Topic: New Treatment = Better Outcome?
|
|
- Moris Little
- 7 years ago
- Views:
Transcription
1 Session on COPD: Novel Concepts and Promising New Drugs Topic: New Treatment = Better Outcome? Through a CME Grant sponsored by
2 New Treatment = Better Outcome? Tim S. Trinidad, MD
3 Disclosure Present: COPD Advisory Board Member & Lecturer Novartis Astra Zeneca UAP Past: COPD Lecturer Nycomed Takeda Boehringer Ingelheim Glaxo Smith Kline
4 Scope of the Discussion New Treatment = Better Outcome? Pharmacologic Non-pharmacologic Risk reduction Vaccination Rehab or Physical Activity Invasive (surgical or non-bronchoscopic LVRS)
5 Reference Point for New (2001) (2004) (2011) (2014) LABA/ ICS Tiotropium Old PDE4I New
6 Pharmacologic Agents: Recently approved in some countries or Undergoing clinical development (Not listed in GOLD 2014) TNF-a inhibitors: Infliximab, PKF , PKF IL-6 inhibitors: Tocilizumab Chemokine antagonists: ADZ8309, SCH , SB NF-kB inhibitors: IMD-0354, IMD-0650, BMS , SC-514, AS p38 MAPK inhibitors: SB681323, PH797804, PF , GSK PI3K inhibitors: PI3K-g inhibitors, TG JAK/STAT inhibitors: Tofacitinib Ngkelo, A. et al. New treatments for COPD. Current Opinion in Pharmacology 2013, 13:
7 Pharmacologic Agents: Recently approved in some countries or Undergoing clinical development (Not listed in GOLD 2014)) LABA/ICS combination: Mometasone/ Indacaterol (QMF149) LAMA/LABA/ICS triple combination inhalers : Ciclesonide/ Tiotropium/ Formoterol Beclomethasone/ Formoterol/ Glycopyrronium QMF149/Glycopyrronium Umeclidinium/ Vilanterol/ Fluticasone furoate GSK961081/ Fluticasone Ngkelo, A. et al. New treatments for COPD. Current Opinion in Pharmacology 2013, 13:
8 LABAs: LAMAs: Olodaterol, Vilanterol, Abediterol Umeclidinium LAMA/LABA combinations: MABAs: Glycopyrronium/ Indacaterol (QVA149), Umeclidinium/ Vilanterol Tiotropium/ Olodaterol Aclidinium/ Formoterol Glycopyrronium bromide/ Formoterol (PT001) GSK , AZD2115 Ngkelo, A. et al. New treatments for COPD. Current Opinion in Pharmacology 2013, 13:
9 New Pharmacologic Treatment (UPDATE 2015) (2001) (2004) (2011) (2014) (2015) LABA/ ICS Tiotropium PDE4I LABA/LAMA
10 Reference Point for Better Outcome (GOLD Treatment Goals) Reduce symptoms Relieve symptoms Improve exercise tolerance Improve health status Prevent future risks Prevent and treat exacerbations Prevent disease progression Reduce mortality GOLD Available from:
11 LABA/ ICS & Treatment Goals Relieve symptoms Improve health status Prevent and treat exacerbations Improve exercise tolerance X Reduce mortality? Prevent disease progression Calverley, P et al. Salmeterol and Fluticasone Propionate and Survival in Chronic Obstructive Pulmonary Disease. N Engl J Med 2007;356: Cochrane Database of Systematic Reviews, Issue 4, 2008
12 Tiotropium & Treatment Goals Relieve symptoms Improve health status Prevent and treat exacerbations Improve exercise tolerance? Reduce mortality X Prevent disease progression Tashkin, D et al. A 4-Year Trial of Tiotropium in Chronic Obstructive Pulmonary Disease. N Engl J Med 2008;359: The Cochrane Library 2012, Issue 7
13 Unmet needs in COPD management
14 Infliximab (TNF-A Inhibitor) X CRQ X Pre-FEV1 X 6-MWT X SF-36 X TDI (?) Cancer (?) Pneumonia Rennard SI, et al. The safety and efficacy of infliximab in moderateto-severe COPD. Am J Respir Crit Care Med 2007; 175:
