International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Managing Small Airways Dysfunction in COPD Patients in Real Life Under Fixed Triple Combination of Beclomethasone/Formoterol/Glycopyrronium: The MASCOT Real World Evidence Study.","authors":"Athena Gogali, Konstantinos Kostikas, Christos Kyriakopoulos, Dimitrios Potonos, Konstantinos Porpodis, Ioanna Tsiouprou, Evangelia Fouka, Stavros Tryfon, Efthymia Papadopoulou, Maria Kipourou, Konstantinos Katsoulis","doi":"10.2147/COPD.S513350","DOIUrl":"https://doi.org/10.2147/COPD.S513350","url":null,"abstract":"<p><strong>Introduction: </strong>The efficacy of the fixed extrafine combination of beclomethasone/formoterol/glycopyrronium (BDP/FF/G 87/5/9 μg) has been evaluated in randomized controlled trials of patients with chronic obstructive pulmonary disease (COPD). However, only few data exist on its effectiveness on small airways dysfunction (SAD).</p><p><strong>Methods: </strong>The MASCOT (MAnaging Small airways dysfunction in COPD patients in real life on the fixed Triple combination of BDP/FF/G 87/5/9 μg pMDI) prospective observational study evaluated the effectiveness of this combination on SAD in a period of 4 weeks, after direct switch from long-acting β₂-agonists (LABA) and long-acting muscarinic antagonists (LAMA) in COPD patients with SAD (forced expiratory flow at 25-75% of the vital capacity, FEF25-75% <60% predicted). The primary endpoint was improvement in R5-19 in oscillometry; secondary endpoints included other oscillometry parameters, lung function and health status (COPD assessment test-CAT, Saint-George's Respiratory Questionnaire-SGRQ).</p><p><strong>Results: </strong>Between May 2022 and July 2023 we recruited 93 COPD patients (mean age 68.5 years, 82% men) with forced expiratory volume in 1 second (FEV₁, mean ± SD) 1.53 ± 0.47L (53.4 ± 14.5% predicted) and small airways dysfunction (FEF25-75% predicted 27.7 ± 15.4%). We observed statistically significant improvement in R5-19 between baseline (V1) and follow-up (V2) visits [median (IQR) V2 0.70 (0.41-1.10) vs V1 0.90 (0.60-1.83); mean change (95% CI) -0.49, -0.66 to -0.33 cmH₂O/L/sec, p < 0.0001). There were improvements in multiple parameters, including FEF25-75% (3.43, 1.20% to 5.66%, p = 0.0005), FEV₁ (0.142, 0.078 to 0.205 L, p < 0.0001) and RV/TLC (-6.09, -9.61% to -2,56% predicted, p < 0.0001), as well as improvement in CAT score -4.09 (-5.09 to -3.08) και SGRQ total score (-8.75, -11.58 to -5.93 points, p < 0.0001).</p><p><strong>Conclusion: </strong>Extrafine triple therapy improved SAD and spirometric parameters, leading to improvement in health status at 4 weeks. These results need to be confirmed in longer studies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1651-1663"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163178","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":"Prognostic Value of Apolipoprotein E in Predicting One-year Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.","authors":"Yuqun Li, Qilan Wu, Zhenxing Li, Yang Xiao, Liping Wei","doi":"10.2147/COPD.S512096","DOIUrl":"https://doi.org/10.2147/COPD.S512096","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is a serious disease with significantly higher mortality. Evidence suggests that there may be a co-relation between ApoE and the mortality risk in individuals who are diagnosed with COPD. This study sought to investigate the correlation between the levels of ApoE and all-cause mortality over one year in individuals who are diagnosed with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).</p><p><strong>Methods: </strong>In this study, we checked serum ApoE concentrations of AECOPD patients on admission and collected the patients' laboratory and clinical information. The co-relation between the concentration of ApoE and one year risk of all-cause mortality was analyzed by univariate, multivariate Cox regression and Subgroup analysis. Restricted Cubic Spline (RCS) were employed to illustrate the connection between ApoE levels and the hazard ratio (HR) for one-year total mortality rate.