International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Frequency of Exacerbations of Chronic Obstructive Pulmonary Disease Associated with the Long-Term Exposure to Air Pollution in the AIREPOC Cohort.","authors":"Astrid Berena Herrera Lopez, Carlos A Torres-Duque, Alejandro Casas Herrera, María Patricia Arbeláez, Horacio Riojas-Rodríguez, José Luis Texcalac-Sangrador, Néstor Y Rojas, Laura Andrea Rodriguez-Villamizar","doi":"10.2147/COPD.S498437","DOIUrl":"10.2147/COPD.S498437","url":null,"abstract":"<p><strong>Background: </strong>Exacerbations of chronic obstructive pulmonary disease (COPD-E) have been associated with levels of air pollution. The occurrence of COPD-E is associated with increased mortality in this population.</p><p><strong>Purpose: </strong>To determine the association between long-term exposure to PM_2.5 and NO₂, and the frequency of COPD-E in patients belonging to AIREPOC, an institutional integrated care program for COPD in Bogota, Colombia.</p><p><strong>Patients and methods: </strong>Retrospective cohort study included patients with COPD living in Bogotá, between 2018 and 2021, who received health care in the AIREPOC program. Each patient´s home address was geolocated. Information from local air quality network stations was used to estimate daily and annual mean PM_2.5 and NO₂ exposure level for each patient using the inverse distance squared weighted regression (IDWR) method. The effect of PM_2.5 and NO₂ concentrations categorized at 15 µg/m³ and 25 µg/m³ respectively on the frequency of COPD-E was estimated using a zero-truncated negative binomial model adjusted for potential confounders. Goodness-of-fit was assessed by residuals.</p><p><strong>Results: </strong>During the observation period, 580 COPD-E occurred in 722 patients. Significant associations were found between COPD-E and NO₂ concentrations ≥25 µg/m³ (incidence density ratio, RDI: 1.29, 95% CI: 1.02-1.67) after adjustment for sun exposure, COPD severity, depression, and ambient humidity. No association was found between the frequency of COPD-E and PM_2.5 concentrations ≥15µg/m³.</p><p><strong>Conclusion: </strong>Prolonged exposure to high levels of NO₂ increases the frequency of COPD exacerbations in patients residing in Bogotá. These results highlight the importance of strengthening air quality control measures and educating people with COPD to know and interpret the local air quality indices and to follow the recommendations derived from its alterations.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"425-435"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517126","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}

{"title":"Adherence to Inhalation Therapy Among COPD Patients: A Cross-Sectional Study in a Tertiary Hospital in Quito, Ecuador.","authors":"Juan S Izquierdo-Condoy, Fernando Gualpa Álvarez, Estefania Morales-Lapo, Washington David Arias Calvache, Jessica Bermúdez Moreira, Katherine M Quinga-Chiguano, Esteban Ortiz-Prado","doi":"10.2147/COPD.S493992","DOIUrl":"10.2147/COPD.S493992","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD), the third leading cause of death globally, poses a significant public health burden. Despite its high prevalence, underdiagnosis and poor treatment adherence remain major challenges, contributing to increased hospitalization and mortality.</p><p><strong>Purpose: </strong>This study aimed to assess adherence to inhalation therapy among COPD patients treated at a specialty hospital in Quito, Ecuador.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted on 85 patients diagnosed with COPD at a tertiary hospital in Quito. Data was collected through face-to-face surveys, utilizing the TAI-10 questionnaire to assess treatment adherence, along with demographic and clinical characteristics of the patients.</p><p><strong>Results: </strong>Among the participants, 34.1% demonstrated good adherence to inhalation therapy, while 32.9% exhibited intermediate adherence, and 32.9% were non-adherent. The majority were older adults aged ≥76 years (67.1%) with a high prevalence of comorbidities (91.8%), particularly hypertension (58.8%). Non-adherence was primarily associated with forgetfulness and financial constraints. Higher BMI was significantly linked to better adherence, with obese patients showing higher odds of intermediate (OR=7.228, 95% CI 1.866-27.996) and good adherence (OR=9.966, 95% CI 2.538-39.139).</p><p><strong>Conclusion: </strong>Approximately one-third of COPD patients in Ecuador demonstrate good adherence to inhalation therapy, while similar proportions show intermediate or poor adherence. Predominantly older adults and retirees with comorbidities, the population identified forgetfulness and financial constraints as key barriers. These findings emphasize the need for enhanced patient education, regular follow-ups, and tailored support for vulnerable groups.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"399-410"},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505247","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}