15 ABX vs IL-8 TDI X FEV1 X SGRQ X 6MWT Mahler DA et al. Efficacy and safety of a monoclonal antibody recognizing interleukin-8 in COPD: a pilot study. Chest 2004; 126:
16 PDE4I: Roflumilast Achieved GOLD guidelines recommendations and FDA approval in several countries Anti-inflammatory drug: used for ECOPD prevention In comparison to other (old) drugs (NNT) LAMA: 16 LABA/ ICS: 20 General COPD Roflumilast: 3-4 Cochrane Database Syst Rev Jul 11; 7:CD Nannini LJ, et al. Cochrane Database of Systematic Reviews 2012, Issue 9 Bateman, E et al. Roflumilast with long-acting β2-agonists for COPD: influence of exacerbation history. ERJ September 1, 2011 vol. 38 no
17 We continue to know more
18 Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) 3 years Follow-up Pulmonary function Whole body impedance/fat-free mass Chest computed tomography Exercise capacity Resting oxygen saturation Biomarkers Blood samples Induced sputum Exhaled breath condensate Blood and urine metabolomics Health outcomes Blood samples for genetic markers Vestbo J, et al. Am J of Resp & Crit Care Med Vol. 189 Num. 9 May
19 COPD is very heterogeneous clinical presentation Some patients are frequent exacerbator others are not Some patients have severe inflammation others have less inflammation Some patients are rapid FEV1 decliners others are not For those rapid decliners, the greatest decline occurs in the moderate to severe stage Vestbo J, et al. Am J of Resp & Crit Care Med Vol. 189 Num. 9 May
20 COPD phenotype A single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes : Symptoms Exacerbations Response to therapy Rate of disease progression Death
21 COPD Phenotype Application Roflumilast Story
22 Design OPUS ( 111) / RATIO (112) Study N: 2,686 FEV1: <50% Meds: SABA & SAMA ICS 52 Weeks Roflumilast: 500 Placebo
23 Rate Ratio of Exacerbation (moderate & severe) Study Favors Roflumilast Favors Placebo iexacerb. Rate (%) M M Why? Rate Ratio
24 Post-hoc Analysis: Who are the responders?
25 Identification of Patient Target Population Subgroup analyses of early phase III studies M2-111, M2-112 Confirmatory 1-yr pivotal studies M2-124, M2-125 Severe/very severe COPD Severe/very severe COPD Hx chronic cough & sputum Hx chronic cough & sputum Hx of exacerbations
26 Pivotal Study M2-124/ M2-125 N: 3,091 FEV1: <50% IC: (+) C. Bronchitis (+) Sputum (+) Exacerbations Meds: No ICS (+) LABA (+) SAMA 52 Weeks Roflumilast: 500 Placebo Calverley PMA, Rabe, KF et al. Lancet 2009;374:
27 Rate Ratio of Exacerbation (moderate & severe) Study Favors Roflumilast Favors Placebo iexacerb. Rate (%) M M M M Rate Ratio Calverley PMA, Rabe, KF et al. Lancet 2009;374:
28 GOLD: Statements on Roflumilast The phosphodiesterase 4 inhibitor (Roflumilast) may also be used to reduce exacerbations for patients with chronic bronchitis, severe and very severe airflow limitation, and frequent exacerbations that are not adequately controlled by long- acting bronchodilators. GOLD Available from:
29 FEV 1 (% of value at age 25) Decline in Lung Function of COPD Patients Fletcher-Peto Curve vs ECLIPSE Curve Most Rapid Decline (ECLIPSE) Most Rapid Decline (Fletcher) Never smoked or not susceptible to smoke Smoked regularly and susceptible to its effects Age (years) Vestbo J, et al. Am J of Resp & Crit Care Med Vol. 189 Num. 9 May
30 Do we have a better response if we give the drugs during the early stage? Tiotropium UPLIFT Story