</p><p><strong>Results: </strong>Of the 449 participants who were enrolled, 358 patients were included in the study. The mean age was 76 (±9.46) years old, of which 65.92% were male. The body-mass index was 22.18 (±4.66). Of the participants, 24.86% were non-smokers, 54.75% were former smokers, and 20.39% were active smokers, with a smoking history of 28.68 (±20.43) years. The restricted cubic spline curve revealed that patients exhibiting ApoE concentrations exceeding the mean value of 41.50 mg/L faced a notably higher risk of mortality in comparison to individuals with lower levels. In univariate analysis, the HR was 2.663 (95% CI 1.533-4.627, P = 0.001), but in adjusted analyses, the HR was 2.103 (95% CI 1.19-3.716, P = 0.01).</p><p><strong>Conclusion: </strong>Elevated levels of ApoE were independently risk factor for one-year mortality in patients with AECOPD. Subgroup analyses revealed that the association was stronger in younger patients (<76 years) and male, as well as in those without comorbidities such as congestive heart failure or cerebrovascular disease. This suggests that ApoE may be a potential prognostic biomarker for AECOPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1639-1650"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163183","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":"Role of Digoxin in Preventing Cigarette Smoke-Induced COPD via HIF-1α Inhibition in a Mouse Model.","authors":"Kedong Zhang, Feng Zhou, Caixia Zhu, Liang Yuan, Defu Li, Jian Wang, Wenju Lu","doi":"10.2147/COPD.S493856","DOIUrl":"https://doi.org/10.2147/COPD.S493856","url":null,"abstract":"<p><strong>Purpose: </strong>Hypoxia-inducible factor-1α (HIF-1α) plays an important regulatory role in inflammatory and hypoxic diseases. Higher HIF-1α level was found in the lungs of chronic obstructive pulmonary disease (COPD) patients, however, its role in cigarette smoke (CS)-induced COPD has not been fully studied. Digoxin has been showed to inhibit HIF-1α translation and block HIF-1α activity and thus is often used as the HIF-1α inhibitor. Therefore, in the present study, we chose digoxin as the inhibitor to investigate whether HIF-1α contributes to the progression in a mouse model of COPD and possible mechanism.</p><p><strong>Methods: </strong>The COPD model was established by cigarette smoke (CS) exposed; animals were intragastrically treated with vehicle or different doses of digoxin (0.02 mg/kg and 0.1 mg/kg). COPD associated phenotypes such as pathological changes in lungs, inflammation, lung function and mucus secretion in airways were evaluated. Meanwhile, cigarette smoke extract (CSE) treated A549 cells were administrated with digoxin (50nM) or Smad3 inhibitor (S7959 100uM). Moreover, EMT associated markers together with HIF-1α/TGF-β1/Smad3 signaling pathway were detected both in vivo and in vitro.</p><p><strong>Results: </strong>The level of HIF-1α was significantly increased in lungs of COPD mice and CSE-exposed A549 cells, which was markedly suppressed by digoxin. Moreover, digoxin inhibited CS-induced inflammatory responses, lung function decline, and mucus hyper-secretion in COPD mouse model. In vitro studies, digoxin decreased CSE-induced pro-inflammatory cytokine release. Importantly, CS-induced or CSE-induced EMT and up-regulation of HIF-1α/TGF-β1/Smad pathway were inhibited by digoxin in vitro. Additionally, S7959 mitigated CSE-induced EMT in A549 cells.</p><p><strong>Conclusion: </strong>Digoxin can protect CS-induced COPD and prevent CS-induced EMT possibly through HIF-1α/TGF-β1/Smad3 signaling pathway in mice. This study suggests HIF1-α could be a potential intervention target for COPD prevention and treatment, especially for EMT in CS-induced COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1665-1678"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163188","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":"A Systematic Review of Codelists to Identify Chronic Bronchitis and Emphysema in Routine Electronic Healthcare Record Data and Derivation of a Standardized Codelist for Future Research.","authors":"Harley Hiu Yung Kwok, Georgie May Massen, Alexander J Adamson, Constantinos Kallis, Adam Lahmami, Yaqoob Abbas Sheikh, Mohammed Hafzalla Elhag Elseddig, Nabaz Mutabchi, Jennifer Kathleen Quint","doi":"10.2147/COPD.S501421","DOIUrl":"https://doi.org/10.2147/COPD.S501421","url":null,"abstract":"<p><p>Medical