{"title":"Skeletal Muscle Function in Relation to COPD Severity and Its Predictive Significance for Disease Progression.","authors":"Zemin He, Boxiong Cao, Keting Liu, Qiang Wei","doi":"10.2147/COPD.S510425","DOIUrl":"10.2147/COPD.S510425","url":null,"abstract":"<p><strong>Purpose: </strong>To compare skeletal muscle function levels in different COPD severities and explore their relationship with COPD severity and progression.</p><p><strong>Patients and methods: </strong>The study included COPD patients from the First People's Hospital of Shuangliu District, Chengdu between May 2021 and May 2022, categorized into mild, moderate, severe and very severe groups based on FEV1%. Skeletal muscle function (quadriceps strength, respiratory muscle strength, 6MWD) was compared among these groups. Patients were followed up to assess disease progression, and logistic regression was used to analyze the predictive value of skeletal muscle function for COPD progression.</p><p><strong>Results: </strong>Among the 400 subjects, respiratory muscle strength, quadriceps strength, and 6MWD were all higher in the nonsmoking group than in the smoking group, with the mild group better than the moderate group, the moderate group better than the severe group, males stronger than females, the MMRC score ≤ 2 group better than the >2 group, and strength greater in the age ≤ 70 group than in the age >70 group. The mild group had a higher 6MWD than the moderate group, the moderate group was better than the severe group, non-smokers had a higher 6MWD than smokers, and the difference between males and females was greater with statistical significance. There are differences in quadriceps strength, respiratory strength, and 6MWD within the progression group. Logistic regression analysis showed that respiratory muscle strength, quadriceps strength, 6MWD, and COPD severity were risk factors for COPD progression (P < 0.05).</p><p><strong>Conclusion: </strong>COPD patients show skeletal muscle dysfunction that worsens with disease severity. Respiratory muscle strength, quadriceps strength, 6MWD, and COPD severity predict COPD prognosis.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"389-397"},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505249","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}

{"title":"Cholesterol Accumulation Enhances Cigarette Smoke-Induced Airway Epithelial Inflammation.","authors":"Du Jing, Jin-Kang Yu, Hai-Pin Chen, Ling-Ling Dong, Wen Li, Zhou-Yang Li, Jie-Sen Zhou","doi":"10.2147/COPD.S495306","DOIUrl":"10.2147/COPD.S495306","url":null,"abstract":"<p><strong>Background: </strong>Statins, commonly used to lower cholesterol, have been shown to have anti-inflammatory effects in respiratory disease models. Disorders of cholesterol metabolism can cause damage to cells and tissues, and further lead to the development of a variety of diseases. However, the role of cholesterol metabolism in cigarette smoke-induced airway epithelial inflammation is unclear. The present study aims to explore this question.</p><p><strong>Methods: </strong>Human bronchial epithelial cells (HBEs) were stimulated with cigarette smoke extract (CSE) and mice were exposed to CS as models. The expression of cholesterol content and cholesterol metabolism-related molecules such as Sterol Regulatory Element-Binding Protein 2 (SREBP2), 3-Hydroxy-3-Methylglutaryl-CoA Reductase (HMGCR), ATP Binding Cassette Transporter A1 (ABCA1), and ATP Binding Cassette Transporter G1 (ABCG1) were detected by cholesterol assay kits and immunohistochemistry (IHC) in vivo, and were detected by cholesterol assay kits, Western blot (WB), and quantitative real-time polymerase chain reaction (Q-PCR) in vitro. Cholesterol metabolism molecules related siRNAs, inhibitors or agonists were used to intervene the Cholesterol levels in HBE. The mRNA level and protein level of interleukin IL-6 and IL-8 were detected by RT-qPCR and enzyme-linked immunosorbent assay (ELISA). Cellular reactive oxygen species (ROS) levels were detected by reactive oxygen species assay kits.</p><p><strong>Results: </strong>We found that cigarette smoke exposure inhibited cholesterol efflux by decreasing the expression of ABCA1, thereby increasing cholesterol accumulation in airway epithelial cells, which promotes the production of reactive oxygen species and promotes the secretion of inflammatory cytokines, ultimately aggravating cigarette smoke-induced airway inflammation. Reducing intracellular cholesterol content by inhibiting intracellular synthesis and promoting increased efflux can reduce the cigarette smoke-induced airway epithelial inflammatory factors secretion.</p><p><strong>Conclusion: </strong>In conclusion, cholesterol accumulation plays an important role in cigarette smoke-induced airway inflammation and may provide new targets in the treatment of this disease in the future.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"411-423"},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505248","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}

