International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"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":"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":"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":"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":"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}

{"title":"A Peptide Encoded by lncRNA HOXB-AS3 Promotes Cigarette Smoke-Induced Inflammation in Bronchial Epithelial Cells via EZH2-Mediated H3K27me3 Modification.","authors":"Mei Lin, Xiaoman Zhou, Yixiu Yang, Pingdong Xie, Quanni Li, Chanyi He, Qi Lin, Xingwei Wei, Yipeng Ding","doi":"10.2147/COPD.S495581","DOIUrl":"10.2147/COPD.S495581","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) primarily results from cigarette smoke (CS)-induced chronic inflammation. Although numerous long non-coding ribonucleic acids (lncRNAs) have been extensively studied for their crucial roles in COPD, the peptides encoded by these lncRNAs have garnered limited attention. This study aimed to investigate the role of a peptide encoded by lncRNA HOXB-AS3 in cigarette smoke extract (CSE)-induced inflammation and in 16HBE cells.</p><p><strong>Methods: </strong>Open reading frames (ORF) Find software was utilized to predict the encoding potential of HOXB-AS3. Quantitative real-time polymerase chain reaction (qRT-PCR) was employed to detect the levels of peptide HOXB-AS3-32aa in peripheral blood mononuclear cells (PBMCs) from both healthy controls and COPD patients and in 16HBE cells exposed to different CSE. To establish an in vitro inflammatory cell model of COPD, 16HBE cells were treated with 2% CSE. Enzyme-Linked Immunosorbent Assay (ELISA) measured inflammatory cytokines, while CCK-8 assay assessed cell viability. Flow cytometry was employed to assess cell apoptosis. Western blot analysis was performed to measure the expression of HOXB-AS3-32aa, EZH2, and H3K27me3 proteins. Co-Immunoprecipitation (Co-IP) was conducted to verify the interaction between EZH2 and HOXB-AS3-32aa.</p><p><strong>Results: </strong>Our findings revealed elevated expression of HOXB-AS3-32aa in PBMCs of COPD patients compared to controls. CSE treatment dose-dependently increased HOXB-AS3-32aa expression. Overexpression of HOXB-AS3-32aa exacerbated CS-induced inflammation in bronchial epithelial cells, leading to inhibited cell proliferation and increased cell apoptosis. Furthermore, HOXB-AS3-32aa suppressed EZH2 and H3k27me3 protein levels in 16HBE cells. Co-IP results confirmed the interaction between HOXB-AS3-32aa and EZH2 protein.</p><p><strong>Conclusion: </strong>Our results demonstrate that the novel peptide HOXB-AS3-32aa encoded by lncRNA HOXB-AS3 promotes CS-induced inflammation and apoptosis in 16HBE cells via EZH2-mediated H3K27me3 modification.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1543-1553"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144030","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":"Comparative Efficacy of Nutritional Supplements in Modulating Lung Function and Exercise Capacity in COPD Patients: A Network Meta-Analysis.","authors":"Yi Zeng, Tian He, Xinyi Ma, Qiong Guo, Jing Zhang","doi":"10.2147/COPD.S517252","DOIUrl":"10.2147/COPD.S517252","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of nutritional supplements on lung function and exercise tolerance in chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) on nutritional supplements in COPD patients, with the search ending December 31, 2023. Two authors independently screened studies, extracted data, and assessed quality using the Cochrane risk of bias tool. Data were analyzed using RevMan 5.4 and R 4.2.3.</p><p><strong>Results: </strong>Forty-eight studies with 2481 COPD patients were included. Network meta-analysis showed six supplements significantly improved the 6-minute walk distance (6MWD) (all p<0.05), with the top three being: Coenzyme Q10+ Creatine [MD=63, 95% CI (36, 90)], L-carnitine [MD=53, 95% CI (24, 82)], and anabolic steroids [MD=44, 95% CI (7.1, 82)]. Four supplements improved FEV₁%(all p<0.05): nanocurcumin [MD=13, 95% CI (7.7, 18)], Vitamin D [MD=7.5, 95% CI (5.1, 9.9)], probiotics [MD=7.1, 95% CI (5.2, 9.1)] and BSO [MD=4.9, 95% CI (1.6, 8.3)]. In pairwise comparisons, nanocurcumin outperformed BSO and Probiotics. Nanocurcumin [MD=12, 95% CI (4.6, 19), <i>p</i><0.05] improved FEV₁/FVC, and nitrate [MD=26, 95% CI (9.7, 42), <i>p</i><0.05] was effective for the Incremental Shuttle Walk Test (ISWT). Traditional Chinese Medicine (TCM) products [MD=-1.3, 95% CI (-1.9, -0.67)], melatonin (MLT) [MD=-0.9, 95% CI (-1.6, -0.21)] and Calcitriol [MD=-0.66, 95% CI (-0.93, -0.39)] improved the modified Medical Research Council(mMRC) dyspnea score (all p<0.05), with comparable efficacy among them.