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Novel approaches to the management of noneosinophilic asthma
This article reviews the evidence for noneosinophilic inflammation being a target for therapy in asthma and assesses clinical trials of licensed drugs, novel small molecules and biologics agents in noneosinophilic inflammation. Current symptoms, rate of exacerbations and decline in lung function are generally less in noneosinophilic asthma than eosinophilic asthma. Noneosinophilic inflammation is associated with corticosteroid insensitivity. Neutrophil activation in the airways and systemic inflammation is reported in neutrophilic asthma. Neutrophilia in asthma may be due to corticosteroids, associated chronic pulmonary in...
Source: Therapeutic Advances in Respiratory Disease - June 1, 2016 Category: Respiratory Medicine Authors: Thomson, N. C. Tags: Reviews Source Type: research

Treatment response according to small airway phenotypes: a real-life observational study
Conclusions: This real-life observational study indicates that extrafine BDP/F in a fixed combination improves asthma control and symptoms in the overall population as well as specific subgroups of patients. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - June 1, 2016 Category: Respiratory Medicine Authors: Marth, K., Spinola, M., Kisiel, J., Woergetter, C., Petrovic, M., Pohl, W. Tags: Original Research Source Type: research

Bodily isomerism is an independent risk factor for pulmonary hypertension in adults with congenital heart disease
Conclusion: Pulmonary hypertension is more common in those with isomerism, with isomerism being an independent risk factor for pulmonary hypertension. The prevalence of pulmonary hypertension is 5.6% in the setting of isomerism. Independent risk factors for pulmonary hypertension in patients with isomerism include age, obesity, and history of anomalous pulmonary venous connection. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - June 1, 2016 Category: Respiratory Medicine Authors: Loomba, R. S., Aggarwal, S., Arora, R. R., Anderson, R. Tags: Original Research Source Type: research

Risk of pneumonitis in cancer patients treated with immune checkpoint inhibitors: a meta-analysis
Conclusions: Our analysis provided evidence that the use of immune checkpoint inhibitors is associated with an increased risk of all-grade pneumonitis compared with chemotherapy or placebo controls. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - June 1, 2016 Category: Respiratory Medicine Authors: Abdel-Rahman, O., Fouad, M. Tags: Original Research Source Type: research

The challenge of diagnosing a mixed asthma-COPD phenotype (ACOS) in clinical practice
(Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Garcia-Garcia, M. d. C., Hernandez-Borge, J., Barrecheguren, M., Miravitlles, M. Tags: Letter to the Editor Source Type: research

The role of viral infections in exacerbations of chronic obstructive pulmonary disease and asthma
Asthma and chronic obstructive pulmonary disease (COPD) are major causes of global morbidity and mortality worldwide. The clinical course of both asthma and COPD are punctuated by the occurrence of exacerbations, acute events characterized by increased symptoms and airflow obstruction. Exacerbations contribute most of the morbidity, mortality and excess healthcare costs associated with both asthma and COPD. COPD and asthma exacerbations are frequently associated with respiratory virus infections and this has led to an intense research focus into the mechanisms of virus-induced exacerbations over the past decade. Current th...
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Hewitt, R., Farne, H., Ritchie, A., Luke, E., Johnston, S. L., Mallia, P. Tags: Reviews Source Type: research

The role of NIV in chronic hypercapnic COPD following an acute exacerbation: the importance of patient selection?
Recently, clear benefits have been shown from long-term noninvasive ventilation (NIV) in stable chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnic respiratory failure. In our opinion, these benefits are confirmed and nocturnal NIV using sufficiently high inspiratory pressures should be considered in COPD patients with chronic hypercapnic respiratory failure in stable disease, preferably combined with pulmonary rehabilitation. In contrast, clear benefits from (continuing) NIV at home after an exacerbation in patients who remain hypercapnic have not been shown. In this review we will discuss the r...
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Duiverman, M. L., Windisch, W., Storre, J. H., Wijkstra, P. J. Tags: Reviews Source Type: research

The potential role and limitations of echocardiography in acute respiratory distress syndrome
Bedside use of Doppler echocardiography is being featured as a promising, clinically useful tool in assessing the pulmonary circulation in patients with acute respiratory distress syndrome (ARDS). The present review is aimed at summarizing the available evidence obtained with echocardiography on right ventricle (RV) function and pulmonary circulation in ARDS and to highlight the potential of this technique in clinical practice (only articles in English language were considered). According to the available evidence on echocardiographic findings, the following conclusions can be drawn: (a) echocardiography (transthoracic and...
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Lazzeri, C., Cianchi, G., Bonizzoli, M., Batacchi, S., Peris, A., Gensini, G. F. Tags: Reviews Source Type: research