codes and codelists are essential to identify diseases, medicines, and related events when using electronic healthcare records (EHRs) for research. As multiple codes can be used to define the same medical condition, an inconsistency of applying codes by clinicians or researchers may complicate the identification of diseases. To minimize the inconsistency of codes and increase the comparability of research findings, we sought to integrate all medical codes and codelists generated from existing studies to produce a single list of codes for both chronic bronchitis and emphysema for future research. We systematically reviewed studies, which included codes used to define chronic bronchitis and/or emphysema regardless of code systems. We searched MEDLINE, Embase, Web of Science, Scopus, CINAHL, and Global Health from 1^st January 2000 to May 2024 for relevant studies. Medical codes or codelists were identified, extracted, and compiled into single codelists for chronic bronchitis and emphysema separately based on their frequency of appearance across all included studies (PROSPERO: CRD42024529169). We identified 18 studies containing codelists, from a total of 1082 studies. Only International Classification of Disease (ICD) codes were found in studies, which defined chronic bronchitis and emphysema. Chronic bronchitis was defined as 490 and 491 in ICD-9 and J40, J41, J42, and J44 in ICD-10. Meanwhile, emphysema was defined as 492 in ICD-9 and J43 in ICD-10. Additionally, to fill the current gap, we created SNOMED CT codelists for both chronic bronchitis and emphysema, to standardize the definitions of these diseases in future studies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1679-1691"},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163126","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":"Weight-Adjusted Waist Index as a Novel Predictor of Chronic Obstructive Pulmonary Disease: Evidence from NHANES 2013-2018.","authors":"Hongjin Wang, Weiming Chen, Feilong Guo, Zengkai Xu, Xin Luo, Jiahuang Wu, Yong Zhu, Zhisheng Wang","doi":"10.2147/COPD.S513853","DOIUrl":"https://doi.org/10.2147/COPD.S513853","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a major global health burden. The weight-adjusted waist index (WWI), a novel adiposity metric, may improve COPD risk prediction, but its association remains underexplored.</p><p><strong>Methods: </strong>Using the National Health and Nutrition Examination Survey (NHANES) 2013-2018 data (n=15,278), we assessed the WWI-COPD relationship via multivariable logistic regression, ROC analysis, and subgroup evaluations.</p><p><strong>Results: </strong>Higher WWI tertiles correlated with elevated COPD incidence. After full adjustment, each WWI unit increase linked to 70% higher COPD risk (OR=1.70, 95% CI: 1.48-1.95). Participants in the highest quartile of WWI faced a 290% increased risk compared to the lowest quartile (OR=3.90, 95% CI: 2.60-5.86). WWI (AUC=0.707) outperformed BMI (AUC=0.525) and waist circumference (AUC=0.609) in COPD prediction. A nonlinear threshold effect emerged at WWI=12.54. Subgroup analyses confirmed robustness across demographics.</p><p><strong>Conclusion: </strong>WWI is a simple, cost-effective tool for early COPD detection, outperforming BMI and waist circumference, especially in resource-limited settings, enabling timely intervention and reducing disease burden.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1625-1638"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152540","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":"Characterizing ECOPD Phenotypes: Associations with In-Hospital Outcomes and Immunoinflammatory Mechanisms.","authors":"Qin Wang, Lei Wang, Li Zhang, Chongyang Zhao, Ying Liu, Lei Liu, Lishan Yuan, Min Feng, Gang Wang, Li Li, Shuwen Zhang, Yulai Yuan, Deying Kang, Xin Zhang","doi":"10.2147/COPD.S505016","DOIUrl":"https://doi.org/10.2147/COPD.S505016","url":null,"abstract":"<p><strong>Background: </strong>Hospitalization due to exacerbations of chronic obstructive pulmonary disease (ECOPD) is linked to substantial mortality rates.