31 UPLIFT Study N: 4,383 FEV1: <70% Meds allowed: SABA, LABA ICS, Xanthine 4 Years Tiotropium 18 ug OD Placebo Yearly decline in Pre FEV1 Post FEV1
32 Tashkin, D et al. A 4-Year Trial of Tiotropium in COPD. N Engl J Med 2008;359: Decramer, M. et al. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): a prespecified subgroup analysis of a randomised controlled trial. Lancet 2009; 374: UPLIFT Decline in FEV1 N: All Subjects N: Subjects with moderate Obstruction Tiotropium : 40±1 ml per year Placebo: 42±1 ml per year P = 0.21 Tiotropium : 43±2 ml per year Placebo: 49±2 ml per year P = 0.024
33 Clinical Trials in COPD FEV1 Inclusion Criteria Study FEV1 % predicted inclusion criteria TORCH ( ) < 60% UPLIFT ( ) < 70% Glycopyronium/ Indacaterol < 80% and 30% Umeclidinium/ Vilanterol 70% Glycopyrrolate/ Formoterol < 80% and 30% Tiotropium/ Olodaterol < 80%
34 LAMA/ LABA FDC for COPD: Approved or Under Investigation Banerji, D. et al. Dual bronchodilation for the treatment of chronic obstructive pulmonary disease: a review of the latest clinical data. Clin. Invest. (2014) 4(6),
35 Banerji, D. et al. Dual bronchodilation for the treatment of chronic obstructive pulmonary disease: a review of the latest clinical data. Clin. Invest. (2014) 4(6),
36 Banerji, D. et al. Dual bronchodilation for the treatment of chronic obstructive pulmonary disease: a review of the latest clinical data. Clin. Invest. (2014) 4(6),
37 Banerji, D. et al. Dual bronchodilation for the treatment of chronic obstructive pulmonary disease: a review of the latest clinical data. Clin. Invest. (2014) 4(6),
38 Banerji, D. et al. Dual bronchodilation for the treatment of chronic obstructive pulmonary disease: a review of the latest clinical data. Clin. Invest. (2014) 4(6),
39 New Treatment = Better Outcome? Yes, but there is room for improvement.
40 Medicines in Development COPD: 2012 Report America s biopharmaceutical research companies
41 Medicines in Development COPD: 2012 Report America s biopharmaceutical research companies
42 New Treatment = Better Outcome? (part 2) PCCP Mid-year 2018 Version
43 New Treatment = Better Outcome? We know more about COPD. Beginning to know: Who and when to give the drug. Yes, new treatment = better outcome but we need more. More drugs in development.
44 RCT New Treatment Better Outcome Real World Morbidity Mortality Health providers General population Patient Diagnose early COPD Spirometry facility Increase awareness How to recognize How to treat Why & how to use inhalers
45 Thank you very much for your attention
46 Session on COPD: Novel Concepts and Promising New Drugs Topic: New Treatment = Better Outcome? Through a CME Grant sponsored by
Prevention of Acute COPD exacerbations
December 3, 2015 Prevention of Acute COPD exacerbations George Pyrgos MD 1 Disclosures No funding received for this presentation I have previously conducted clinical trials with Boehringer Ingelheim. Principal
More informationBronchodilators in COPD
TSANZSRS Gold Coast 2015 Can average outcomes in COPD clinical trials guide treatment strategies? Long live the FEV1? Christine McDonald Dept of Respiratory and Sleep Medicine Austin Health Institute for
More informationBefore prescribing for COPD management, the patient should have had appropriate assessment, including spirometry, as per NICE guidelines.
