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van Nijnatten J, Faiz A, Timens W, Guryev V, Slebos DJ, Klooster K, Hartman JE, Kole T, Choy DF, Chakrabarti A, Grimbaldeston M, Rosenberger CM, Kerstjens H, Brandsma CA, van den Berge M. A bronchial gene signature specific for severe COPD that is retained in the nose. ERJ Open Res 2023; 9:00354-2023. [PMID: 38020574 PMCID: PMC10680034 DOI: 10.1183/23120541.00354-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction A subset of COPD patients develops advanced disease with severe airflow obstruction, hyperinflation and extensive emphysema. We propose that the pathogenesis in these patients differs from mild-moderate COPD and is reflected by bronchial gene expression. The aim of the present study was to identify a unique bronchial epithelial gene signature for severe COPD patients. Methods We obtained RNA sequencing data from bronchial brushes from 123 ex-smokers with severe COPD, 23 with mild-moderate COPD and 23 non-COPD controls. We identified genes specific to severe COPD by comparing severe COPD to non-COPD controls, followed by removing genes that were also differentially expressed between mild-moderate COPD and non-COPD controls. Next, we performed a pathway analysis on these genes and evaluated whether this signature is retained in matched nasal brushings. Results We identified 219 genes uniquely differentially expressed in severe COPD. Interaction network analysis identified VEGFA and FN1 as the key genes with the most interactions. Genes were involved in extracellular matrix regulation, collagen binding and the immune response. Of interest were 10 genes (VEGFA, DCN, SPARC, COL6A2, MGP, CYR61, ANXA6, LGALS1, C1QA and C1QB) directly connected to fibronectin 1 (FN1). Most of these genes were lower expressed in severe COPD and showed the same effect in nasal brushings. Conclusions We found a unique severe COPD bronchial gene signature with key roles for VEGFA and FN1, which was retained in the upper airways. This supports the hypothesis that severe COPD, at least partly, comprises a different pathology and supports the potential for biomarker development based on nasal brushes in COPD.
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Affiliation(s)
- Jos van Nijnatten
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Technology Sydney, Respiratory Bioinformatics and Molecular Biology, Sydney, NSW, Australia
| | - Alen Faiz
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Technology Sydney, Respiratory Bioinformatics and Molecular Biology, Sydney, NSW, Australia
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Wim Timens
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
| | - Victor Guryev
- University of Groningen University Medical Center Groningen, European Research Institute for the Biology of Ageing, Groningen, the Netherlands
| | - Dirk-Jan Slebos
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Karin Klooster
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Jorine E. Hartman
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Tessa Kole
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | | | | | | | | | - Huib Kerstjens
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - Corry-Anke Brandsma
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- These authors contributed equally
| | - Maarten van den Berge
- University of Groningen University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
- University of Groningen University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
- These authors contributed equally
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van Gemert J, Steenberg F, van Leer-Buter C, Kerstjens H, Steenhuis W, Akkerman O, Verschuuren E, Gan T. Increasing Antibody Responses to Five Doses of SARS-CoV-2 mRNA Vaccine in Lung Transplant Patients. J Clin Med 2023; 12:4125. [PMID: 37373817 PMCID: PMC10299568 DOI: 10.3390/jcm12124125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/10/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE COVID-19 causes high mortality in Lung Transplant (LTx) patients, therefore vaccination in this population is potentially life-saving. However, the antibody response is impaired after three vaccinations in LTx patients. We questioned whether this response might be increased, and therefore studied the serological IgG antibody response across up to five doses of the SARS-CoV-2 vaccine. In addition, risk factors for non-response were investigated. METHODS In this large retrospective cohort study, antibody responses were assessed after 1-5 mRNA-based SARS-CoV-2 vaccines in all LTx patients between February 2021 and September 2022. A positive vaccine response was defined as an IgG level ≥ 300 BAU/mL. Positive antibody responses due to COVID-19 infection were excluded from the analysis. Outcome and clinical parameters were compared between responders and non-responders, and multivariable logistic regression analysis was performed to determine the risk factors for vaccine-response failure. RESULTS The antibody responses of 292 LTx patients were analyzed. Positive antibody response to 1-5 SARS-CoV-2 vaccinations occurred in 0%, 15%, 36%, 46%, and 51%, respectively. During the study period, 146/292 (50%) of the vaccinated individuals tested positive for SARS-CoV-2 infection. The COVID-19-related mortality was 2.7% (4/146), and all four patients were non-responders. Risk factors associated with non-response to SARS-CoV-2 vaccines in univariable analyses were age (p = 0.004), chronic kidney disease (CKD) (p = 0.006), and shorter time since transplantation (p = 0.047). In the multivariable analysis, they were CKD (p = 0.043), and shorter time since transplantation (p = 0.028). CONCLUSION A two- to five-dose regime of SARS-CoV-2 vaccines in LTx patients increases the probability of vaccine response and results in a cumulative vaccine response in 51% of the LTx population. LTx patient antibody response to SARS-CoV-2 vaccinations is therefore impaired, especially in patients shortly after LTx, patients with CKD, and the elderly.
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Affiliation(s)
- Johanna van Gemert
- Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (F.S.); (H.K.); (W.S.); (O.A.); (E.V.); (T.G.)
| | - Fleur Steenberg
- Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (F.S.); (H.K.); (W.S.); (O.A.); (E.V.); (T.G.)
| | - Coretta van Leer-Buter
- Department of Virology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - Huib Kerstjens
- Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (F.S.); (H.K.); (W.S.); (O.A.); (E.V.); (T.G.)
| | - Willie Steenhuis
- Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (F.S.); (H.K.); (W.S.); (O.A.); (E.V.); (T.G.)
| | - Onno Akkerman
- Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (F.S.); (H.K.); (W.S.); (O.A.); (E.V.); (T.G.)
| | - Erik Verschuuren
- Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (F.S.); (H.K.); (W.S.); (O.A.); (E.V.); (T.G.)
| | - Tji Gan
- Department of Pulmonary Diseases, Tuberculosis and Lung Transplantation, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (F.S.); (H.K.); (W.S.); (O.A.); (E.V.); (T.G.)