Is there a role for e-cigarettes in smoking cessation?
The use of e-cigarettes has dramatically increased over the past few years and their role in smoking cessation remains controversial. Several clinical studies have evaluated their efficacy in smoking cessation but most of them are prospective cohort studies. Only two randomized, controlled trials have compared e-cigarettes versus placebo or patches. A meta-analysis of these two randomized, controlled trials has been performed. Nicotine-containing e-cigarettes appear to help smokers unable to stop smoking altogether to reduce their cigarette consumption when compared with placebo. However, these results are rated ‘low...
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Leduc, C., Quoix, E. Tags: Reviews Source Type: research

Management of advanced non-small cell lung cancers with known mutations or rearrangements: latest evidence and treatment approaches
Precision oncology is now the evidence-based standard of care for the management of many advanced non-small cell lung cancers (NSCLCs). Expert consensus has defined minimum requirements for routine testing and identification of epidermal growth factor (EGFR) mutations (15% of tumors harbor EGFR exon 19 deletions or exon 21 L858R substitutions) and anaplastic lymphoma kinase (ALK) rearrangements (5% of tumors) in advanced lung adenocarcinomas (ACs). Application of palliative targeted therapies with oral tyrosine kinase inhibitors (TKIs) in advanced/metastatic lung ACs harboring abnormalities in EGFR (gefitinib, erlotinib, a...
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Shea, M., Costa, D. B., Rangachari, D. Tags: Reviews Source Type: research

Reporting of central airway obstruction on radiology reports and impact on bronchoscopic airway interventions and patient outcomes
Conclusions: Findings of CAOs were not described in a significant proportion of radiology reports. This results in significant delay in bronchoscopic airway management. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Harris, K., Alraiyes, A. H., Attwood, K., Modi, K., Dhillon, S. S. Tags: Original Research Source Type: research

Comparative efficacy of fixed-dose combinations of long-acting muscarinic antagonists and long-acting {beta}2-agonists: a systematic review and network meta-analysis
Conclusion: All LAMA/LABA FDCs were found to have similar efficacy and safety. Definitive assessment of the relative efficacy of different treatments can only be performed through direct comparison in head-to-head RCTs. In the absence of such data, this indirect comparison may be of value in clinical and health economic decision-making. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - March 11, 2016 Category: Respiratory Medicine Authors: Schlueter, M., Gonzalez-Rojas, N., Baldwin, M., Groenke, L., Voss, F., Reason, T. Tags: Original Research Source Type: research

Alpha-1-antitrypsin deficiency: increasing awareness and improving diagnosis
Alpha-1-antitrypsin deficiency (AATD) is a hereditary disorder that is characterized by a low serum level of alpha-1-antitrypsin (AAT). The loss of anti-inflammatory and antiproteolytic functions, together with pro-inflammatory effects of polymerized AAT contribute to protein degradation and increased inflammation resulting in an increased risk of developing chronic obstructive pulmonary disease (COPD) and emphysema, especially in smokers. AATD is a rare disease that is significantly underdiagnosed. According to recent data that are based on extrapolations, in many countries only 5–15% of homozygous individuals have ...
Source: Therapeutic Advances in Respiratory Disease - February 1, 2016 Category: Respiratory Medicine Authors: Greulich, T., Vogelmeier, C. F. Tags: Reviews Source Type: research

Asthma and chronic obstructive pulmonary disease overlap: asthmatic chronic obstructive pulmonary disease or chronic obstructive asthma?
Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another. However, especially in older patients (>55 years) it seems more difficult to differentiate between asthma and COPD. This has led to the definition of a new phenotype called asthma COPD overlap syndrome (ACOS). However, our understanding of ACOS is at a very preliminary stage, as most research has involved subjects with existing diagnoses of asthma or COPD from studies with different definitions for ACOS. This has led to different and sometime...
Source: Therapeutic Advances in Respiratory Disease - February 1, 2016 Category: Respiratory Medicine Authors: Slats, A., Taube, C. Tags: Reviews Source Type: research

The combination of fluticasone furoate and vilanterol trifenatate in the management of asthma: clinical trial evidence and experience
The treatment of persistent asthma has been aided by the recent approval of new medications. The combined inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA) powder inhaler fluticasone furoate (FF)/vilanterol trifenatate (VI) is one of these new agents, which was recently approved as a maintenance therapy for persistent asthma. This once-daily ICS/LABA inhaler has previously been approved and used in chronic obstructive pulmonary disease as a maintenance therapy. Both FF and VI individually have been shown to have efficacy in the treatment of persistent asthma; the combination of FF/VI at the dose of 100/25 &mu...
Source: Therapeutic Advances in Respiratory Disease - February 1, 2016 Category: Respiratory Medicine Authors: Albertson, T. E., Richards, J. R., Zeki, A. A. Tags: Reviews Source Type: research