Profiling the effects of indacaterol on dyspnoea and health status in patients with COPD

Jones, Paul; Mahler, Donald A.; Gale, Rupert; Owen, Roger; Krämer, Benjamin

doi:10.1016/j.rmed.2011.02.013

Cited by 29 publications

(27 citation statements)

References 35 publications

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“…This finding, however, is consistent with those previously published by Jones, Mahler, Gale, Owen, and Kramer (2011). In the latter study, the symptom subscale was heavily influenced by medication use, while the activity and impact subscales were not.…”

Section: Discussionsupporting

confidence: 93%

Epigenetic Change (GATA-4 Gene Methylation) Is Associated With Health Status in Chronic Obstructive Pulmonary Disease

Meek

Sood

Petersen

et al. 2014

Biological Research For Nursing

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Gene methylation is an epigenetic change that involves a heritable modification of chromatin structure that alters gene expression without a change in DNA sequence. It has previously been shown that methylation of the GATA-4 gene promoter region in sputum DNA is associated with low lung function and increased odds of chronic obstructive pulmonary disease (COPD) among smokers. Given these findings, we hypothesized that GATA-4 gene methylation in sputum DNA would be associated with low health status, as measured by the St. George's Respiratory Questionnaire (SGRQ), in subjects with COPD. Self-reported SGRQ, spirometry, and induced sputum samples were obtained from 168 COPD subjects from the Lovelace Smokers Cohort. GATA-4 gene methylation was evaluated in sputum DNA using nested methylation-specific polymerase chain reaction (PCR) assays. Using general linear model with Poisson regression, we found that GATA-4 gene methylation was significantly associated with overall lower SGRQ health status (parameter estimate = .296, p < .001). This finding remained significant even after controlling for age, lung function, and other covariates. In an additional analysis using logistic regression and comparing extreme tertiles of overall SGRQ score, we confirmed that GATA-4 gene methylation was associated with a 3-fold increase in risk of poor health status (OR 2.95 and p = .028). The unexplored links between epigenetic changes and psychosocial factors such as health status are critical gaps in the literature. This study is the first to suggest that airway GATA-4 gene methylation status may independently predict health status in individuals with COPD.

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Section: Discussionsupporting

confidence: 93%

Epigenetic Change (GATA-4 Gene Methylation) Is Associated With Health Status in Chronic Obstructive Pulmonary Disease

Meek

Sood

Petersen

et al. 2014

Biological Research For Nursing

View full text Add to dashboard Cite

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“…A systematic review compared the effi cacy of three therapeutic approaches: tiotropium plus long-acting b 2 -agonist (dual therapy), long-acting b 2 -agonist plus inhaled corticosteroid (combined therapy), and tiotropium plus inhaled corticosteroid plus longacting b 2 -agonist (triple therapy), each compared with tiotropium single therapy. 214 Twenty trials enrolling 6,803 patients were included in the review. Th e authors concluded that dual therapy improved lung function and health-related quality of life but failed to decrease exacerbation frequency compared with tiotropium monotherapy.…”

Section: Evidence For Combination Inhaled Corticosteroid/ Long-actingmentioning

confidence: 99%

Prevention of Acute Exacerbations of COPD

Criner

Bourbeau

Diekemper

et al. 2015

Chest

245

148

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“…26 Many studies have demonstrated that monotherapy with long-acting bronchodilators -both LABA and LAMA -can provide clinically relevant improvements in health status of COPD patients, at least in the shorter term. [37][38][39][40][41] The addition of ICS to a long-acting bronchodilator appears to improve health status by approximately 2 units.…”

Section: Effect Of Ics On Health Statusmentioning

confidence: 99%

Risk-to-benefit ratio of inhaled corticosteroids in patients with COPD

Price

Yawn

Brusselle

et al. 2012

Primary Care Respiratory Journal

161

139

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While the pharmacological management of chronic obstructive pulmonary disease (COPD) has evolved from the drugs used to treat asthma, the treatment models are different and the two diseases require clear differential diagnosis in order to determine the correct therapeutic strategy. In contrast to the almost universal requirement for anti-inflammatory treatment of persistent asthma, the efficacy of inhaled corticosteroids (ICS) is less well established in COPD and their role in treatment is limited. There is some evidence of a preventive effect of ICS on exacerbations in patients with COPD, but there is little evidence for an effect on mortality or lung function decline. As a result, treatment guidelines recommend the use of ICS in patients with severe or very severe disease (forced expiratory volume in 1 second <50% predicted) and repeated exacerbations. Patients with frequent exacerbations -a phenotype that is stable over time -are likely to be less common among those with moderate COPD (many of whom are managed in primary care) than in those with more severe disease. The indiscriminate use of ICS in COPD may expose patients to an unnecessary increase in the risk of side-effects such as pneumonia, osteoporosis, diabetes and cataracts, while wasting healthcare spending and potentially diverting attention from other more appropriate forms of management such as pulmonary rehabilitation and maximal bronchodilator use. Physicians should carefully weigh the likely benefits of ICS use against the potential risk of side-effects and costs in individual patients with COPD.

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Profiling the effects of indacaterol on dyspnoea and health status in patients with COPD

Abstract: Indacaterol provided clinically important improvements in dyspnoea and health status that were at least as good as and often better than those observed with existing bronchodilator treatments for COPD.

Cited by 29 publications

References 35 publications

Epigenetic Change (GATA-4 Gene Methylation) Is Associated With Health Status in Chronic Obstructive Pulmonary Disease

Epigenetic Change (GATA-4 Gene Methylation) Is Associated With Health Status in Chronic Obstructive Pulmonary Disease

Prevention of Acute Exacerbations of COPD

Risk-to-benefit ratio of inhaled corticosteroids in patients with COPD

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