The clinical respiratory journal
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Treatment of chronic obstructive pulmonary disease (COPD) is evolving specially with triple inhaler therapy. ⋯ Among patients with moderate-to-severe COPD, triple inhaler therapy was associated with a reduction of moderate-to-severe COPD exacerbations, improved lung function and improved quality of life when compared to dual inhaler therapy but with an increased pneumonia risk.
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Meta Analysis
Effects of inspiratory muscle training in COPD patients: A systematic review and meta-analysis.
In chronic obstructive pulmonary disease (COPD), quality of life and exercise capacity are altered in relationship to dyspnea. Benefits of inspiratory muscle training (IMT) on quality of life, dyspnea, and exercise capacity were demonstrated, but when it is associated to pulmonary rehabilitation (PR), its efficacy on dyspnea is not demonstrated. The aim of this systematic review with meta-analysis was to verify the effect of IMT using threshold devices in COPD patients on dyspnea, quality of life, exercise capacity, and inspiratory muscles strength, and the added effect on dyspnea of IMT associated with PR (vs. PR alone). ⋯ IMT using threshold devices improves inspiratory muscle strength, exercise capacity and quality of life, decreases dyspnea. However, there is no added effect of IMT on dyspnea during PR (compared with PR alone).
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Review Meta Analysis
Smoking and EGFR status may predict outcomes of advanced NSCLC treated with PD-(L)1 inhibitors beyond first line: A meta-analysis.
The aim of this study was to assess the potential clinical and biological predictive markers of survival in pretreated advanced NSCLC patients treated with the three PD-(L)1 inhibitors (nivolumab, pembrolizumab and atezolizumab). ⋯ Smoking history and EGFR status may help predict the performance of PD-(L)1 inhibitors vs docetaxel in previously treated NSCLC patients.
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Prognostic factors of idiopathic pulmonary fibrosis (IPF) currently recognized include changes in vital capacity and radiologic findings. However, most of the prognostic studies in IPF are based on clinical studies with preselected IPF populations. Therefore, we decided to analyze the factors influencing IPF prognosis based on the real-practice data from our IPF registry. ⋯ DLCO changes over time were shown as a better predictor of mortality compared with FVC changes in our study. In our opinion it is necessary to implement the DLCO analysis into clinical trials and routine practice.
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Review Meta Analysis
Risk factors for acute exacerbation of idiopathic pulmonary fibrosis: A systematic review and meta-analysis.
Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive fibrotic disease limited to the lungs. The course of disease varies widely, with some patients experiencing acute respiratory deterioration, a condition called acute exacerbations of IPF (AE-IPF). The risk factors contributing to AE-IPF are unclear. This systematic review and meta-analysis investigated the risk factors for AE-IPF. ⋯ Poor pulmonary function, mechanical procedures, higher serum KL-6 and secondary pulmonary hypertension were associated with increased risks of AE-IPF.