Pathophysiological Factors in the Relationship between Chronological Age and Calculated Lung Age as Detected in a Screening Setting in Community-Dwelling Subjects

Effect of smoking status on spirometric lung age in adult Chinese Men

Smoking is one of the most unhealthy behaviours and responsible for a variety of respiratory diseases. Although spirometric lung age (SLA) is regarded as an effective way to augment the smoking quit rate in other countries, it has not been calculated in Chinese smokers. Thus, the aim of this study was to determine the association of SLA with smoking status, and further explore whether smoking duration, dependence and other factors such as obesity and physical exercise affect SLA in Chinese current smokers. A total of 431 healthy men aged 20 years and older took part in the study from September 2018 to August 2019. Spirometric test was measured through a portable spirometry, and smoking status including smoking duration and dependence was investigated by using a questionnaire. SLA was calculated from an established equation which is based on the inverse calculation of the forced expiratory volume in one second in the Chinese population. Lung age difference (∆LA) could be obtained by counting the difference between SLA and chronological age. Results indicated that ∆LA is remarkably higher in current smokers than that in ex-smokers and non-smokers (p < 0.01). The study also revealed that smoking duration and dependence are related to ∆LA. Smokers with long smoking duration (smoked ≥10 years) and high dependence (consumed ≥20 cigarettes per day) had a significantly higher ∆LA than their counterparties (p < 0.01). Multiple regression analysis showed that body mass index, smoking duration and cigarettes per day were independently correlated with ∆LA in the current smokers (p < 0.01). The findings suggest that not only smoking or not, but smoking duration, dependence and obesity are strongly associated with SLA.

Characterization of differential patient profiles and therapeutic responses of pharmacy customers for four ambroxol formulations

Background

Ambroxol relieves cough symptoms based on its secretagogue, anti-inflammatory, anti-oxidant, anti-bacterial, anti-viral, immunomodulatory and local anesthetic effects. The present study was designed to explore differential patient profiles and efficacy against acute respiratory symptoms of four formulations registered as over-the-counter medicines.

Methods

Nine hundred sixty-five pharmacy customers purchasing one of four branded ambroxol formulations (extended release capsules, adult syrup, pediatric syrup and soft pastilles) filled a questionnaire including a patient-adapted version of the Bronchitis Severity Scale, several questions on degree of impairment by acute cough, time to onset of symptom relief and duration of treatment. Data on pediatric syrup users were entered by their parents. Based on the exploratory character of the study, no hypothesis-testing statistical analysis was applied.

Results

Users of the pediatric syrup and the pastilles reported somewhat less severe baseline symptoms. The patient-adapted Bronchitis Severity Scale proved feasible as a self-administered tool. Among BSS items, ambroxol formulations improved chest pain while coughing to the largest and sputum to smallest degree (− 75% vs. -40%). Reported efficacy was comparable among formulations with minor differences in favor of the pediatric syrup. Time to onset of symptom relief was less than 60 min in more than 90% of patients and occurred prior to known systemic t_max. Time to onset was the parameter with the greatest differences between formulations, being reported fastest with pastilles and pediatric syrup and, as expected, slowest with extended release capsules. All ambroxol formulations were well tolerated.

Conclusions

We conclude that over-the-counter formulations of ambroxol exhibit comparable user profiles and efficacy. Differences in speed of onset of symptom relief may involve not only those in systemic pharmacokinetics but also local anesthetic effects of immediate release formulations. Differences between pediatric and adult syrup may in part reflect reporting bias.

Factors associated with efficacy of an ibuprofen/pseudoephedrine combination drug in pharmacy customers with common cold symptoms

AIM

The aim of this study was to explore factors affecting efficacy of treatment of common cold symptoms with an over-the-counter ibuprofen/pseudoephedrine combination product.

METHODS

Data from an anonymous survey among 1770 pharmacy customers purchasing the combination product for treatment of own common cold symptoms underwent post-hoc descriptive analysis. Scores of symptoms typically responsive to ibuprofen (headache, pharyngeal pain, joint pain and fever), typically responsive to pseudoephedrine (congested nose, congested sinus and runny nose), considered non-specific (sneezing, fatigue, dry cough, cough with expectoration) and comprising all 11 symptoms were analysed. Multiple regression analysis was applied to explore factors associated with greater reduction in symptom intensity or greater probability of experiencing a symptom reduction of at least 50%.

RESULTS

After intake of first dose of medication, typically ibuprofen-sensitive, pseudoephedrine-responsive, non-specific and total symptoms were reduced by 60.0%, 46.3%, 45.4% and 52.8%, respectively. A symptom reduction of at least 50% was reported by 73.6%, 55.1%, 50.9% and 61.6% of participants, respectively. A high baseline score was associated with greater reductions in symptom scores but smaller probability of achieving an improvement of at least 50%. Across both multiple regression approaches, two tablets at first dosing were more effective than one and (except for ibuprofen-sensitive symptoms) starting treatment later than day 2 of the cold was generally less effective.

DISCUSSION AND CONCLUSIONS

Efficacy of an ibuprofen/pseudoephedrine combination in the treatment of common cold symptoms was dose-dependent and greatest when treatment started within the first 2 days after onset of symptoms.