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3
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De Zwart A, Riezebos-Brilman A, Rasoul A, Luijk B, Kerstjens H, Gan T, Alffenaar J, Verschuuren E. Parainfluenza Virus Infections in Lung Transplant Recipients: A Multicenter Comparison with Influenza Virus and Assessment of Ribavirin Efficacy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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4
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Mooren K, Wester D, Kerstjens H, Bergkamp E, Spathis A, Engels Y. Filling the Gap: A Feasibility Study of a COPD-Specific Breathlessness Service. COPD 2022; 19:324-329. [PMID: 36004678 DOI: 10.1080/15412555.2022.2099821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Refractory breathlessness is a devastating symptom in chronic obstructive pulmonary disease (COPD). Symptom-focused breathlessness services, involving palliative care teams, offer individualized support but are not yet widely available for people with nonmalignant disease among which COPD. Our primary aim was to demonstrate the feasibility of setting up a breathlessness service specifically for COPD patients within a respiratory outpatient clinic. Our secondary aims were to assess how many sessions patients need to complete the intervention; to obtain an indication of effect size (on the Chronic Respiratory Questionnaire (CRQ), subset mastery domain); and to evaluate patient and professional satisfaction. We conducted a non-randomized single-center feasibility study. Participants had COPD and refractory breathlessness. During at least one session with a respiratory nurse and a pulmonologist, and one session with a physiotherapist, patients learned non-pharmacological interventions to manage breathlessness. Of 34 screened patients, 19 were included. All completed the intervention. A median of two clinical visits and two telephone calls were needed to complete the intervention. The mean improvement of 1.55 in CRQ, mastery domain, significantly exceeded the clinically important difference of 0.5. The service was rated as excellent by the eight patients who completed the survey. The health professional team gave positive feedback on the experience of delivering the intervention. Delivery of a breathlessness service for COPD outpatients with refractory breathlessness appears feasible, easy to implement in a respiratory outpatient clinic, and has the potential to be effective. A randomized controlled clinical trial is needed to test effectiveness and cost-effectiveness in this context.
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Affiliation(s)
- Kris Mooren
- Department of Lung Disease, Spaarne Gasthuis, Haarlem, Noord-Holland, The Netherlands.,Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Danielle Wester
- Department of Lung Disease, Spaarne Gasthuis, Haarlem, Noord-Holland, The Netherlands
| | - Huib Kerstjens
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, and University Medical Centre Groningen, and Groningen Research Center for Asthma and COPD, Groningen, The Netherlands
| | - Erik Bergkamp
- Department of Lung Disease, Spaarne Gasthuis, Haarlem, Noord-Holland, The Netherlands
| | - Anna Spathis
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | - Yvonne Engels
- Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
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5
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de Zwart A, Riezebos-Brilman A, Lunter G, Vonk J, Glanville AR, Gottlieb J, Permpalung N, Kerstjens H, Alffenaar JW, Verschuuren E. Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Virus Infections in Lung Transplant Recipients: A Systematic Review of Outcomes and Treatment Strategies. Clin Infect Dis 2022; 74:2252-2260. [PMID: 35022697 PMCID: PMC9258934 DOI: 10.1093/cid/ciab969] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Indexed: 12/16/2022] Open
Abstract
Background Respiratory syncytial virus (RSV), parainfluenza virus (PIV), and human metapneumovirus (hMPV) are increasingly associated with chronic lung allograft dysfunction (CLAD) in lung transplant recipients (LTR). This systematic review primarily aimed to assess outcomes of RSV/PIV/hMPV infections in LTR and secondarily to assess evidence regarding the efficacy of ribavirin. Methods Relevant databases were queried and study outcomes extracted using a standardized method and summarized. Results Nineteen retrospective and 12 prospective studies were included (total 1060 cases). Pooled 30-day mortality was low (0–3%), but CLAD progression 180–360 days postinfection was substantial (pooled incidences 19–24%) and probably associated with severe infection. Ribavirin trended toward effectiveness for CLAD prevention in exploratory meta-analysis (odds ratio [OR] 0.61, [0.27–1.18]), although results were highly variable between studies. Conclusions RSV/PIV/hMPV infection was followed by a high CLAD incidence. Treatment options, including ribavirin, are limited. There is an urgent need for high-quality studies to provide better treatment options for these infections.
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Affiliation(s)
- Auke de Zwart
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, The Netherlands
| | | | - Gerton Lunter
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Judith Vonk
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | | | - Jens Gottlieb
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Nitipong Permpalung
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Huib Kerstjens
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, The Netherlands
| | - Jan-Willem Alffenaar
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Westmead Hospital, Westmead, Australia.,Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Erik Verschuuren
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Medicine and Tuberculosis, Groningen, The Netherlands
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6
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Grootjans H, Verschuuren E, van Gemert A, Berger S, Kerstjens H, Droogh J, Gan T. Long-Term Renal Outcome in Patients Bridged on ICU for Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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7
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Scosyrev E, van Zyl-Smit R, Kerstjens H, Gessner C, Kornmann O, Jain D, Aubrun E, D'Andrea P, Hosoe M, Pethe A, Brittain D. Cardiovascular safety of mometasone/indacaterol and mometasone/indacaterol/glycopyrronium once-daily fixed-dose combinations in asthma: pooled analysis of phase 3 trials. Respir Med 2021; 180:106311. [PMID: 33711782 DOI: 10.1016/j.rmed.2021.106311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate cardiovascular safety of two new inhaled fixed-dose combinations for treatment of asthma: (i) the inhaled corticosteroid/long-acting beta2-agonist (ICS/LABA) mometasone furoate/indacaterol acetate (MF/IND), (ii) the ICS/LABA/long-acting muscarinic antagonist (LAMA) MF/IND/glycopyrronium bromide (GLY). METHODS Patient-level data were pooled from four randomized trials, including 52-week studies PALLADIUM (n = 2216) and IRIDIUM (n = 3092), 24-week study ARGON (n = 1426), and 12-week study QUARTZ (n = 802). Cardio-/cerebrovascular (CCV) event frequencies were examined in the following comparisons: (1) LABA effect: pooled-dose MF/IND vs. pooled-dose MF; (2) LAMA effect: pooled-dose MF/IND/GLY vs. pooled-dose MF/IND; (3) ICS-dose effects: (a) high-dose MF/IND vs. medium-dose MF/IND, (b) high-dose MF/IND/GLY vs. medium-dose MF/IND/GLY; (4) intra-class effects: (a) high-dose MF/IND vs. Fluticasone/Salmeterol (F/S), (b) high-dose MF/IND/GLY vs. F/S + Tiotropium (TIO). Risk estimates (percentage of patients with ≥1 CCV event) and risk differences (RDs) with 95% confidence intervals (CIs) were calculated for each comparison. RESULTS The frequency of CCV events was low, without notable differences between comparison groups. Risk estimates and corresponding RDs (95% CIs) were as follows: (1) pooled-dose MF/IND = 2.35%, pooled-dose MF = 2.18%, RD = 0.17% (-1.00%, 1.34%); (2) pooled-dose MF/IND/GLY = 3.65%, pooled-dose MF/IND = 3.77%, RD = -0.12% (-1.63%, 1.39%); (3a) high-dose MF/IND = 3.69%, medium-dose MF/IND = 3.35%, RD = 0.34% (-1.25%, 1.94%); (3b) high-dose MF/IND/GLY = 2.84%, medium-dose MF/IND/GLY = 2.02%, RD = 0.82% (-0.49%, 2.13%); (4a) high-dose MF/IND = 3.69%, F/S = 2.82%, RD = 0.87% (-0.66%, 2.40%); (4b) high-dose MF/IND/GLY = 1.26%, F/S + TIO = 1.05%, RD = 0.21% (-1.26%, 1.68%). CONCLUSIONS There was no evidence of increased cardiovascular risk attributable to the addition of IND to MF or addition of GLY to MF/IND. Similarly, no evidence of increased cardiovascular risk was observed with an increase in the ICS-dose or relative to F/S ± TIO.