{"title":"The Miasma Mentality: Investigating the Association Between Beliefs in Noxious Fumes and Obstructive Pulmonary Disease (COPD), Symptoms, and Quality of Life.","authors":"Yexian Zhao, Yunlei Ma, Limei Geng, Jia Nie, Xiangyan Yu, Zenglu Kang, Yun Liu, Yinghao Su","doi":"10.2147/COPD.S500502","DOIUrl":"10.2147/COPD.S500502","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) significantly impacts morbidity and mortality globally. While established risk factors like smoking and occupational exposures are well-documented, patients' beliefs-especially those from the miasma theory attributing disease to \"bad air\" in cultures like China-may also significantly influence health outcomes.</p><p><strong>Methods: </strong>This case-control study was conducted at Hospital of Hebei University of Traditional Chinese, involving 500 individuals diagnosed with COPD and 500 matched control participants. Each participant completed questionnaires that gathered information on demographic details, clinical history, and beliefs about the causes of COPD. Clinical data were collected, including spirometry tests to assess lung function, the COPD Assessment Test (CAT) to evaluate symptom burden, and the St. George's Respiratory Questionnaire (SGRQ) to measure health-related quality of life.</p><p><strong>Results: </strong>The study found that 81% of COPD patients endorsed high miasma beliefs, compared to 28% of controls (p < 0.01). Those with strong beliefs reported significantly worse symptoms (mean CAT score: 23 vs 14, p < 0.001) and poorer quality of life (mean SGRQ score: 48 vs 39, p < 0.001) compared to low-belief individuals. Higher levels of anxiety and depression were also observed in patients with strong miasma beliefs. Laboratory biomarkers such as neutrophils, RDW width, and CRP were also elevated in the high-belief group compared to the low-belief group.</p><p><strong>Conclusion: </strong>The findings suggest that adherence to miasma theory beliefs is associated with adverse health outcomes in COPD patients. Addressing these beliefs through targeted education may enhance patient engagement and adherence to evidence-based treatments, ultimately improving health outcomes.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"361-372"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484187","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}

{"title":"Metabolic Regulation in Acute Respiratory Distress Syndrome: Implications for Inflammation and Oxidative Stress.","authors":"Lixia Yue, Yihe Yan","doi":"10.2147/COPD.S491687","DOIUrl":"10.2147/COPD.S491687","url":null,"abstract":"<p><p>Acute respiratory distress syndrome (ARDS) is a severe and life-threatening pulmonary condition characterized by intense inflammation and disrupted oxygen exchange, which can lead to multiorgan failure. Recent findings have established ARDS as a systemic inflammatory disorder involving complex interactions between lung injury, systemic inflammation, and oxidative stress. This review examines the pivotal role of metabolic disturbances in the pathogenesis of ARDS, emphasizing their influence on inflammatory responses and oxidative stress. Common metabolic abnormalities in ARDS patients, including disruptions in carbohydrate, amino acid, and lipid metabolism, contribute significantly to the disease's severity. These metabolic dysfunctions interplay with systemic inflammation and oxidative stress, further exacerbating lung injury and worsening patient outcomes. By analyzing the regulatory mechanisms of various metabolites implicated in ARDS, we underscore the potential of targeting metabolic pathways as a therapeutic approach. Such interventions could help attenuate inflammation and oxidative stress, presenting a promising strategy for ARDS treatment. Additionally, we review potential drugs that modulate metabolic pathways, providing valuable insights into the etiology of ARDS and potential therapeutic directions. This comprehensive analysis enhances our understanding of ARDS and highlights the importance of metabolic regulation in the development of effective treatment strategies. Key findings from this review demonstrate that metabolic disturbances, particularly those affecting carbohydrate, amino acid, and lipid metabolism, play critical roles in amplifying inflammation and oxidative stress, underscoring the potential of metabolic-targeted therapies to improve patient outcomes.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"373-388"},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484225","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}

