Respiratory medicine
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Respiratory medicine · Jun 2008
Randomized Controlled TrialAntioxidant effect of zinc picolinate in patients with chronic obstructive pulmonary disease.
An imbalance between oxidative stress and antioxidant capacity is thought to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, studies in regard to stable COPD patients and effect of zinc supplementation are lacking. We investigated the effects of zinc picolinate supplementation on the oxidant stress, and pulmonary function tests (PFTs) of patients with stable COPD. ⋯ In conclusion, the results indicate that zinc supplementation may have favorable effects on oxidant-antioxidant balance in patients with COPD. The lack of an effect on PFT may be due to the short duration of the supplementation. Longer duration of zinc supplementation may be necessary to see clinical benefit.
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Respiratory medicine · Apr 2008
Randomized Controlled TrialConcomitant treatment with nebulized formoterol and tiotropium in subjects with COPD: a placebo-controlled trial.
Adding a long-acting beta(2)-agonist (LABA) by dry powder inhaler (DPI) to tiotropium provides significantly increased and sustained bronchodilation in chronic obstructive pulmonary disease (COPD) patients over either product alone. To demonstrate similar benefits with a nebulized LABA, a placebo-controlled trial was conducted to evaluate the efficacy and safety of formoterol fumarate inhalation solution in subjects receiving tiotropium as a maintenance treatment for COPD. After a 7-14-day screening period using tiotropium 18 microg once daily, subjects with diagnosed COPD (> or = 25% to <65% predicted FEV(1)) were randomized to receive 20 microg formoterol fumarate inhalation solution twice daily for nebulization plus tiotropium (FFIS/TIO) or nebulized placebo twice daily plus tiotropium (PLA/TIO) for 6 weeks. ⋯ PLA/TIO (p=0.04). More PLA/TIO- than FFIS/TIO-treated subjects experienced AEs (39.7% vs. 22.9%), COPD exacerbations (7.9% vs. 4.5%), and serious AEs (3.2% vs. 1.5%). Nebulized formoterol fumarate in combination with tiotropium provided statistically and clinically significant improvements in bronchodilation and symptom control over tiotropium alone and demonstrated good tolerability.
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Respiratory medicine · Feb 2008
Randomized Controlled Trial Multicenter StudyEfficacy and safety of formoterol fumarate delivered by nebulization to COPD patients.
Nebulized solutions of long-acting bronchodilators provide an alternative to DPI and MDI delivery, particularly for COPD patients unable to use hand-held devices easily or correctly. The long-acting beta2-agonist, formoterol fumarate, is differentiated by its onset of significant bronchodilation within 5 min of administration. In a randomized, double-blind, double-dummy trial, COPD subjects (n=351, mean forced expiratory volume FEV1=1.3 L, 44% predicted) received nebulized formoterol fumarate (Perforomist inhalation solution; FFIS 20 microg) or DPI (Foradil Aerolizer; FA 12 microg), or placebo twice daily for 12 weeks. ⋯ Drug related AEs in the FFIS arm with a frequency > or = 1% and exceeding placebo were dry mouth, nausea, and insomnia. Nebulized FFIS provided significant improvement in respiratory status and quality of life in subjects with COPD relative to placebo and was well tolerated. The efficacy and safety profile of FFIS was comparable to FA DPI.
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Respiratory medicine · Jan 2008
Randomized Controlled Trial Comparative StudyA randomized study of tiotropium Respimat Soft Mist inhaler vs. ipratropium pMDI in COPD.
The aim of these studies was to compare the efficacy and the safety of tiotropium, delivered via Respimat Soft Mist Inhaler (SMI), a novel multi-dose, propellant-free inhaler, with ipratropium pressurized metered-dose inhaler (pMDI) in chronic obstructive pulmonary disease (COPD) patients. Two identical, 12-week, multi-national, randomized, double-blind, double-dummy, parallel-group, active- and placebo-controlled studies were performed. COPD patients were randomized to treatment with either inhaled tiotropium (5 or 10 microg) via Respimat SMI administered once daily, ipratropium (36 microg) pMDI QID or placebo. ⋯ All active treatments significantly reduced the rescue medication use compared with placebo, but only tiotropium 10 microg was statistically superior to ipratropium (P=0.04). The incidence of adverse events was comparable across groups. In conclusion, tiotropium 5 and 10 microg daily, delivered via Respimat SMI, significantly improved lung function compared with ipratropium pMDI and placebo.
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Respiratory medicine · Jan 2008
Randomized Controlled Trial Comparative StudyEarly administration of two intravenous bolus of aminophylline added to the standard treatment of children with acute asthma.
Evaluate the efficacy of adding two intravenous bolus of aminophylline to the standard treatment of acute asthma episode in children admitted to the pediatric emergency room (PER). ⋯ In children aged 2-5 years admitted to a PER with asthma, two intravenous doses of 5mg/kg of aminophylline given 6h apart did not change the length of stay in hospital, the number of nebulizations given or the duration of oxygen therapy required. We are unable to tell whether there would be benefit with higher doses of aminophylline designed to give levels in the usual therapeutic range.