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Affiliation(s)
- Emil Scosyrev
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
| | - Richard van Zyl-Smit
- Division of Pulmonology and UCT Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Huib Kerstjens
- Department of Pulmonology, University of Groningen, University Medical Center Groningen, and Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands
| | - Christian Gessner
- Universitätsklinikum Leipzig, Germany POIS Leipzig GbR, Leipzig, Germany
| | - Oliver Kornmann
- IKF Pneumologie Frankfurt, Clinical Research Centre Respiratory Diseases, Frankfurt, Germany
| | | | | | - Peter D'Andrea
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | | | - Abhijit Pethe
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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8
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Hanania N, Bailes Z, Barnes N, Gardiner F, Lugogo N, Mannino D, Mehta V, Nyanjom D, Sitz K, Kerstjens H. P206 CAPTAIN STUDY: EFFECTS OF FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL ON FEV1 IMPROVEMENT IN ASTHMA ACCORDING TO AGE. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Nathan R, Boulet LP, Kerstjens H, Papi A, Pavord I, Hanania N, Oppenheimer J, Caceres DM, Liu M, Weinstein S, Mannino D, Peachey G, Zarankaite A, Sule N, Fowler A, Lee L, Kerwin E. CAPTAIN STUDY: EFFECT OF BASELINE LUNG FUNCTION ON RESPONSE TO TRIPLE THERAPY IN PATIENTS WITH ASTHMA INADEQUATELY CONTROLLED ON INHALED CORTICOSTEROID/LONG-ACTING BETA2-AGONIST THERAPY. Chest 2020. [DOI: 10.1016/j.chest.2020.09.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Sule N, Fowler A, Kerstjens H, Kerwin E, Lee L, Nathan R, Oppenheimer J, Pavord I, Peachey G, Tabberer M, Zarankaite A, Manning M, Millard M, Mannino D, Hanania N. CAPTAIN STUDY: ASSOCIATION OF MODERATE AND SEVERE ASTHMA EXACERBATIONS WITH LUNG FUNCTION AND PATIENT-REPORTED OUTCOMES IN A LARGE RANDOMIZED PHASE III CLINICAL TRIAL. Chest 2020. [DOI: 10.1016/j.chest.2020.08.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Pavord I, Peachey G, Kerstjens H, Kerwin E, Nathan R, Hanania N, Pascoe S, Fowler A, Bailes Z, Edwards D, Sule N, Barnes N, Boulet LP, Tabberer M, Lee L. Once-daily, single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus FF/VI in inadequately controlled asthma: the CAPTAIN study. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hazenberg A, Hofker S, van der Aa H, Nieuwenhuis J, Kerstjens H, Wijkstra P. [Diaphragm pacemaker: alternative for long-term ventilatory support; 5 years later]. Ned Tijdschr Geneeskd 2019; 163:D3675. [PMID: 31050274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Currently, more than 3000 patients in the Netherlands receive long-term ventilatory support. In the majority of patients, long-term ventilatory support leads to increased survival without any complications. Diaphragm pacing with an external pacemaker (diaphragm pacing system, DPS) seems an attractive alternative for long-term ventilatory support by mask or tracheostomy. Scientific research has since shown that DPS is effective in patients with high cervical paraplegia. In addition, patients with congenital central hypoventilation syndrome are also eligible for DPS. Patients with diaphragm paralysis are a new group of patients who may be eligible for DPS. Two European studies have shown that DPS should not be used in patients with amyotrophic lateral sclerosis. In our experience, patients are no longer completely dependent on a ventilator or may even be able to discontinue using one if the procedure was successful. In the Netherlands, as far as we know, the technique is only used at the University Medical Center Groningen.
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Affiliation(s)
- Anda Hazenberg
- UMCG, afd. Longziekten en Tuberculose, Centrum voor Thuisbeademing, Groningen
- Contact: A. Hazenberg
| | | | - Hans van der Aa
- UMCG, afd. Longziekten en Tuberculose, Centrum voor Thuisbeademing, Groningen
| | - Jellie Nieuwenhuis
- UMCG, afd. Longziekten en Tuberculose, Centrum voor Thuisbeademing, Groningen
| | - Huib Kerstjens
- UMCG, afd. Longziekten en Tuberculose, Centrum voor Thuisbeademing, Groningen
| | - Peter Wijkstra
- UMCG, afd. Longziekten en Tuberculose, Centrum voor Thuisbeademing, Groningen
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13
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Wouda EMN, Stienstra Y, van der Werf TS, Kerstjens H, de Lange WCM, Coppes M, Kuijlen J, Tepper M, Akkerman OW. Neurological and functional recovery in tuberculosis patients with spinal cord injury in The Netherlands. NeuroRehabilitation 2017; 40:439-445. [PMID: 28222564 DOI: 10.3233/nre-161431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Spinal tuberculosis (TB) accounts for approximately 1% to 3% of all TB cases and it can cause a wide range of neurological symptoms, from none to a complete spinal cord injury (SCI), resulting in complete paraplegia or tetraplegia. OBJECTIVES To describe the functional and neurological outcome of SCI caused by TB. METHODS Retrospective data on the admission period was combined with prospectively collected data on long-term follow-up. Primary outcome was neurological outcome in terms of motor function. Secondary outcome measures were functional outcome in terms of level of independence and community participation. Results were compared to the outcome in patients with SCI due to trauma. RESULTS Six TB patients with complete motor SCI (American Spinal Injury Association Impairment Scale (AIS) A or B) were compared to eighteen patients with traumatic SCI. Most TB patients regained almost full neurological function (median motor score improved from 50 to 100), and reached high levels of independence, whereas trauma patients did not improve neurologically (median motor score remained 50) and reached a plateau in level of independence. CONCLUSIONS SCI due to tuberculosis in the Netherlands shows remarkable improvement in both neurological and functional outcome, especially compared with traumatic SCI.