{"title":"Association Between Blood Urea Nitrogen to Serum Albumin Ratio and Mortality in Critically Ill Patients With Chronic Obstructive Pulmonary Disease: A Retrospective Study.","authors":"Jili Li, Jianyue Peng, Chuke Cheng, Julin Zhang, Lei Li","doi":"10.2147/COPD.S503228","DOIUrl":"10.2147/COPD.S503228","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological studies suggest that elevated blood urea nitrogen (BUN) and reduced serum albumin could independently predict adverse clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). However, the predictive performance of BUN-albumin ratio (BAR) in critically ill patients with COPD remains to be confirmed. This study aimed to investigate the association between BAR and all-cause mortality in intensive care unit (ICU) patients with COPD.</p><p><strong>Methods: </strong>This was a retrospective study that included COPD patients with BUN and serum albumin value on the first day of each ICU admission and data were obtained from the eICU Collaborative Research Database. The included COPD patients were divided into three groups stratified by BAR tertiles (T1-T3). Multivariate logistic regression and Cox proportional hazards models were used to examine the association between BAR and all-cause in-hospital and ICU mortality, respectively. Kaplan-Meier curves were plotted to evaluate survival differences among three groups and discrepancies were compared with the log-rank test.</p><p><strong>Results: </strong>A total of 4037 patients were included in the final analysis and the in-hospital and ICU mortality rates were 11.79% and 6.51%, respectively. The multivariate logistic regression analyses showed that continuous BAR was a significant risk predictor of in-hospital mortality (OR: 1.039, 95% CI: 1.026-1.052, <i>P</i> < 0.001) and ICU mortality (OR: 1.030, 95% CI: 1.015-1.045, <i>P</i> < 0.001) in fully adjusted model. The Cox proportional hazards models revealed that patients in the highest BAR tertile (T3) were significantly associated with higher risk of in-hospital mortality (HR: 1.983, 95% CI: 1.419-2.772, <i>P</i> < 0.001) and ICU mortality (HR: 2.166, 95% CI: 1.373-3.418, <i>P</i> < 0.001). The Kaplan-Meier curves showed that the survival differences of all-cause mortality were statistically significant in three tertile groups (log-rank <i>P</i> < 0.0001). Correlated subgroup analyses indicated that this positive association might vary in certain population settings.</p><p><strong>Conclusion: </strong>High level of BAR is associated with the increasing all-cause mortality in critically ill patients with COPD. As an innovative and promising biomarker, BAR might be useful in predicting high risk of death in patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"349-360"},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484221","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}

{"title":"Real-World Evaluation of an EHR-Enabled Chronic Obstructive Pulmonary Disease Assessment Test.","authors":"Nathaniel Gaeckle, Edward Corazalla, Judy S Kelloway, Joshua N Liberman, Jonathan David Darer, Kristin Kahle-Wrobleski, Rosirene Paczkowski, Purva Parab, Charles Ruetsch","doi":"10.2147/COPD.S479853","DOIUrl":"10.2147/COPD.S479853","url":null,"abstract":"<p><strong>Purpose: </strong>The Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) measures COPD's impact on well-being and daily activities and is a recommended assessment by the Global Initiative for Obstructive Lung Disease (GOLD). Our research objective was to describe a real-world CAT implementation, including the association of CAT scores with subsequent treatment and clinical outcomes.</p><p><strong>Patients and methods: </strong>A retrospective, observational, comparative cohort study was conducted among adults with COPD who received care from M Health Fairview, a US healthcare delivery system. Eligible patients had an initial electronic health record (EHR) enabled CAT administration (index) between 8/2017 and 12/2021. Patients were grouped by score (<10 [low impact]; 11-20 [moderate]; and 21-40 [high]). Demographics, comorbidities, provider specialty, and exacerbation history were derived from EHR data in the 12 months preceding index.</p><p><strong>Results: </strong>Of 11,194 eligible individuals, 821 (7.3%) were administered CAT (cases). Compared to individuals with no documented CAT scores (comparators), cases were older (66.7 vs 63.9 years; <i>p</i> < 0.05) and had higher rates of comorbidities (93.9% vs 79.2%, <i>p</i> < 0.05) and exacerbations (0.31 vs 0.14 PPPY). A total of 61.5% of pulmonologists and 11.5% of primary care providers (PCPs) administered the CAT at least once. Repeated use was more common among pulmonologists (55.7%) than PCPs (7.0%). Medication intensification was most common (28.1%) among individuals with high CAT scores, followed by moderate (21.6%), and low (10.0%). Post-index exacerbations were experienced by 24.2%, 17.4%, and 7.7% of patients with high, moderate, and low CAT scores.</p><p><strong>Conclusion: </strong>In a real-world practice setting, few patients with COPD received a CAT, although pulmonologists demonstrated repeated use. Higher CAT scores were associated with COPD medication regimen intensification and exacerbations. Further investigation on how to incorporate the CAT into routine care and optimize its impact on medical decision making and evaluation is warranted.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"325-334"},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460377","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}

