Physicians’ attitudes towards combination therapy with inhaled corticosteroids and long-acting ß2-agonists : an observational study in UK specialist care

Acknowledgments This publication is based on research that was funded by Napp Pharmaceuticals Limited. Editorial support for preparation of this manuscript was provided by Oxford PharmaGenesis™ Ltd on behalf of Mundipharma International Limited.Peer reviewedPublisher PD

Linked health data for pharmacovigilance in children : Perceived legal and ethical issues for stakeholders and data guardians

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A retrospective cohort study in severe asthma describing commonly measured biomarkers: Eosinophil count and IgE levels.

Background: Identifying asthma patients suitable for biologic therapy includes the assessment of blood biomarkers (IgE and eosinophils (EOS)). How they relate to each other is unclear. Methods: This retrospective, database study used routinely collected clinical data to identify and evaluate an asthma cohort (classification code for asthma; ≥ 18 years; ≥1 prescription for asthma; ≥1 estimation of serum IgE, in 2 years prior to index date). Distribution into high and low IgE and EOS groups (IgE cut-point: > or ≤75 kU/L; EOS cut point: >or ≤400 μ/L), and characteristics by group are described. Findings: In patients with severe asthma (British Thoracic Society Step (BTS) ≥4; N = 884), using maximum recorded IgE/EOS, 33% had high IgE/high EOS, 28% low IgE/low EOS and approximately a fifth each had high IgE/low EOS or low IgE/high EOS. Proportions were similar when EOS values measured 2 or 4 weeks before an exacerbation were excluded. Using EOS/IgE ′same day’ measurements (N = 578) only identified half of the high EOS group. Patients in high IgE groups were more likely to be younger males without comorbid COPD; those in high EOS groups were more likely to be on BTS treatment Step 5 vs 4. The low IgE/low EOS group had the lowest incidence of asthma-related hospital attendances, the highest incidence was observed in the high EOS groups. Conclusion: Maximum available EOS measurement irrespective of exacerbations may be relevant when considering therapy. These data showed low IgE/Low EOS to be more benign and high EOS groups at increased risk of frequent, severe exacerbations

First maintenance therapy for COPD in the UK between 2009 and 2012 : a retrospective database analysis

This research was conducted by Research in Real-Life Ltd (Cambridge, UK), an independent company. Medical writing support was provided by Tracey Lonergan on behalf of Complete Medical Communications and was funded by Almirall S.A. Funding This research was funded by Almirall S.A.Peer reviewedPublisher PD

The long-term clinical impact of COPD exacerbations : a 3-year observational study (SHERLOCK)

Acknowledgements Medical writing support, under the direction of the authors, was provided by Sara Cameron, M. Phil., of CMC Connect, McCann Health Medical Communications, funded by AstraZeneca in accordance with Good Publication Practice (GPP3) guidelines. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by AstraZeneca. Employees of AstraZeneca were involved in the design of the study, interpretation of the data (but not the data collection), in the writing of the report, and in the decision to submit the article for publication.Peer reviewedPublisher PD

Short- and Long-Term Impact of Prior Chronic Obstructive Pulmonary Disease Exacerbations on Healthcare Resource Utilization and Related Costs : An Observational Study (SHERLOCK)

Acknowledgments Medical writing support, under the direction of the authors, was provided by Sara Cameron, MPhil, CMC Connect, a division of IPG Health Medical Communications, funded by AstraZeneca in accordance with Good Publication Practice (GPP 2022) guidelines [Citation28]. All authors were involved in the design and conduct of the study and in the interpretation of the data. All authors were involved in the writing of the manuscript and the final decision to submit to COPD: Journal of Chronic Obstructive Pulmonary Disease. Funding This study was sponsored by AstraZeneca. AstraZeneca authors were involved in the design of the study; in the analysis, and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.Peer reviewedPublisher PD

Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study

Background: Serious inhaler technique errors can impair drug delivery to the lungs. This randomised, crossover, open-label study evaluated the proportion of patients making predefined serious errors with Pulmojet compared with Diskus and Turbohaler dry powder inhalers. Methods: Patients ≥18 years old with asthma and/or COPD who were current users of an inhaler but naïve to the study devices were assigned to inhaler technique assessment on Pulmojet and either Diskus or Turbohaler in a randomised order. Patients inhaled through empty devices after reading the patient information leaflet. If serious errors potentially affecting dose delivery were recorded, they repeated the inhalations after watching a training video. Inhaler technique was assessed by a trained nurse observer and an electronic inhalation profile recorder. Results: Baseline patient characteristics were similar between randomisation arms for the Pulmojet-Diskus (n = 277) and Pulmojet-Turbohaler (n = 144) comparisons. Non-inferiority in the proportions of patients recording no nurse-observed serious errors was demonstrated for both Pulmojet versus Diskus, and Pulmojet versus Turbohaler; therefore, superiority was tested. Patients were significantly less likely to make ≥1 nurse-observed serious errors using Pulmojet compared with Diskus (odds ratio, 0.31; 95 % CI, 0.19–0.51) or Pulmojet compared with Turbohaler (0.23; 0.12–0.44) after reading the patient information leaflet with additional video instruction, if required. Conclusions These results suggest Pulmojet is easier to learn to use correctly than the Turbohaler or Diskus for current inhaler users switching to a new dry powder inhaler

A Charter to Fundamentally Change the Role of Oral Corticosteroids in the Management of Asthma

Asthma affects 339 million people worldwide, with an estimated 5–10% experiencing severe asthma. In emergency settings, oral corticosteroids (OCS) can be lifesaving, but acute and long-term treatment can produce clinically important adverse outcomes and increase the risk of mortality. Therefore, global guidelines recommend limiting the use of OCS. Despite the risks, research indicates that 40–60% of people with severe asthma are receiving or have received long-term OCS treatment. Although often perceived as a low-cost option, long-term OCS use can result in significant health impairments and costs owing to adverse outcomes and increased utilization of healthcare resources. Alternative treatment methods, such as biologics, may produce cost-saving benefits with a better safety profile. A comprehensive and concerted effort is necessary to tackle the continued reliance on OCS. Accordingly, a threshold for OCS use should be established to help identify patients at risk of OCS-related adverse outcomes. Receiving a total dose of more than 500 mg per year should trigger a review and specialist referral. Changes to national and local policies, following examples from other chronic diseases, will be crucial to achieving this goal. Globally, multiple barriers to change still exist, but specific steps have been identified to help clinicians reduce reliance on OCS. Implementing these changes will result in positive health outcomes for patients and social and economic benefits for societies.</p

Case-finding of chronic obstructive pulmonary disease with questionnaire, peak flow measurements and spirometry : a cross-sectional study

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