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Affiliation(s)
- Eva M N Wouda
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ymkje Stienstra
- Department of Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tjip S van der Werf
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Huib Kerstjens
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wiel C M de Lange
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands
| | - Maarten Coppes
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Spine Center Groningen, Groningen, The Netherlands
| | - Jos Kuijlen
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Spine Center Groningen, Groningen, The Netherlands
| | - Marga Tepper
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Onno W Akkerman
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands
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Boudewijn IM, Faiz A, Steiling K, van der Wiel E, Telenga E, Hoonhorst S, ten Hacken N, Brandsma CA, Kerstjens H, Timens W, Heijink I, Jonker M, de Bruin H, Vroegop S, Pasma H, Boersma W, Wielders P, van den Elshout F, Mansour K, Spira A, Lenburg M, Postma D, van den Berge M. A nasal gene expression profile differentiates individuals with and without COPD and overlaps bronchial gene expression. Genes Environ 2017. [DOI: 10.1183/1393003.congress-2017.pa4470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Slok A, Kotz D, van Breukelen G, Chavannes NH, Rutten-van Mölken M, Kerstjens H, van der Molen T, Asijee GM, Dekhuijzen R, Holverda S, Salomé P, Goossens L, Twellaar M, in 't Veen J, van Schayck O. Wirksamkeit des „Assessment of Burden of COPD“ (ABC) Instruments bezüglich gezundheitsbezogener Lebensqualität bei COPD Patienten: eine Cluster-randomisierte, kontrollierte Studie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - D Kotz
- Institut für Allgemeinmedizin, Schwerpunkt Suchtforschung und Klinische Epidemiologie, Medizinische Fakultät der Heinrich-Heine-Universität Düsseldorf
| | | | | | | | | | | | | | | | | | - P Salomé
- Huisartsencoöperatie Preventzorg, Bilthoven
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Bousquet J, Bewick M, Cano A, Eklund P, Fico G, Goswami N, Guldemond NA, Henderson D, Hinkema MJ, Liotta G, Mair A, Molloy W, Monaco A, Monsonis-Paya I, Nizinska A, Papadopoulos H, Pavlickova A, Pecorelli S, Prados-Torres A, Roller-Wirnsberger RE, Somekh D, Vera-Muñoz C, Visser F, Farrell J, Malva J, Andersen Ranberg K, Camuzat T, Carriazo AM, Crooks G, Gutter Z, Iaccarino G, Manuel de Keenoy E, Moda G, Rodriguez-Mañas L, Vontetsianos T, Abreu C, Alonso J, Alonso-Bouzon C, Ankri J, Arredondo MT, Avolio F, Bedbrook A, Białoszewski AZ, Blain H, Bourret R, Cabrera-Umpierrez MF, Catala A, O'Caoimh R, Cesari M, Chavannes NH, Correia-da-Sousa J, Dedeu T, Ferrando M, Ferri M, Fokkens WJ, Garcia-Lizana F, Guérin O, Hellings PW, Haahtela T, Illario M, Inzerilli MC, Lodrup Carlsen KC, Kardas P, Keil T, Maggio M, Mendez-Zorrilla A, Menditto E, Mercier J, Michel JP, Murray R, Nogues M, O'Byrne-Maguire I, Pappa D, Parent AS, Pastorino M, Robalo-Cordeiro C, Samolinski B, Siciliano P, Teixeira AM, Tsartara SI, Valiulis A, Vandenplas O, Vasankari T, Vellas B, Vollenbroek-Hutten M, Wickman M, Yorgancioglu A, Zuberbier T, Barbagallo M, Canonica GW, Klimek L, Maggi S, Aberer W, Akdis C, Adcock IM, Agache I, Albera C, Alonso-Trujillo F, Angel Guarcia M, Annesi-Maesano I, Apostolo J, Arshad SH, Attalin V, Avignon A, Bachert C, Baroni I, Bel E, Benson M, Bescos C, Blasi F, Barbara C, Bergmann KC, Bernard PL, Bonini S, Bousquet PJ, Branchini B, Brightling CE, Bruguière V, Bunu C, Bush A, Caimmi DP, Calderon MA, Canovas G, Cardona V, Carlsen KH, Cesario A, Chkhartishvili E, Chiron R, Chivato T, Chung KF, d'Angelantonio M, De Carlo G, Cholley D, Chorin F, Combe B, Compas B, Costa DJ, Costa E, Coste O, Coupet AL, Crepaldi G, Custovic A, Dahl R, Dahlen SE, Demoly P, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Du Toit G, Dubakiene R, Dupeyron A, Emuzyte R, Fiocchi A, Wagner A, Fletcher M, Fonseca J, Fougère B, Gamkrelidze A, Garces G, Garcia-Aymeric J, Garcia-Zapirain B, Gemicioğlu B, Gouder C, Hellquist-Dahl B, Hermosilla-Gimeno I, Héve D, Holland C, Humbert M, Hyland M, Johnston SL, Just J, Jutel M, Kaidashev IP, Khaitov M, Kalayci O, Kalyoncu AF, Keijser W, Kerstjens H, Knezović J, Kowalski M, Koppelman GH, Kotska T, Kovac M, Kull I, Kuna P, Kvedariene V, Lepore V, MacNee W, Maggio M, Magnan A, Majer I, Manning P, Marcucci M, Marti T, Masoli M, Melen E, Miculinic N, Mihaltan F, Milenkovic B, Millot-Keurinck J, Mlinarić H, Momas I, Montefort S, Morais-Almeida M, Moreno-Casbas T, Mösges R, Mullol J, Nadif R, Nalin M, Navarro-Pardo E, Nekam K, Ninot G, Paccard D, Pais S, Palummeri E, Panzner P, Papadopoulos NK, Papanikolaou C, Passalacqua G, Pastor E, Perrot M, Plavec D, Popov TA, Postma DS, Price D, Raffort N, Reuzeau JC, Robine JM, Rodenas F, Robusto F, Roche N, Romano A, Romano V, Rosado-Pinto J, Roubille F, Ruiz F, Ryan D, Salcedo T, Schmid-Grendelmeier P, Schulz H, Schunemann HJ, Serrano E, Sheikh A, Shields M, Siafakas N, Scichilone N, Siciliano P, Skrindo I, Smit HA, Sourdet S, Sousa-Costa E, Spranger O, Sooronbaev T, Sruk V, Sterk PJ, Todo-Bom A, Touchon J, Tramontano D, Triggiani M, Tsartara SI, Valero AL, Valovirta E, van Ganse E, van Hage M, van den Berge M, Vandenplas O, Ventura MT, Vergara I, Vezzani G, Vidal D, Viegi G, Wagemann M, Whalley B, Wickman M, Wilson N, Yiallouros PK, Žagar M, Zaidi A, Zidarn M, Hoogerwerf EJ, Usero J, Zuffada R, Senn A, de Oliveira-Alves B. Building Bridges for Innovation in Ageing: Synergies between Action Groups of the EIP on AHA. J Nutr Health Aging 2017; 21:92-104. [PMID: 27999855 DOI: 10.1007/s12603-016-0803-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 04/12/2016] [Indexed: 01/08/2023]
Abstract
The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).