</p><p><strong>Objective: </strong>This study aimed to identify the clinical and inflammatory phenotypes of patients with ECOPD, as well as to examine their associations with in-hospital outcomes. We sought to explore the underlying mechanisms that contribute to the relationship between ECOPD phenotypes and these outcomes.</p><p><strong>Methods: </strong>A k-means cluster analysis was conducted on 20,890 recruited patients hospitalized for ECOPD. Logistic regression analyses were utilized to evaluate the associations between the identified phenotypes and in-hospital outcomes, such as mortality, invasive mechanical ventilation (IMV), and intensive care unit (ICU) admission. Additionally, a mediation analysis was performed to elucidate the immunoinflammatory mechanisms underlying the relationship between ECOPD phenotypes and in-hospital outcomes.</p><p><strong>Results: </strong>Three distinct phenotypes were identified: Cluster 1 (n=4,944, 23.67%) exhibited a \"Female Eosinophilic Phenotype\", Cluster 2 (n=10,814, 51.77%) displayed a \"Male Eosinophilic Phenotype\", and Cluster 3 (n=5,132, 24.57%) presented as an \"Geriatric Multimorbidity-Associated Neutrophilic Systemic Inflammatory Phenotype\". Clusters 2 and 3 were associated with higher risks of in-hospital mortality (adjusted odds ratio [OR_adj]=1.88 and 17.07, respectively) and IMV (OR_adj=2.52 and 7.59, respectively) compared to Cluster 1. Patients in Cluster 3 also experienced an extended hospital stay (median of 13 days) and an increased risk of ICU admission (OR_adj=7.72). Additionally, blood eosinophils, neutrophils, CRP, and albumin played a mediating role in the relationship between ECOPD phenotypes and the composite outcome.</p><p><strong>Conclusion: </strong>Our study identified three phenotypes stratified by sex, multimorbidity burden, and inflammatory endotypes, which advanced threshold definition for eosinophilic exacerbations and provided prognostic insights for ECOPD management.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1613-1624"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152428","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":"Single-Inhaler Triple Therapy in Primary Care Across Europe: Expert Panel Consensus on the Consequences of Payer-Driven Access Rules and Call to Action.","authors":"Fabiano Di Marco, Orjola Shahaj, Arschang Valipour, Bertrand Legrand, Claudio Jommi, Claudio Micheletto, Claus Franz Vogelmeier, Daryl Freeman, Janwillem W H Kocks, Luis Alves, Myriam Calle Rubio, Rudi Peché, Susanna Palkonen Snr, Tonya Winders, Nicolas Roche","doi":"10.2147/COPD.S503726","DOIUrl":"https://doi.org/10.2147/COPD.S503726","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a prevalent condition characterized by persistent airflow obstruction and respiratory symptoms. Single-Inhaler Triple Therapy (SITT) has been shown to improve patient adherence, reduce exacerbations, and lower healthcare resource utilization in patients who are not controlled despite being on dual therapy or Multiple-Inhaler Triple Therapy (MITT). Despite evidence supporting SITT, payer-driven access rules across Europe sometimes limit its use in primary care, creating barriers to optimal COPD management.</p><p><strong>Purpose: </strong>Through expert consensus, the study seeks to generate a shared understanding of the unintended consequences of payer-driven access criteria for SITT in managing moderate-to-severe COPD in primary care.</p><p><strong>Methods: </strong>A targeted literature review (TLR) was conducted to assess SITT initiation in primary care across Europe and examine the impact of access criteria. Semi-structured interviews were held with 14 experts from nine European countries, including clinicians, health economists, and patient advocacy representatives. A consensus generation workshop was conducted, where experts evaluated the findings and developed position statements to highlight the challenges posed by payer-driven access criteria.