COPD Science

Medication adherence and health-related quality of life among patients with chronic obstructive pulmonary disease.
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Medication adherence and health-related quality of life among patients with chronic obstructive pulmonary disease.

Acta Pharm. 2018 Mar 01;68(1):117-125

Authors: Horvat N, Locatelli I, Kos M, Janežič A

Abstract
This study evaluated medication adherence and health-related quality of life (HRQoL) of Slovenian patients with chronic obstructive pulmonary disease (COPD) and examined the factors associated with HRQoL. Demographic and therapy information was collected from 65 patients through interviews. The St. George's Respiratory Questionnaire and the Morisky Medication Adherence Scale were used to evaluate HRQoL and adherence, resp. A multiple linear regression model was used to assess the association between the factors and HRQoL. The mean St. George's Respiratory Questionnaire score (range 0-100, with higher scores indicating lower HRQoL) was 41.4. COPD affected patients' daily activities more than their social and psychological functioning. Slightly more than 53 % of the patients were optimally adherent, while 12 % were non-adherent. Patients with lower HRQoL had a larger number of medications for concomitant diseases, experienced COPD exacerbation in the last year, and had less education. No statistically significant correlation was found between medication adherence and HRQoL.

PMID: 29453914 [PubMed - in process]



Editing out five Serpina1 paralogs to create a mouse model of genetic emphysema.
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Editing out five Serpina1 paralogs to create a mouse model of genetic emphysema.

Proc Natl Acad Sci U S A. 2018 Feb 16;:

Authors: Borel F, Sun H, Zieger M, Cox A, Cardozo B, Li W, Oliveira G, Davis A, Gruntman A, Flotte TR, Brodsky MH, Hoffman AM, Elmallah MK, Mueller C

Abstract
Chronic obstructive pulmonary disease affects 10% of the worldwide population, and the leading genetic cause is α-1 antitrypsin (AAT) deficiency. Due to the complexity of the murine locus, which includes up to six Serpina1 paralogs, no genetic animal model of the disease has been successfully generated until now. Here we create a quintuple Serpina1a-e knockout using CRISPR/Cas9-mediated genome editing. The phenotype recapitulates the human disease phenotype, i.e., absence of hepatic and circulating AAT translates functionally to a reduced capacity to inhibit neutrophil elastase. With age, Serpina1 null mice develop emphysema spontaneously, which can be induced in younger mice by a lipopolysaccharide challenge. This mouse models not only AAT deficiency but also emphysema and is a relevant genetic model and not one based on developmental impairment of alveolarization or elastase administration. We anticipate that this unique model will be highly relevant not only to the preclinical development of therapeutics for AAT deficiency, but also to emphysema and smoking research.

PMID: 29453277 [PubMed - as supplied by publisher]



COPD: an overlooked cause of excess mortality in patients with rheumatoid arthritis.
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COPD: an overlooked cause of excess mortality in patients with rheumatoid arthritis.

Lancet Respir Med. 2018 Feb 13;:

Authors: Hyldgaard C, Ellingsen T, Bendstrup E

PMID: 29452912 [PubMed - as supplied by publisher]



Postoperative pneumonia among patients with and without COPD in Spain from 2001 to 2015.
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Postoperative pneumonia among patients with and without COPD in Spain from 2001 to 2015.

Eur J Intern Med. 2018 Feb 13;:

Authors: de Miguel-Díez J, López-de-Andrés A, Hernández-Barrera V, Jiménez-Trujillo I, Méndez-Bailón M, de Miguel-Yanes JM, Jiménez-García R

Abstract
BACKGROUND: To describe and compare incidence, characteristics and outcomes of postoperative pneumonia among patients with or without COPD.
METHODS: We included hospitalized patients aged ≥40 years whose medical diagnosis included pneumonia and ventilator-associated pneumonia in the secondary's diagnosis field and who were discharged from Spanish hospitals from 2001 to 2015. Irrespectively of the position at the procedures coding list, we retrieved data about the type of surgical procedures using the enhanced ICD-9-CM codes. We grouped admissions by COPD status. The data were collected from the National Hospital Discharge Database.
RESULTS: We included 117,665 hospitalizations of patients that developed postoperative pneumonia (18.06% of them had COPD). The incidence of postoperative pneumonia was significantly higher in COPD patients than in those without COPD (IRR 1.93, 95%CI 1.68-2.24). In hospital-mortality (IHM) was significantly lower in the first group of patients (29.79% vs 31.43%, p < 0.05). Factors independently associated with IHM, among COPD and non-COPD patients, were older age, more comorbidities, mechanical ventilation, pleural drainage tube, red blood cell transfusion, dialysis and emergency room admission. Time trend analysis showed a significant decrease in IHM from 2001 to 2015. COPD was associated with lower IHM (OR 0.91, 95%CI 0.88-0.95).
CONCLUSIONS: The incidence of postoperative pneumonia was higher in COPD patients than in those without this disease. However, IHM was lower among COPD patients. IHM decreased over time, regardless of the existence or not of COPD.

PMID: 29452729 [PubMed - as supplied by publisher]



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