International journal of chronic obstructive pulmonary disease
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Randomized Controlled TrialBronchodilator efficacy of extrafine glycopyrronium bromide: the Glyco 2 study.
An extrafine formulation of the long-acting muscarinic antagonist glycopyrronium bromide (GB) is in development for chronic obstructive pulmonary disease (COPD), in combination with beclometasone dipropionate and formoterol fumarate - a "fixed triple". This two-part study was randomized, double blind, placebo controlled in patients with moderate-to-severe COPD: Part 1: single-dose escalation, GB 12.5, 25, 50, 100 or 200 μg versus placebo; Part 2: repeat-dose (7-day), four-period crossover, GB 12.5, 25 or 50 μg twice daily (BID) versus placebo, with an open-label extension in which all patients received tiotropium 18 μg once daily. On the morning of Day 8 in all five periods, patients also received formoterol 12 μg. ⋯ All adverse events were mild-moderate in severity and there was no indication of a dose-related relationship. This study provides initial evidence on bronchodilation, safety and pharmacokinetics of extrafine GB BID. Overall, the results suggest that GB 25 μg BID is the optimal dose in patients with COPD.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Randomized Controlled TrialIs cardiac autonomic modulation during upper limb isometric contraction and Valsalva maneuver impaired in COPD patients?
To evaluate the heart rate variability (HRV) indices and heart rate (HR) responses during isometric contraction (IC) and Valsalva maneuver (VM) in COPD patients. ⋯ COPD patients responded properly to the upper limb IC and to the VM; however, HR recovery during VM was impaired in these patients. The severity of the disease and MIP were associated with increased parasympathetic modulation and higher chronotropic response.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Randomized Controlled TrialEffects of a self-management education program on self-efficacy in patients with COPD: a mixed-methods sequential explanatory designed study.
Self-management education programs (SMEPs) are potentially effective in the symptomatic management of COPD. Little is presently known about the effectiveness of these programs in Chinese COPD patients. The objective of this study was to evaluate the effectiveness of a specifically designed SMEP on levels of self-efficacy in Chinese patients with COPD. ⋯ These findings highlight the potential putative benefits of an SMEP in Chinese patients with COPD. Further attention should be given to cultural considerations when developing this type of intervention in Chinese populations with COPD and other chronic diseases.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Randomized Controlled TrialFluticasone propionate/formoterol for COPD management: a randomized controlled trial.
To evaluate fluticasone propionate/formoterol (FP/FORM) in COPD. ⋯ FP/FORM did not reduce exacerbation rates versus FORM. Numerical benefits were observed with FP/FORM 500/20 µg versus FORM for secondary variables, including lung function, EXACT exacerbations, SGRQ-C and EXACT-respiratory symptoms total and breathlessness scores. Few efficacy differences were evident between FP/FORM 250/10 µg and FORM. Pneumonia was more frequent in FP/FORM-treated patients, although the absolute difference was low. Adverse events were otherwise similar between treatments.
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Int J Chron Obstruct Pulmon Dis · Jan 2017
Randomized Controlled TrialEffects of a simple prototype respiratory muscle trainer on respiratory muscle strength, quality of life and dyspnea, and oxidative stress in COPD patients: a preliminary study.
The aim of this study was to evaluate the efficiency of a simple prototype device for training respiratory muscles in lung function, respiratory muscle strength, walking capacity, quality of life (QOL), dyspnea, and oxidative stress in patients with COPD. ⋯ This study proposes that a simple prototype device can be used clinically in COPD patients as a standard device to train respiratory muscles, improving lung function and QOL, as well as involving MDA and NO levels.