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Affiliation(s)
- J Bousquet
- Professor Jean Bousquet, CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France, Tel +33 611 42 88 47,
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Bousquet J, Bewick M, Cano A, Eklund P, Fico G, Goswami N, Guldemond NA, Henderson D, Hinkema MJ, Liotta G, Mair A, Molloy W, Monaco A, Monsonis-Paya I, Nizinska A, Papadopoulos H, Pavlickova A, Pecorelli S, Prados-Torres A, Roller-Wirnsberger RE, Somekh D, Vera-Muñoz C, Visser F, Farrell J, Malva J, Andersen Ranberg K, Camuzat T, Carriazo AM, Crooks G, Gutter Z, Iaccarino G, de Keenoy EM, Moda G, Rodriguez-Mañas L, Vontetsianos T, Abreu C, Alonso J, Alonso-Bouzon C, Ankri J, Arredondo MT, Avolio F, Bedbrook A, Białoszewski AZ, Blain H, Bourret R, Cabrera-Umpierrez MF, Catala A, O’Caoimh R, Cesari M, Chavannes NH, Correia-Da-Sousa J, Dedeu T, Ferrando M, Ferri M, Fokkens WJ, Garcia-Lizana F, Guérin O, Hellings PW, Haahtela T, Illario M, Inzerilli MC, Lodrup Carlsen KC, Kardas P, Keil T, Maggio M, Mendez-Zorrilla A, Menditto E, Mercier J, Michel JP, Murray R, Nogues M, O’Byrne-Maguire I, Pappa D, Parent AS, Pastorino M, Robalo-Cordeiro C, Samolinski B, Siciliano P, Teixeira AM, Tsartara SI, Valiulis A, Vandenplas O, Vasankari T, Vellas B, Vollenbroek-Hutten M, Wickman M, Yorgancioglu A, Zuberbier T, Barbagallo M, Canonica GW, Klimek L, Maggi S, Aberer W, Akdis C, Adcock IM, Agache I, Albera C, Alonso-Trujillo F, Angel Guarcia M, Annesi-Maesano I, Apostolo J, Arshad SH, Attalin V, Avignon A, Bachert C, Baroni I, Bel E, Benson M, Bescos C, Blasi F, Barbara C, Bergmann KC, Bernard PL, Bonini S, Bousquet PJ, Branchini B, Brightling CE, Bruguière V, Bunu C, Bush A, Caimmi DP, Calderon MA, Canovas G, Cardona V, Carlsen KH, Cesario A, Chkhartishvili E, Chiron R, Chivato T, Chung KF, D’Angelantonio M, de Carlo G, Cholley D, Chorin F, Combe B, Compas B, Costa DJ, Costa E, Coste O, Coupet AL, Crepaldi G, Custovic A, Dahl R, Dahlen SE, Demoly P, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, du Toit G, Dubakiene R, Dupeyron A, Emuzyte R, Fiocchi A, Wagner A, Fletcher M, Fonseca J, Fougère B, Gamkrelidze A, Garces G, Garcia-Aymeric J, Garcia-Zapirain B, Gemicioğlu B, Gouder C, Hellquist-Dahl B, Hermosilla-Gimeno I, Héve D, Holland C, Humbert M, Hyland M, Johnston SL, Just J, Jutel M, Kaidashev IP, Khaitov M, Kalayci O, Kalyoncu AF, Keijser W, Kerstjens H, Knezović J, Kowalski M, Koppelman GH, Kotska T, Kovac M, Kull I, Kuna P, Kvedariene V, Lepore V, Macnee W, Maggio M, Magnan A, Majer I, Manning P, Marcucci M, Marti T, Masoli M, Melen E, Miculinic N, Mihaltan F, Milenkovic B, Millot-Keurinck J, Mlinarić H, Momas I, Montefort S, Morais-Almeida M, Moreno-Casbas T, Mösges R, Mullol J, Nadif R, Nalin M, Navarro-Pardo E, Nekam K, Ninot G, Paccard D, Pais S, Palummeri E, Panzner P, Papadopoulos NK, Papanikolaou C, Passalacqua G, Pastor E, Perrot M, Plavec D, Popov TA, Postma DS, Price D, Raffort N, Reuzeau JC, Robine JM, Rodenas F, Robusto F, Roche N, Romano A, Romano V, Rosado-Pinto J, Roubille F, Ruiz F, Ryan D, Salcedo T, Schmid-Grendelmeier P, Schulz H, Schunemann HJ, Serrano E, Sheikh A, Shields M, Siafakas N, Scichilone N, Siciliano P, Skrindo I, Smit HA, Sourdet S, Sousa-Costa E, Spranger O, Sooronbaev T, Sruk V, Sterk PJ, Todo-Bom A, Touchon J, Tramontano D, Triggiani M, Tsartara SI, Valero AL, Valovirta E, van Ganse E, van Hage M, van den Berge M, Vandenplas O, Ventura MT, Vergara I, Vezzani G, Vidal D, Viegi G, Wagemann M, Whalley B, Wickman M, Wilson N, Yiallouros PK, Žagar M, Zaidi A, Zidarn M, Hoogerwerf EJ, Usero J, Zuffada R, Senn A, de Oliveira-Alves B. Erratum to: Building bridges for innovation in ageing: Synergies between action groups of the EIP on AHA. J Nutr Health Aging 2016. [DOI: 10.1007/s12603-016-0850-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Beck E, Casale T, Hanania NA, Haughney J, Vandewalker M, Meltzer E, Paggiaro P, Engel M, Unseld A, Moroni-Zentgraf P, Kerstjens H. Once-daily tiotropium Respimat®: safety and tolerability results from five Phase III trials in adults with symptomatic asthma. Pneumologie 2016. [DOI: 10.1055/s-0036-1572093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dusser D, Dahl R, Casale T, Bleecker E, Pizzichini E, Engel M, Moroni-Zentgraf P, Bour L, Kerstjens H. Efficacité du tiotropium Respimat® chez les adultes atteints d’asthme modéré utilisant ou non des antileucotriènes (LTRA). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dahl R, Casale T, Vandewalker M, Schmidt H, Engel M, Moroni-Zentgraf P, Kerstjens H. Once-Daily Tiotropium Respimat Reduces Risk of Severe Asthma Exacerbation and Asthma Worsening in Symptomatic Asthma, Independent of Allergic and Inflammatory Status. Chest 2015. [DOI: 10.1378/chest.2280021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Greos L, Berger W, Moroni-Zentgraf P, Engel M, Luehmann R, Kerstjens H. Once-Daily Tiotropium Respimat Add-on to Medium-Dose Inhaled Corticosteroids Improves Lung Function and Asthma Control in Adult Patients With Moderate Symptomatic Asthma, Independent of Prior Long-Acting _2-Agonist Use. Chest 2015. [DOI: 10.1378/chest.2274996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Brusse-Keizer M, Zuur-Telgen M, van der Palen J, VanderValk P, Kerstjens H, Boersma W, Blasi F, Kostikas K, Milenkovic B, Tamm M, Stolz D. Adrenomedullin optimises mortality prediction in COPD patients. Respir Med 2015; 109:734-42. [PMID: 25937049 DOI: 10.1016/j.rmed.2015.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Current multicomponent scores that predict mortality in COPD patients might underestimate the systemic component of COPD. Therefore, we evaluated the accuracy of circulating levels of proadrenomedullin (MR-proADM) alone or combined with the ADO (Age, Dyspnoea, airflow Obstruction), updated ADO or BOD (Body mass index, airflow Obstruction, Dyspnoea) index to predict all-cause mortality in stable COPD patients. METHODS This study pooled data of 1285 patients from the COMIC and PROMISE-COPD study. RESULTS Patients with high MR-proADM levels (≥0.87 nmol/l) had a 2.1 fold higher risk of dying than those with lower levels (p < 0.001). Based on the C-statistic, the ADOA index (ADO plus MR-proADM) (C = 0.72) was the most accurate predictor followed by the BODA (BOD plus MR-proADM) (C = 0.71) and the updated ADOA index (updated ADO plus MR-proADM) (C = 0.70). Adding MR-proADM to ADO and BOD was superior in forecasting 1- and 2-year mortality. The net percentages of persons with events correctly reclassified (NRI+) within respectively 1-year and 2-year was 31% and 20% for ADO, 31% and 20% for updated ADO and 25% and 19% for BOD. The net percentages of persons without events correctly reclassified (NRI-) within respectively 1-year and 2-year was 26% and 27% for ADO, 27% and 28% for updated ADO and 34% and 34% for BOD. CONCLUSIONS Adding MR-proADM increased the predictive power of BOD, ADO and updated ADO index.