Formulary Guidance for Management of COPD patients Before prescribing for COPD management, the patient should have had appropriate assessment, including spirometry, as per NICE guidelines. For inhaler
More informationPost-market review of COPD medicines. Joint submission from Lung Foundation Australia (LFA) and Thoracic Society of Australia and New Zealand (TSANZ)
Post-market review of COPD medicines Joint submission from Lung Foundation Australia (LFA) and Thoracic Society of Australia and New Zealand (TSANZ) EXECUTIVE SUMMARY With the addition of new medicines
More informationCOPD and Asthma Differential Diagnosis
COPD and Asthma Differential Diagnosis Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in America. Learning Objectives Use tools to effectively diagnose chronic obstructive
More informationPathway for Diagnosing COPD
Pathway for Diagnosing Visit 1 Registry Clients at Risk Patient presents with symptoms suggestive of Exertional breathlessness Chronic cough Regular sputum production Frequent bronchitis ; wheeze Occupational
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical
More informationLongitudinal Modeling of Lung Function in Respiratory Drug Development
Longitudinal Modeling of Lung Function in Respiratory Drug Development Fredrik Öhrn, PhD Senior Clinical Pharmacometrician Quantitative Clinical Pharmacology AstraZeneca R&D Mölndal, Sweden Outline A brief
More informationGEORGIA MEDICAID FEE-FOR-SERVICE ASTHMA and COPD AGENTS PA SUMMARY
GEORGIA MEDICAID FEE-FOR-SERVICE ASTHMA and COPD AGENTS PA SUMMARY Preferred Anticholinergics and Combinations Atrovent HFA (ipratropium) Combivent Respimat (ipratropium/albuterol) Ipratropium neb inhalation
More informationSponsor Novartis Pharmaceuticals
Clinical Trial Results Database Page 1 Sponsor Novartis Pharmaceuticals Generic Drug Name Indacaterol Therapeutic Area of Trial Chronic Obstructive Pulmonary Disease (COPD) Indication studied: COPD Study
More informationAcute Care of COPD: Gaps in our knowledge. Robert A. Wise, M.D. May 20, 2010
Acute Care of COPD: Gaps in our knowledge Robert A. Wise, M.D. May 20, 2010 Outline of talk Importance of COPD exacerbations Current treatments Areas for improvement Significant knowledge gaps Strategies
More informationCOPD Prescribing Guidelines
South Staffordshire Area Prescribing Group COPD Prescribing Guidelines Inhaler choices in this guideline are different from previous versions produced by the APG. It is not expected patients controlled
More informationRES/006/APR16/AR. Speaker : Dr. Pither Sandy Tulak SpP
RES/006/APR16/AR Speaker : Dr. Pither Sandy Tulak SpP Definition of Asthma (GINA 2015) Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families
More informationProf. Florian Gantner. Vice President Respiratory Diseases Research Boehringer Ingelheim
Prof. Florian Gantner Vice President Respiratory Diseases Research Boehringer Ingelheim Research and Development in Practice: COPD Chronic Obstructive Pulmonary Disease (COPD) Facts Main cause of COPD
More informationCOPD PROTOCOL CELLO. Leiden
COPD PROTOCOL CELLO Leiden May 2011 1 Introduction This protocol includes an explanation of the clinical picture, diagnosis, objectives and medication of COPD. The Cello way of working can be viewed on
More informationObjectives. Asthma Management
Objectives Asthma Management BREATHE Conference Allergy and Asthma Specialists PC Christine Malloy MD March 22, 2013 Review the role of inflammation in asthma Discuss the components of the EPR-3 management
More informationThis clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.
abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical
More informationIrish Association for Emergency Medicine (IAEM) submission to the National COPD Strategy
31 st Irish Association for Emergency Medicine (IAEM) submission to the National COPD Strategy 1 Introduction Chronic obstructive pulmonary disease (COPD) is an important disease for patients, the health
More informationChronic obstructive pulmonary disease. Efficacy and safety of twice-daily aclidinium bromide in COPD patients: the ATTAIN study
Eur Respir J 212; 4: 83 836 DOI: 1.1183/931936.225511 CopyrightßERS 212 Efficacy and safety of twice-daily aclidinium bromide in COPD patients: the ATTAIN study Paul W. Jones*, Dave Singh, Eric D. Bateman
More informationManagement of exacerbations in chronic obstructive pulmonary disease in Primary Care
Management of exacerbations in chronic obstructive pulmonary disease in Primary Care Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant morbidity and mortality.