</p><p><strong>Results: </strong>The TLR identified variability in access to SITT in Europe, with several countries restricting its initiation to specialists, thus limiting primary care physicians' (PCPs) ability to prescribe SITT. The expert panel generated seven consensus points stating that enabling PCPs to step up or switch eligible patients to SITT has the potential to support care continuity, enhance clinical autonomy for PCPs, reduce reliance on potentially less effective treatment options, improve patient and healthcare system outcomes, avoid unnecessary referrals to specialists, enable prompt initiation of guideline-directed medical therapy for COPD in primary care and reduce access inequalities.</p><p><strong>Conclusion: </strong>Restrictions for SITT initiation in primary care may need to be revisited to mitigate their unintended health and cost consequences and improve equitable access to treatment. This should take into consideration each country's unique healthcare system.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1595-1612"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163192","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 Association Between Medication Adherence and Health-Related Quality of Life in Patients with COPD: A Cross-Sectional Study.","authors":"Maha F Saja, Afnan S Younis, Lamiss A Alzahrani, Ibtisam N Alkhlassi, Lama S Aldakhil, Rawan M Albayyat, Noura A Alnasser, Khalid S Alokla, Lamia A Alghamdi, Albatol N Rashed, Samy A Azer","doi":"10.2147/COPD.S509949","DOIUrl":"https://doi.org/10.2147/COPD.S509949","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition with debilitating manifestations that adversely affect patients' health-related quality of life (HRQoL). The clinical course is complicated by patients' low medication adherence level. Low adherence and poor HRQoL are linked to unfavorable disease outcomes. Although many factors affect adherence and HRQoL in COPD, the impact of adherence on HRQoL remain controversial. This study aimed to measure medication adherence and its impact on HRQoL in patients with COPD.</p><p><strong>Patients and methods: </strong>This cross-sectional observational study included patients with COPD from two health centers in Riyadh, Saudi Arabia. Patients were identified using the medical database and only those fulfilling the GOLD 2020 criteria for COPD diagnosis were recruited. Data were collected via phone interviews and included sociodemographic information, the level of medication adherence assessed using the 5-item Medication Adherence Report Scale (MARS-5), and the HRQoL measured using the St. George Respiratory Questionnaire for COPD (SGRQ-C). Simple and multiple-regression analysis was used to study the factors affecting both parameters and the relation between adherence and HRQoL.</p><p><strong>Results: </strong>The mean MARS-5 score was 21.17± 4.8 (mean ± SD) with only 56.4% of patients with COPD reporting high adherence to their medications. The average total SGRQ score was 51.35 ± 23.82 indicating low HRQoL. Using multiple-regression analysis, comorbidity and intermediate disease duration were associated with lower adherence, while older age, female gender, polypharmacy, and concomitant hypertension predicted lower HRQoL. Moreover, higher adherence to medications was associated with higher overall HRQoL in patients with COPD.</p><p><strong>Conclusion: </strong>Patients with COPD have low medication adherence and low HRQoL. Several patient-, disease-, and therapy-related factors were shown to affect both outcomes; however, higher adherence to medication per se was associated with higher HRQoL in patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1567-1583"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152505","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":"Quinine Use and the Risk of Exacerbations of Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Registry Study.","authors":"Frida Vilstrup, Pradeesh Sivapalan, Josefin Eklöf, Alexander Jordan, Tor Biering-Sørensen, Søren Sperling, Jens-Ulrik Stæhr Jensen","doi":"10.2147/COPD.S496676","DOIUrl":"10.2147/COPD.S496676","url":null,"abstract":"<p><strong>Objective: </strong>Patients with chronic obstructive pulmonary disease (COPD) are a heavily comorbid group. Quinine is often used in the treatment of restless leg syndrome (RLS), although the adverse effects of the drug may be harmful for specific patient groups. The aim of this study was to determine the association between treatment with Quinine and the risk of acute exacerbations and mortality in patients with COPD, which has not previously been investigated.