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Affiliation(s)
| | - Maaike Zuur-Telgen
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Job van der Palen
- Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands
| | - Paul VanderValk
- Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Huib Kerstjens
- University Of Groningen, University Medical Centre Groningen, Department of Pulmonary Medicine, and Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - Wim Boersma
- Department of Pneumology, Medisch Centrum Alkmaar, Alkmaar, The Netherlands
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Cà Granda Milan, Italy
| | | | - Branislava Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Pulmonary Diseases, Clinical Center of Serbia, Belgrade, Serbia
| | - Michael Tamm
- Clinic of Pneumology and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinic of Pneumology and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland
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Schmidt O, Halpin D, Bateman E, Paggiaro P, Bleecker E, Engel M, Moroni-Zentgraf P, Schmidt H, Kerstjens H. Once-daily tiotropium Respimat add-on to at least ICS maintenance therapy reduces exacerbation risk in patients with uncontrolled symptomatic asthma. Pneumologie 2015. [DOI: 10.1055/s-0035-1544684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Schmidt O, FitzGerald JM, Kerstjens H, Paggiaro P, Ohta K, Ichinose M, Moroni-Zentgraf P, Engel M, Schmidt H, Bateman E. Once-daily tiotropium Respimat add-on to ICS ± LABA improves control across asthma severities. Pneumologie 2015. [DOI: 10.1055/s-0035-1544685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dusser D, Devillier P, Buhl R, Castro M, Kerstjens H, Paggiaro P, Engel M, Moroni-Zentgraf P, Unseld A, Bateman E. Tolérance du tiotropium Respimat en traitement additionnel d’un traitement continu par CSI±LABA chez des patients adultes ayant un asthme symptomatique : analyse des données groupées. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.10.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Devillier P, Dusser D, Halpin D, Bateman E, Paggiaro P, Bleecker E, Engel M, Moroni-Zentgraf P, Schmidt H, Kerstjens H. Le tiotropium Respimat en traitement bronchodilatateur additionnel d’un traitement de fond par CSI±LABA réduit le risque d’exacerbation chez les patients asthmatiques adultes non contrôlés. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.10.408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brusse-Keizer M, VanderValk P, Hendrix R, Kerstjens H, van der Palen J. Necessity of amoxicillin clavulanic acid in addition to prednisolone in mild-to-moderate COPD exacerbations. BMJ Open Respir Res 2014; 1:e000052. [PMID: 25562034 PMCID: PMC4281527 DOI: 10.1136/bmjresp-2014-000052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 11/13/2014] [Accepted: 11/16/2014] [Indexed: 11/15/2022] Open
Abstract
Background The effectiveness of antibiotics in chronic obstructive pulmonary disease (COPD) exacerbations is still a matter of debate, especially in outpatients with an intermediate probability of bacterial infection. Methods In this study, 35 COPD outpatients diagnosed by their chest physician with moderately severe COPD exacerbation, but without pneumonia, were randomised in a double blind, placebo-controlled study. Patients had one or two of the following characteristics: a positive Gram's stain of the sputum, 2 or more exacerbations in the previous year, a decrease in lung function of >200 mL and >12%. Patients received amoxicillin clavulanic acid (500/125 mg three times daily) or placebo for 7 days, always combined with a course of prednisolone (30 mg/day) for 7 days. Primary outcome was duration of the exacerbation. Additionally, we measured severity of the exacerbation, health-related quality of life, sputum parameters, number of relapses within 28 days and the number of re-exacerbations within 4 months after the study. Results There was no difference observed in time to resolution of the exacerbation between the two groups (HR=1.12; (95% CI 0.5 to 2.3; p=0.77)), nor in any other treatment parameter. Conclusions We detected no evidence for the effectiveness of addition of antibiotics to prednisolone for COPD exacerbations of moderate severity and with intermediate probability of bacterial infection in this underpowered study. More placebo-controlled studies are needed to properly define subgroups of COPD outpatients in which antibiotics are of additional value. Trials registration number clinical trial registered with http://www.trialregister.nl/(NTR351).
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Affiliation(s)
| | - Paul VanderValk
- Department of Pulmonary Medicine , Medisch Spectrum Twente , Enschede , The Netherlands
| | - Ron Hendrix
- Regional Laboratory of Public Health , Enschede , The Netherlands ; Department of Medical Microbiology , University Medical Centre Groningen, and University of Groningen , Groningen , The Netherlands
| | - Huib Kerstjens
- Department of Pulmonary Medicine, and Gro ningen Research Institute for Asthma and COPD (GRIAC) , University Of Groningen, University Medical Centre Groningen , Groningen , The Netherlands
| | - Job van der Palen
- Department of Pulmonary Medicine , Medisch Spectrum Twente , Enschede , The Netherlands ; Department of Research Methodology, Measurement, and Data Analysis , University of Twente , Enschede , The Netherlands
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Dahl R, Doherty D, Corren J, Karpel J, Kerstjens H, Engel M, Moroni-Zentgraf P, Schmidt H, Hashimoto S. P230 Once-daily Tiotropium Respimat(R) Improves Lung Function In Patients With Severe Symptomatic Asthma Independent Of Leukotriene Modifier Use. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Price D, Engel M, Moroni-Zentgraf P, Schmidt H, Dahl R, Paggiaro P, Vandewalker M, Kerstjens H, Kaplan A. S91 Once-daily tiotropium Respimat(R) add-on to ICS + LABA improves symptom control and reduces exacerbations in patients with symptomatic asthma. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.97] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dahl R, Casale T, Pizzichini E, Vandewalker M, Virchow J, Engel M, Sigmund R, Moroni-Zentgraf P, Kerstjens H. P229 Once-daily Tiotropium Respimat(R) As Add-on To At Least Medium- To High-dose Ics, With Or Without Laba, Improves Lung Function In Patients With Symptomatic Asthma, Independent Of Allergic Status. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.357] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Haughney J, Vandewalker M, Meltzer E, Paggiaro P, Engel M, Unseld A, Moroni-Zentgraf P, Kerstjens H. P231 Once-daily Tiotropium Respimat(R): Safety And Tolerability Results From Five Phase Iii Trials In Adults With Symptomatic Asthma. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Halpin D, Paggiaro P, Bleecker E, Engel M, Moroni-Zentgraf P, Schmidt H, Kerstjens H. P255 Once-daily Tiotropium Respimat(R) Add-on To At Least Ics Maintenance Therapy Reduces Exacerbation Risk In Patients With Uncontrolled Symptomatic Asthma. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Price D, Bateman E, Paggiaro P, Kaplan A, Engel M, Schmidt H, Moroni-Zentgraf P, Kerstjens H. S92 Efficacy Of Once-daily Tiotropium Respimat(R) 5 g From Five Phase Iii Trials In Adults With Symptomatic Asthma. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tashkin D, Moroni-Zentgraf P, Engel M, Schmidt H, Kerstjens H. Once-Daily Tiotropium Respimat Add-On to ICS+LABA Reduces Risk of Severe Exacerbation and Asthma Worsening in Patients With Asthma, Independent of Degree of Airflow Obstruction. Chest 2014. [DOI: 10.1378/chest.1994283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Vandewalker M, Meltzer E, Engel M, Sigmund R, Moroni-Zentgraf P, Kerstjens H. Safety and Tolerability of Once-Daily Tiotropium Respimat Add-On to at Least ICS: Results From Five Phase III Trials in Adult Patients With Symptomatic Asthma. Chest 2014. [DOI: 10.1378/chest.1994482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Boom L, Vaessen D, Uil S, Kerstjens H, Berg JWVD. The Effects of Montelukast in Patients With Chronic Cough and Bronchial Hyperreactivity. Chest 2011. [DOI: 10.1378/chest.1117302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Hesselink A, Hesselink A, Uil S, Kerstjens H, Berg JWVD. Effectiveness of an Outpatient Care On-Demand System in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Pilot Study. Chest 2011. [DOI: 10.1378/chest.1115560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Brusse-Keizer M, ten Bokum L, Movig K, van der Valk P, Kerstjens H, van der Palen J, Hendrix R. Relation between amoxicillin concentration in sputum of COPD patients and length of hospitalization. COPD 2011; 8:66-70. [PMID: 21495834 DOI: 10.3109/15412555.2011.558863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Amoxicillin is a widely used antibiotic in COPD. Little is known about the transfer of amoxicillin into sputum of COPD patients. The objective was to investigate the relationship between the concentration of amoxicillin in sputum in hospitalized COPD patients and length of hospitalization. To be effective against bacterial pathogens, the amoxicillin concentration in target tissues should be higher than the Minimal Inhibiting Concentration (MIC) of 2 mg/l. Therefore, this was also used as the cut-off value for the amoxicillin concentration in sputum, as a marker for lung tissue concentration. Fifty-two COPD in-patients with an exacerbation, treated with amoxicillin clavulanic acid, were included in this cohort study. Of these patients 7 also had pneumonia. Patients were divided in patients with an amoxicillin sputum concentration ≥ 2 mg/l and < 2 mg/l. Furthermore, inflammation markers in sputum and serum and clinical parameters were obtained. Of the 33 patients with usable sputum, 11 had a concentration in sputum ≥ 2 mg/l. The mean length of hospitalization for patients with concentrations below the MIC90 to common respiratory pathogens was 11.0 days, while for patients with concentrations at or above the MIC90 this was 7.0 days (p = 0.005). COPD patients admitted for an acute exacerbation of COPD, with a sputum concentration of amoxicillin ≥ 2 mg/l had a markedly reduced length of hospitalization compared to patients with a concentration < 2 mg/l. It is worthwhile testing whether individualized treatment based on sputum amoxicillin concentrations of patients during hospitalization for acute exacerbations can effectively reduce hospital stay.
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Affiliation(s)
- Frans Greven
- Department of Environmental Health, Municipal Health Services Groningen, Groningen, The Netherlands
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Esmeralda Krop
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Nena Burger
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Huib Kerstjens
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Effing T, Zielhuis G, Kerstjens H, van der Valk P, van der Palen J. Community based physiotherapeutic exercise in COPD self-management: A randomised controlled trial. Respir Med 2011; 105:418-26. [PMID: 20951018 DOI: 10.1016/j.rmed.2010.09.017] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 09/16/2010] [Accepted: 09/17/2010] [Indexed: 11/25/2022]
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Greven F, Krop E, Spithoven J, Rooyackers J, Kerstjens H, Heederik D. Lung function, bronchial hyperresponsiveness, and atopy among firefighters. Scand J Work Environ Health 2011; 37:325-31. [DOI: 10.5271/sjweh.3153] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Brusse-Keizer M, van der Palen J, van der Valk P, Hendrix R, Kerstjens H. Clinical predictors of exacerbation frequency in chronic obstructive pulmonary disease. Clin Respir J 2010; 5:227-34. [PMID: 21106031 DOI: 10.1111/j.1752-699x.2010.00234.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Reduction of exacerbation frequency plays an increasingly important role in interventions in chronic obstructive pulmonary disease (COPD). To reduce this frequency efficiently, patients at risk for frequent exacerbations need to be identified. OBJECTIVE The objective of the study was to identify predictors for frequent exacerbations from multiple domains of COPD during a stable phase of the disease. METHODS Data of multiple domains of COPD were collected from 121 patients with moderate to severe COPD. Patients were divided into infrequent (<2 exacerbations per year) and frequent (≥2 exacerbations) exacerbators. RESULTS St. George's Respiratory Questionnaire (SGRQ) total score and a course of oral corticosteroid within 3 months prior to the study together predicted best whether patients would be infrequent or frequent exacerbators over the course of the next year. Each unit increase in total SGRQ score was associated with a 3% higher risk of being a frequent exacerbator [odds ratio (OR) = 1.03; 95% confidence interval (CI): 1.00-1.06; P = 0.047]. Patients who received a course of oral corticosteroids in the period of 3 months prior to the study had a three-fold increased risk of being a frequent exacerbator (OR = 3.17; 95% CI: 1.20-8.34; P = 0.02). Furthermore, we observed that a sizable number of patients switched from being a frequent to an infrequent exacerbator and vice versa. CONCLUSIONS Health-related quality of life and a course of oral corticosteroid in the past 3 months are the best predictors of future exacerbator status. The predictive value of the model is, however, still insufficient. Furthermore, our data suggest, in contrast to previous observations, that exacerbation frequency is not a constant feature.
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Riemersma R, Postma D, Kerstjens H, Buijssen K, Boezen M, Aalbers R, Veldhuizen W, Strijbos J, van der Molen T. Development of a questionnaire for the assessment of bronchial hyperresponsiveness. Prim Care Respir J 2010; 18:287-93. [PMID: 19636477 DOI: 10.4104/pcrj.2009.00026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Bronchial hyperresponsiveness (BHR) is a hallmark of asthma. Treatment approaches based on BHR severity have been shown to be effective. However, challenge tests are expensive, inconvenient to patients, time consuming, and not easily accessible to general practitioners. Assessment of BHR by a questionnaire would be advantageous in the diagnosis and management of asthma. AIM To select a set of respiratory symptoms and provoking stimuli related to BHR to compose a reliable Bronchial Hyperresponsiveness Questionnaire (BHQ). METHOD A list of 33 symptoms and 68 stimuli were selected by in-depth interviews, focus group discussions with asthma patients, and literature review. After a histamine challenge test patients (n=302) were asked to score each question on a 7-point scale (0=no; 6=severe complaints). Factor analysis was performed to identify clusters of interrelated symptoms associated with PC20-histamine. The sensitivity to detect the presence of BHR was analysed by Receiver Operating Curves (ROC). The correlation between the PC20-score and the scores on the questions was analysed. RESULTS 15 symptoms and 19 provoking stimuli were ultimately selected for the BHQ. CONCLUSION The BHQ was developed according to FDA-approved standards and is a condition-specific questionnaire able to assess the presence of BHR.