{"title":"Clinical and Economic Evaluation of Fluticasone Furoate/Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol Therapy in Maintenance Treatment-Naive Patients with COPD in the US.","authors":"Asif Shaikh, John Ritz, Julian Casciano, Swetha R Palli, Brendan Clark, Zenobia Dotiwala, Jennifer K Quint","doi":"10.2147/COPD.S479504","DOIUrl":"10.2147/COPD.S479504","url":null,"abstract":"<p><strong>Purpose: </strong>Long-acting bronchodilator (LABD) therapy is recommended for maintenance treatment in most patients with chronic obstructive pulmonary disease (COPD). However, triple therapy (TT; dual LABDs + inhaled corticosteroid [ICS]) is often used as first-line maintenance treatment. The benefits of TT versus dual LABDs as first-line treatments are unknown, necessitating an evaluation of its effectiveness and costs versus non-ICS alternatives.</p><p><strong>Patients and methods: </strong>This retrospective study assessed administrative claims of maintenance treatment-naive patients in the United States with COPD aged ≥40 years initiating single-inhaler fluticasone furoate+umeclidinium+vilanterol (FF+UMEC+VI) or tiotropium+olodaterol (TIO+OLO). Patients were propensity score-matched (1:1) and followed for up to 12 months. The primary outcome was time to first COPD exacerbation. Secondary outcomes included time to first pneumonia diagnosis, pneumonia-related hospitalization, healthcare resource utilization (HCRU), and costs. COPD exacerbation and pneumonia risk were assessed using Cox proportional hazards regression.</p><p><strong>Results: </strong>A total of 5,121 and 3,996 patients met the eligibility criteria for the FF+UMEC+VI and TIO+OLO groups, respectively. Outcomes were assessed among 2,951 matched pairs. The risk of moderate or severe COPD exacerbation was not significantly different between FF+UMEC+VI and TIO+OLO groups (hazard ratio [HR] [95% confidence interval {CI}]: 1.13 [0.99-1.29]; <i>P</i>=0.064). The risks of pneumonia (HR [95% CI]: 1.04 [0.85-1.27]; <i>P</i>=0.723) and pneumonia-related hospitalization (HR [95% CI]: 1.18 [0.78-1.79]; <i>P</i>=0.429) were also not significantly different between the groups. There were no significant differences in HCRU events or all-cause costs; however, FF+UMEC+VI initiators incurred greater COPD- and/or pneumonia-related pharmacy costs than TIO+OLO initiators (FF+UMEC+VI: $2,934 [$2,827-$3,041], TIO+OLO: $1,994 [$1,915-$2,073]; <i>P</i><0.001).</p><p><strong>Conclusion: </strong>In maintenance treatment-naive patients, FF+UMEC+VI offered no reduction in COPD exacerbation risk over TIO+OLO and resulted in higher pharmacy costs related to COPD and/or pneumonia treatment. These results support treatment recommendations for LAMA+LABA as initial maintenance therapy.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier - NCT05169424.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"335-348"},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449835","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}

{"title":"Diagnostic Inaccuracies in COPD: Misdiagnosis, Race and Gender Disparities.","authors":"Sarah E Maus, Dustin L Norton, Amit K Saha, Brian J Wells, Jill A Ohar","doi":"10.2147/COPD.S490781","DOIUrl":"10.2147/COPD.S490781","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"319-323"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442477","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}