</p><p><strong>Methods: </strong>Analyses were performed on data from Danish national registries containing information about the relevant patients and their health, prescriptions, hospital admissions, and outpatient clinic visits. A propensity score matched cohort was created by matching the population on known predictors of the outcome, and an unadjusted Cox proportional hazards regression analysis was performed. Lastly, a multivariable Cox analysis was performed on the entire, unmatched population, adjusting for the same variables as used in the propensity matching.</p><p><strong>Results: </strong>The study population consisted of a cohort of 56,691 eligible patients with COPD, of whom 3,139 were exposed to Quinine. The propensity score matching led to two groups of 2,537 COPD patients, where one group was exposed to Quinine (cases) and the other group was not (controls). Exposure to Quinine was associated with an increased risk of exacerbations or death in a sensitivity analysis of the propensity-score-matched population (Hazard Ratio (HR) 1.130, 95% Confidence Interval (CI) 1.03 to 1.24). An unadjusted analysis on the unmatched population showed similar results (HR 1.475, 95% CI 1.39 to 1.56).</p><p><strong>Conclusion: </strong>In the current study, we found an association between the use of Quinine in patients with COPD and an increased risk of acute exacerbations and death. The results must be interpreted with attention to the observational nature of the study, and in order to definitively determine the association, further investigations should be performed.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1585-1593"},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144034","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 Cross-Sectional Area of Erector Spinae Muscles Obtained from Chest CT Is an Independent Predictor of Death in COPD.","authors":"Jin Liu, Rui Li, Yuer Li, Shaobo Ge, Shiyuan Yao, Rui Zhang, Hongyan Fu, Pu Ning, Jie Zhang, Ming Zhang","doi":"10.2147/COPD.S520971","DOIUrl":"https://doi.org/10.2147/COPD.S520971","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle loss usually predicts poor clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). However, the prognostic value of erector spinae muscle (ESM) in COPD remains unclear.</p><p><strong>Methods: </strong>The cross-sectional area of ESM (ESMCSA) was retrospectively measured on a single-slice axial image obtained from chest computed tomography of COPD patients. The clinical characteristics and 5-year all-cause mortality of these patients were recorded.</p><p><strong>Results: </strong>The ESMCSA of COPD patients in the non-survivor group was significantly lower than that in the survivor group (P<0.001). Decreased ESMCSA was significantly correlated with pulmonary function decline (P<0.001). The threshold of ESMCSA to predict the 5-year all-cause mortality of COPD was 23.42cm², and Kaplan-Meier survival curves showed that the 5-year cumulative survival rate of COPD patients was significantly decreased when ESMCSA was less than 23.42cm² (P<0.001). Multivariate Cox regression analyses showed that ESMCSA was an independent predictor for 5-year all-cause mortality in COPD patients (P=0.018). Based on the ESMCSA, age, percentage of predicted diffusing lung capacity for carbon monoxide, partial pressure of oxygen as well as carbon dioxide in the arterial blood, a nomogram prediction model for 5-year survival probability in COPD was established. The concordance indexes for the nomogram in the training and validation cohorts were 0.852 and 0.890, respectively. The calibration curve of the nomogram model was close to the ideal curve, and its clinical decision curve showed a good clinical application value.</p><p><strong>Conclusion: </strong>ESMCSA is a significant predictor for 5-year all-cause mortality in COPD patients, and the nomogram model based on ESMCSA has a certain reference value for predicting COPD prognosis.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1555-1565"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152538","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}