More informationThe. Treating patients with COPD with medications
Treating patients with COPD with medications Gilbert E. D Alonzo Jr, MS, DO, FACOI; Fredric Jaffe, DO, FCCP; Samuel L. Krachman, DO SHUTTERSTOCK.COM The management treatment of chronic obstructive pulmonary
More informationHow to use FENO-guided asthma control in routine clinical practice
How to use FENO-guided asthma control in routine clinical practice Asthma is a chronic inflammatory disease of the airways. This has implications for the diagnosis, management and potential prevention
More informationSevere asthma Definition, epidemiology and risk factors. Mina Gaga Athens Chest Hospital
Severe asthma Definition, epidemiology and risk factors Mina Gaga Athens Chest Hospital Difficult asthma Defined as asthma, poorly controlled in terms of chronic symptoms, with episodic exacerbations,
More information9/16/2014. Anti-Immunoglobulin E (IgE) Omalizumab (Xolair ) Dosing Guidance
Disclosure Statement of Financial Interest New Therapies for Asthma Including Omalizumab and Anti-Cytokine Therapies Marsha Dangler, PharmD, BCACP Clinical Pharmacy Specialist James H. Quillen VA Medical
More informationPLAN OF ACTION FOR. Physician Name Signature License Date
PLAN OF ACTION FOR Patient s copy (patient s name) I Feel Well Lignes I feel short directrices of breath: I cough up sputum daily. No Yes, colour: I cough regularly. No Yes I Feel Worse I have changes
More informationCo-morbiditeit associeert met respiratoire aandoeningen louter omwille van de leeftijd. COPD patiënten hebben veel meer kans op longkanker dan rokers
Academisch centrum huisartsgeneeskunde Pneumologie Juni 2012 Prof W Janssens Co-morbiditeit associeert met respiratoire aandoeningen louter omwille van de leeftijd. COPD patiënten hebben veel meer kans
More informationBackground information
Background information Asthma Asthma is a complex disease affecting the lungs that can be managed but cannot be cured. 1 Asthma can be controlled well in most people most of the time, although some people
More informationChronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) Chronic obstructive pulmonary disease (COPD) is the name for a group of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways
More informationGlobal Initiative for Chronic Obstructive Lung Disease
Global Initiative for Chronic Obstructive Lung Disease POCKET GUIDE TO COPD DIAGNOSIS, MANAGEMENT, AND PREVENTION A Guide for Health Care Professionals REVISED 2011 Global Initiative for Chronic Obstructive
More informationClinical Guideline. Recommendation 3: For stable COPD patients with respiratory symptoms
Clinical Guideline Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians,
More informationPosition Statement from the Irish Thoracic Society on the treatment of Idiopathic Pulmonary Fibrosis
BACKGROUND Position Statement from the Irish Thoracic Society on the treatment of Idiopathic Pulmonary Fibrosis Idiopathic Pulmonary Fibrosis (IPF) is a rare, chronic and fatal disease characterised by
More informationClinical Guideline. Recommendation 3: For stable COPD patients with respiratory symptoms
Clinical Guideline Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians,
More informationmedicineupdate to find out more about this medicine
medicineupdate Asking the right questions about new medicines Seretide for chronic obstructive pulmonary disease What this medicine is 1 What this medicine treats 2 Other medicines available for this condition
More informationCOPD RESOURCE PACK SECTION 11. Fife Integrated COPD Care Pathways
COPD RESOURCE PCK SECTION 11 Fife Integrated COPD Care Pathways In this section: 1. COPD Guidance treatment at each stage of the disease 2. Overview of Respiratory (COPD) Integrated Pathway 3. Chronic
More informationRoflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials
in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials Peter M A Calverley*, Klaus F Rabe*, Udo-Michael Goehring, Søren Kristiansen, Leonardo M Fabbri, Fernando J Martinez,
More informationAsthma (With a little SCID to start) Disclosures Outline Starting with the Immune System The Innate Immune System The Adaptive Immune System
1 2 3 4 5 6 7 8 9 Asthma (With a little SCID to start) Lauren Smith, MD CHKD Pediatric Allergy/Immunology Disclosures None Will be discussing some medications that are not yet FDA approved Outline SCID
More informationCOPD MANAGEMENT PROTOCOL STANFORD COORDINATED CARE
I. PURPOSE To establish guidelines f the collabative management of patients with a diagnosis of chronic obstructive pulmonary disease (COPD) who are not adequately controlled and to define the roles and
More informationPharmacology of the Respiratory Tract: COPD and Steroids
Pharmacology of the Respiratory Tract: COPD and Steroids Dr. Tillie-Louise Hackett Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia Associate Head, Centre of Heart
More informationExploratory data: COPD and blood eosinophils. David Price: 9.23-9.35am
Exploratory data: COPD and blood eosinophils David Price: 9.23-9.35am Blood Eosinophilia in COPD The reliability and utility of blood eosinophils as a marker of disease burden, healthcare resource utilisation
More informationMedications for Managing COPD in Hospice Patients. Jim Joyner, PharmD, CGP Director of Clinical Operations Outcome Resources
Medications for Managing COPD in Hospice Patients Jim Joyner, PharmD, CGP Director of Clinical Operations Outcome Resources Goal of medications in COPD Decrease symptoms and/or complications Reduce frequency
More informationAECOPD: Management and Prevention
AECOPD: Management and Prevention Neil MacIntyre MD Duke University Medical Center Durham NC AECOPD: Management and Prevention AECOPD: Definitions and impact Acute management of AECOPD Preventing AECOPD.
