American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Feb 2018
Randomized Controlled Trial Comparative StudyRandomised Controlled Trial of Urokinase versus Placebo for Non-draining Malignant Pleural Effusion.
Patients with malignant pleural effusion experience breathlessness, which is treated by drainage and pleurodesis. Incomplete drainage results in residual dyspnea and pleurodesis failure. Intrapleural fibrinolytics lyse septations within pleural fluid, improving drainage. ⋯ Use of intrapleural urokinase does not reduce dyspnea or improve pleurodesis success compared with placebo and cannot be recommended as an adjunct to pleurodesis. Other palliative treatments should be used. Improvements in hospital stay, radiographic appearance, and survival associated with urokinase require further evaluation. Clinical trial registered with ISRCTN (12852177) and EudraCT (2008-000586-26).
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Am. J. Respir. Crit. Care Med. · Feb 2018
Letter Randomized Controlled TrialPeripheral and Alveolar Cell Transcriptional Programs are Distinct in Acute Respiratory Distress Syndrome.
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Am. J. Respir. Crit. Care Med. · Feb 2018
Randomized Controlled Trial Comparative StudyNintedanib with Add-on Pirfenidone in Idiopathic Pulmonary Fibrosis: Results of the INJOURNEY Trial.
Nintedanib and pirfenidone slow the progression of idiopathic pulmonary fibrosis (IPF), but the disease continues to progress. More data are needed on the safety and efficacy of combination therapy with nintedanib and add-on pirfenidone. ⋯ Nintedanib with add-on pirfenidone had a manageable safety and tolerability profile in patients with IPF, in line with the adverse event profiles of each drug. These data support further research into combination regimens in the treatment of IPF. Clinical trial registered with www.clinicaltrials.gov (NCT02579603).
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Am. J. Respir. Crit. Care Med. · Feb 2018
Randomized Controlled Trial Comparative StudyBronchial Provocation Testing Can Be Improved by Using Dry Powder Adenosine Instead of Nebulized AMP.