improving quality of life and reducing symptoms 茚达特罗与噻托溴铵对生物质暴露所致慢性阻塞性肺病患者改善生活质量和减轻症状的疗效对比。
IF 3.5 3区 医学
Respiratory medicine Pub Date : 2025-03-30 DOI: 10.1016/j.rmed.2025.108074
Robinson E. Robles-Hernández , Francisco Montiel-Lopez , Mónica Velázquez-Uncal , Raúl H. Sansores , Rafael J. Hernández-Zenteno , Rogelio Pérez-Padilla , Alejandra Ramírez-Venegas
{"title":"Efficacy of Indacaterol vs Tiotropium in COPD patients due to biomass exposure in improving quality of life and reducing symptoms","authors":"Robinson E. Robles-Hernández ,&nbsp;Francisco Montiel-Lopez ,&nbsp;Mónica Velázquez-Uncal ,&nbsp;Raúl H. Sansores ,&nbsp;Rafael J. Hernández-Zenteno ,&nbsp;Rogelio Pérez-Padilla ,&nbsp;Alejandra Ramírez-Venegas","doi":"10.1016/j.rmed.2025.108074","DOIUrl":"10.1016/j.rmed.2025.108074","url":null,"abstract":"<div><h3>Background</h3><div>Few treatment trials have been tested on COPD patients associated with biomass smoke exposure (COPD-B). Patients with COPD-B improve hyperinflation 24 hours after inhaling long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA), and after six months of treatment, improve symptoms, quality of life, and exacerbations. However, the usefulness of LAMA or LABA for an extended period for improving quality of life and symptoms has not yet been demonstrated in the COPD-B phenotype. The primary aim of this trial was to compare tiotropium (TIO) with indacaterol (IND) in improving the quality of life (QOL) measured by the Saint George's Respiratory Questionnaire (SGRQ) in COPD-B after six months of treatment.</div></div><div><h3>Methods</h3><div>A randomized, open-label, parallel-group clinical trial designed at a third-level health institute in Mexico City. Seventy-three COPD-B women were randomly assigned to either 150 mcg of indacaterol or 18 mcg of tiotropium once daily for 24 weeks.</div></div><div><h3>Results</h3><div>197 patients underwent the screening visit, of which 73 were randomized. There was no significant change in the three domains nor the total score of the SGRQ in either treatment group. For secondary outcomes, the TIO group showed a substantial change in the IC of 160 mL (p=0.016) after six month-treatment. For both treatment groups, a significant reduction in BDI/TDI score of 3 points was shown (p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Neither TIO nor IND improved quality of life, nor dyspnea evaluated by the mMRC scale, but TIO did improve inspiratory capacity, and TIO and IND improved dyspnea evaluated by BDI/TDI.</div></div><div><h3>Clinical Trial Registration</h3><div>NCT05506865</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108074"},"PeriodicalIF":3.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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