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Affiliation(s)
- Roland Riemersma
- Department of General Practice, University Medical Center Groningen, Groningen, Netherlands.
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Effing T, Kerstjens H, van der Valk P, Zielhuis G, van der Palen J. (Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study. Thorax 2009; 64:956-62. [PMID: 19736179 DOI: 10.1136/thx.2008.112243] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic disease with a high prevalence and rapidly increasing incidence rates. The effect of self-treatment of COPD exacerbations on the severity of exacerbations during a 1-year period was examined and a cost-effectiveness analysis was performed. METHODS Patients were randomly allocated to four 2-hour self-management sessions, with or without training in self-treatment of exacerbations. Patients in the self-treatment group received an action plan with the possibility to initiate a course of prednisolone (with or without antibiotics). During follow-up, all participants kept a daily symptom diary. These provided the data to calculate the frequency of exacerbations, the number of exacerbation days and mean daily severity scores. RESULTS Data were analysed for 142 randomised patients (self-treatment: n = 70; control: n = 72). The frequency of exacerbations was identical in both study groups (mean (SD) 3.5 (2.7)). Patients in the self-treatment group reported fewer exacerbation days (median 31 (interquartile range (IQR) 8.9-67.5) in the self-treatment group vs 40 (IQR 13.3-88.2) in the control group; p = 0.064); the difference was significant in the group of patients with a high number of exacerbation days per year (>137 (90th percentile of the whole study population); p = 0.028). The mean severity score of an exacerbation day was equal in both groups. No between-group differences were found in health-related quality of life. Cost-effectiveness analyses showed that applying self-treatment saved euro154 per patient, with a trend towards a lower probability for hospital admissions (0.20/patient/year in the self-treatment group vs 0.33/patient/year in the control group; p = 0.388) and a significant reduction of health care contacts (5.37/patient/year in the self-treatment group vs 6.51/patient/year in the control group; p = 0.043). CONCLUSION Self-treatment of exacerbations incorporated in a self-management programme leads to fewer exacerbation days and lower costs.
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Affiliation(s)
- T Effing
- Medisch Spectrum Twente, Department of Pulmonology, Enschede, The Netherlands.
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Bathoorn E, Kerstjens H, Postma D, Timens W, MacNee W. Airways inflammation and treatment during acute exacerbations of COPD. Int J Chron Obstruct Pulmon Dis 2008; 3:217-29. [PMID: 18686731 PMCID: PMC2629961 DOI: 10.2147/copd.s1210] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Inflammation is a core feature of acute chronic obstructive pulmonary disease (COPD) exacerbations. It is important to focus on inflammation since it gives insight into the pathological changes causing an exacerbation, thereby possibly providing directions for future therapies which modify inflammation. OBJECTIVES To provide a cell-by-cell overview of the inflammatory processes during COPD exacerbations. To evaluate cell activation, and cytokine production, cellular interactions, damaging effects of inflammatory mediators to tissue, and the relation to symptoms at the onset of COPD exacerbations. To speculate on future therapeutic options to modify inflammation during COPD exacerbations. RESULTS During COPD exacerbations, there is increased airway wall inflammation, with pathophysiological influx of eosinophils, neutrophils, and lymphocytes. Although links have been suggested between the increase in eosinophils and lymphocytes and a viral etiology of the exacerbation, and between the increase in neutrophils and a bacterial aetiology, these increases in both inflammatory cell types are not limited to the respective aetiologies and the underlying mechanisms remain elusive. CONCLUSION Further research is required to fully understand the inflammatory mechanisms in the onset and development of COPD exacerbations. This might make inflammatory pathway-specific intervention possible, resulting in a more effective treatment of COPD exacerbations with fewer side effects.
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Affiliation(s)
- Erik Bathoorn
- Groningen Research Institute for Asthma and COPD (GRIAC), Department of Pulmonology, University Medical Center Groningen, the Netherlands
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ten Hacken N, Kerstjens H, Postma D. Bronchiectasis. BMJ Clin Evid 2008; 2008:1507. [PMID: 19450337 PMCID: PMC2907995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Bronchiectasis is usually a complication of previous lower respiratory infection, and causes chronic cough and copious production of sputum, which is often purulent. Bronchiectasis may cause signs of chronic obstructive pulmonary disease. It can also be associated with cystic fibrosis and other congenital disorders, foreign body inhalation, and other causes of lung damage. METHODS AND OUTCOMES We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments in people with bronchiectasis but without cystic fibrosis? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We performed a GRADE evaluation of the quality of evidence for interventions. RESULTS We found 16 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS In this systematic review we present information relating to the effectiveness and safety of the following interventions: anticholinergic therapy, bronchopulmonary hygiene physical therapy, exercise or physical training, hyperosmolar agents (inhaled), leukotriene receptor antagonists, methyl-xanthines (oral), mucolytics (bromhexine or deoxyribonuclease), prolonged-use antibiotics, beta(2) agonists, steroids (inhaled, oral), and surgery.
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Affiliation(s)
- Nick ten Hacken
- Pulmonary Department, University Hospital Groningen, Groningen, The Netherlands
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Didraga M, Barroso B, de Vries M, Kerstjens H, Postma D, Bischoff R. Purification of decorin core protein from human lung tissue. J Chromatogr A 2006; 1123:151-9. [PMID: 16584743 DOI: 10.1016/j.chroma.2006.03.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Revised: 03/12/2006] [Accepted: 03/14/2006] [Indexed: 11/16/2022]
Abstract
A chromatographic method to purify decorin core protein from human lung tissue is described. The method is simple and rapid, using a combination of two-anion exchange and one reversed phase chromatography steps and the enzymatic digestion with chondroitinase ABC. Approximately 170 microg decorin core protein were purified from 25 g of lung tissue with an enrichment factor of 1800-fold relative to the initial protein content. SDS-PAGE analysis of the final product revealed a single 42 kDa protein band, which was recognized by anti-decorin antibodies upon Western blotting and identified by mass spectrometry. Further digestion with PNGase F evidenced the presence of three N-linked oligosaccharides on the core protein. This method forms the basis for studying structural alterations of decorin related to the pathology of diseases where tissue destruction plays a role.
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Affiliation(s)
- Mihaela Didraga
- University Center for Pharmacy, Department of Analytical Biochemistry, 9700 AD, Groningen, The Netherlands
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Kerstjens H, Postma D, ten Hacken N. Chronic obstructive pulmonary disease. Clin Evid 2006:2077-100. [PMID: 16973079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Huib Kerstjens
- University Hospital Groningen, Groningen, The Netherlands
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ten Hacken N, Kerstjens H, Postma D. Bronchiectasis. Clin Evid 2006:2070-6. [PMID: 16973078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Nick ten Hacken
- Pulmonary Department, University Hospital Groningen, Groningen, The Netherlands
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Kerstjens H, Postma D, ten Hacken N. Chronic obstructive pulmonary disease. Clin Evid 2005:1923-47. [PMID: 16135316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Huib Kerstjens
- University Hospital Groningen, Groningen, The Netherlands
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