</p><p><strong>Conclusion: </strong>Nutritional supplements improve lung function and exercise endurance in COPD. Coenzyme Q10+Creatine is most effective for endurance, while Nanocurcumin has the greatest impact on lung function.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1525-1541"},"PeriodicalIF":2.7,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121211","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 Prognostic Nutritional Index and Mortality Risk in Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Study.","authors":"Qiu-Die Liu, Dao-Xin Wang","doi":"10.2147/COPD.S517676","DOIUrl":"10.2147/COPD.S517676","url":null,"abstract":"<p><strong>Background: </strong>The Prognostic Nutritional Index (PNI), an integrative measure of body's immune and nutritional status, has demonstrated its prognostic value across a range of diseases. However, its role in critically ill patients with Chronic Obstructive Pulmonary Disease (COPD) remains unclear. This study investigates the association between PNI levels and clinical outcomes in critically ill COPD patients, with a focus on identifying its role as a potential predictor of mortality.</p><p><strong>Methods: </strong>A retrospective analysis of 1,250 critically ill COPD patients from the MIMIC-IV (v2.2) database was conducted. Patients were grouped by PNI tertiles. Primary and secondary outcomes were 28-day and 90-day mortality, respectively. Associations were evaluated using restricted cubic splines, Cox proportional hazards regression analysis, and Kaplan‒Meier survival curves. The predictive performance of PNI was assessed via receiver operating characteristic (ROC) curves analysis, and a nomogram integrating Boruta-selected features was developed to enhance clinical utility.</p><p><strong>Results: </strong>The final cohort comprised 1,250 critically ill COPD patients, with observed mortality rates of 25.3% and 33.2% at 28 and 90 days, respectively. Higher PNI levels were associated with reduced risk of both 28-day and 90-day mortality [28-day HR: 0.95 (95% CI: 0.93-0.97), P < 0.001; 90-day HR: 0.94 (95% CI: 0.93-0.96), P < 0.001]. Restricted cubic spline analysis confirmed this trend. Furthermore, ROC analysis demonstrated the utility of PNI as a predictor for 28-day mortality (AUC: 0.61). Boruta-selected features reinforced the importance of PNI, and the constructed nomogram exhibited excellent predictive accuracy (AUC: 0.712).</p><p><strong>Conclusion: </strong>Higher PNI is linked to reduced mortality risk in critically ill COPD patients, indicating its potential as a prognostic marker.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1493-1508"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112411","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":"Pharmacovigilance Study on Adverse Events of Nicotine Replacement Therapy, Bupropion, and Varenicline in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Yi Da Wang, Yan Tian Wang, Hao Hui Chen, Jin Ku Bao, Shou Ming Chen, Dong Xu Chen","doi":"10.2147/COPD.S514133","DOIUrl":"10.2147/COPD.S514133","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is one of the most prevalent respiratory disorders, with smoking being a major risk factor. Smoking cessation is therefore crucial in the management of COPD. This study aimed to comprehensively evaluate the safety profiles of common cessation therapies, including nicotine replacement therapy, bupropion, and varenicline.</p><p><strong>Patients and methods: </strong>Using the FDA Adverse Event Reporting System (FAERS) database from Q1 2004 to Q2 2024, we analyzed adverse events (AEs) associated with bupropion, nicotine, and varenicline in COPD patients. Disproportionality analysis, case-by-case evaluation, and co-medication analysis were performed to identify positive safety signals.