More informationRehabilitation and Lung Cancer Resection. Roberto Benzo MD MS Mindful Breathing Laboratory Division of Pulmonary & CCM Mayo Clinic
Rehabilitation and Lung Cancer Resection Roberto Benzo MD MS Mindful Breathing Laboratory Division of Pulmonary & CCM Mayo Clinic Disclosure Funded by the National Cancer Institute NIH for Preoperative
More informationPulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease (COPD)
Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease (COPD) Development of disability in COPD The decline in airway function may initially go unnoticed as people adapt their lives to avoid
More informationCOPD. What is COPD? How many people have COPD in Canada? Who gets COPD?
What is COPD? COPD stands for Chronic Obstructive Pulmonary Disease. It is a long-term lung disease that makes it difficult for air to move into and out of the lungs. COPD is used to describe a few lung
More informationEMPHYSEMA THERAPY. Information brochure for valve therapy in the treatment of emphysema.
EMPHYSEMA THERAPY Information brochure for valve therapy in the treatment of emphysema. PATIENTS WITH EMPHYSEMA With every breath, lungs deliver oxygen to the rest of the body to perform essential life
More informationChronic Obstructive Pulmonary Disease: Developing Drugs for Treatment Guidance for Industry
Chronic Obstructive Pulmonary Disease: Developing Drugs for Treatment Guidance for Industry DRAFT GUIDANCE This guidance document is being distributed for comment purposes only. Comments and suggestions
More informationThe effect of adding inhaled corticosteroids to tiotropium and long-acting beta 2 -agonists for chronic obstructive pulmonary disease (Review)
The effect of adding inhaled corticosteroids to tiotropium and long-acting beta 2 -agonists for chronic obstructive pulmonary disease Karner C, Cates CJ This is a reprint of a Cochrane review, prepared
More informationCOPD. Information brochure for chronic obstructive pulmonary disease.
COPD Information brochure for chronic obstructive pulmonary disease. CONTENTS What does COPD mean?...04 What are the symptoms of COPD?...06 What causes COPD?...09 Treating COPD...10 Valve therapy in COPD...12
More informationUnderstanding COPD. Carolinas Healthcare System
Understanding COPD Carolinas Healthcare System 2013 This self-directed learning module contains information about the pathophysiology, diagnosis, and treatment of COPD. Target Audience: All RNs and LPNs
More informationNICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.
bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published.
More informationunderstanding the professional guidelines
SEVERE ASTHMA understanding the professional guidelines This guide includes information on what the European Respiratory Society (ERS) and the American Thoracic Society (ATS) have said about severe asthma.