</p><p><strong>Results: </strong>Eighty-eight positive safety signals were identified, primarily involving psychiatric, nervous system, and gastrointestinal disorders. Notable AEs included depression, nausea, anxiety, abnormal dreams, and insomnia. Critically, eight PTs indicated serious AEs associated with psychiatric disorders that were not present in the labeling but required Important Medical Event (IME) surveillance. Experiencing severe neuropsychiatric symptoms (eg, suicidal thoughts and suicide attempts) was the major reason for limiting the use of these drugs, especially varenicline, for which the FDA issued a black box warning in 2009. Nicotine combined with varenicline showed higher risks for skin reactions and gastrointestinal issues. Most AEs occurred within the first 30 days of therapy, with some persisting beyond a year.</p><p><strong>Conclusion: </strong>This study highlights significant psychiatric, neurological, and gastrointestinal AEs associated with smoking cessation therapies in patients with COPD. Clinicians are advised to be particularly cautious of these risks, especially when using combination therapies or treating patients with a predisposition to psychiatric disorders.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1509-1524"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103069","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":"Sputum Microbiome, Potentially Pathogenic Organisms, and Clinical Outcomes in Japanese Patients with COPD and Moderate Airflow Limitation: The Prospective AERIS-J Study.","authors":"Kazuhiro Yatera, Zhang Wang, Yoko Shibata, Nobuhisa Ishikawa, Tetsuya Homma, Kiyoyasu Fukushima, Osamu Hataji, Yoshikazu Inoue, Hiroki Kawabata, Keisuke Miki, Kazuhiro Sato, Kazunori Tobino, Makoto Yoshida, Takeo Ishii, Risako Ito, Tamami Kobayashi, Shinya Kawamatsu, Chris H Compton, Paul W Jones","doi":"10.2147/COPD.S481406","DOIUrl":"10.2147/COPD.S481406","url":null,"abstract":"<p><strong>Background: </strong>In Western studies, lung microbiome changes are reported in patients with chronic obstructive pulmonary disease (COPD) and are associated with poorer outcomes, but similar studies in Asian patients or those with less severe COPD are limited.</p><p><strong>Methods: </strong>The Acute Exacerbation and Respiratory InfectionS in COPD Japan (AERIS-J; jRCT1080224632/NCT03957577) was a prospective, non-interventional study to evaluate sputum microbiome diversity at baseline and after 12 months (V2; exploratory analysis), in patients aged 40-80 years with stable COPD (June 2019-June 2022). Baseline sputum potentially pathogenic organisms (PPOs) were identified. Blood cell counts and COPD Assessment Test (CAT) scores were collected at baseline and COPD symptoms measured over 12 months using the Evaluating Respiratory Symptoms in COPD and EXAcerbations of Chronic pulmonary disease Tool, collected by eDiary.</p><p><strong>Results: </strong>Patients (N=63) had a mean age of 72.8 years, and percent predicted post-bronchodilator forced expiratory volume in 1 second was 58.3%; 92% were male. Across 62 baseline sputum samples, microbiome composition was similar between 16S rRNA/metagenomic datasets. Patients graded Global Initiative for Chronic Obstructive Lung Disease (GOLD) III versus GOLD I/II had minimal differences in their microbial taxonomic profile and no differences in microbial diversity (Wilcoxon <i>P</i>=0.71). Alpha diversity (Shannon index) positively correlated with blood basophils (rho=0.41; <i>P</i>=0.0019) and negatively correlated with CAT score (rho=0.36; <i>P</i>=0.0069). Alpha diversity and sputum (rho: -0.0637; <i>P</i>=0.7836) or blood (rho: 0.1739; <i>P</i>=0.2043) eosinophils were not correlated. No difference in alpha (<i>P</i>=0.5) or beta (<i>P</i>=0.3) diversity or Operational Taxonomic Unit (Anosim R=-0.024; <i>P</i>=0.892) was observed between PPO-positive or -negative sputum.</p><p><strong>Conclusion: </strong>A less diverse microbiome correlated with poorer health status and lower blood basophils in patients with COPD and moderate airflow limitation. There was no relationship between PPO presence and microbiome diversity.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1477-1492"},"PeriodicalIF":2.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103071","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}