More informationCOPD. (Chronic Obstructive Pulmonary Disease) (Emphysema) (Chronic Bronchitis) Education For Our Community
COPD (Chronic Obstructive Pulmonary Disease) (Emphysema) (Chronic Bronchitis) Education For Our Community Chronic Obstructive Pulmonary Disease (COPD) Definition Chronic obstructive pulmonary disease (COPD)
More informationDavid J. Lederer, MD, MS
COPD: Definition Chronic Obstructive Pulmonary Disease Chronic airflow obstruction due to chronic bronchitis and/or pulmonary emphysema David J. Lederer, MD, MS Associate Medical Director, Lung Transplant
More informationJ of Evolution of Med and Dent Sci/ eissn- 2278-4802, pissn- 2278-4748/ Vol. 3/ Issue 65/Nov 27, 2014 Page 13575
EFFECT OF BREATHING EXERCISES ON BIOPHYSIOLOGICAL PARAMETERS AND QUALITY OF LIFE OF PATIENTS WITH COPD AT A TERTIARY CARE CENTRE Sudin Koshy 1, Rugma Pillai S 2 HOW TO CITE THIS ARTICLE: Sudin Koshy, Rugma
More informationEvaluating Steroid Inhalers Used to Treat: Asthma and Chronic Lung Disease. Comparing Effectiveness, Safety, and Price
Evaluating Steroid Inhalers Used to Treat: Asthma and Chronic Lung Disease Comparing Effectiveness, Safety, and Price Our Recommendations Inhaled steroids are effective and safe medicines used to treat
More informationGlucocorticoids, Inhaled Therapeutic Class Review (TCR)
Glucocorticoids, Inhaled Therapeutic Class Review (TCR) July 31, 2015 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying,
More informationYour Go-to COPD Guide
Your Go-to COPD Guide Learning how to live with chronic obstructive pulmonary disease (COPD) Inside, you ll learn: COPD facts COPD symptoms and triggers How to talk with your doctor Different treatment
More informationOutcome of Drug Counseling of Outpatients in Chronic Obstructive Pulmonary Disease Clinic at Thawangpha Hospital
Mahidol University Journal of Pharmaceutical Sciences 008; 35(14): 81. Original Article Outcome of Drug Counseling of Outpatients in Chronic Obstructive Pulmonary Disease Clinic at Thawangpha Hospital
More informationCompare the physiologic responses of the respiratory system to emphysema, chronic bronchitis, and asthma
Chapter 31 Drugs Used to Treat Lower Respiratory Disease Learning Objectives Describe the physiology of respirations Compare the physiologic responses of the respiratory system to emphysema, chronic bronchitis,
More information30 DAY COPD READMISSIONS AND PULMONARY REHAB
30 DAY COPD READMISSIONS AND PULMONARY REHAB Trina M. Limberg, Bs, RRT, FAARC, MAACVPR Director, Preventative Pulmonary and Rehabilitation Services UC San Diego Health System OVERVIEW The Impact of COPD
More informationTests. Pulmonary Functions
Pulmonary Functions Tests Static lung functions volumes Dynamic lung functions volume and velocity Dynamic Tests Velocity dependent on Airway resistance Resistance of lung tissue to change in shape Dynamic
More informationUnderstanding COPD. An educational health series from
Understanding COPD An educational health series from Our Mission since 1899 is to heal, to discover, and to educate as a preeminent healthcare institution. We serve by providing the best integrated and
More informationwritten by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org/copd
written by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org/copd What Is COPD? COPD stands for chronic obstructive pulmonary disease. There are two major diseases included in
More informationCOPD - Education for Patients and Carers Integrated Care Pathway
Patient NHS COPD - Education for Patients and Carers Integrated Care Pathway Date ICP completed:. Is the patient following another Integrated Care Pathway[s].. / If yes, record which other Integrated Care
More informationStanley J. Szefler, MD National Jewish Medical and Research Center
New Asthma Guidelines: Special Attention to Infant Wheezers Stanley J. Szefler, MD Helen Wohlberg & Herman Lambert Chair in Pharmacokinetics, & Professor of Pediatrics and Pharmacology, University of Colorado
More informationU.S. Food and Drug Administration
U.S. Food and Drug Administration Notice: Archived Document The content in this document is provided on the FDA s website for reference purposes only. It was current when produced, but is no longer maintained
More informationHospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis
Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis BR McCurdy March 2012 Ontario Health Technology Assessment Series;
More informationCOPD It Can Take Your Breath Away www.patientedu.org
written by Harvard Medical School COPD It Can Take Your Breath Away www.patientedu.org What Is COPD? COPD stands for chronic obstructive pulmonary disease. There are 2 major diseases included in COPD:
More informationGuideline on clinical investigation of medicinal products in the treatment of chronic obstructive pulmonary disease (COPD)
21 June 2012 EMA/CHMP/483572/2012 -corr 1 Respiratory Drafting Group Guideline on clinical investigation of medicinal products in the treatment of chronic obstructive pulmonary disease (COPD) Draft Agreed
More informationThe thick cloud cover over the understanding of
8 SUPPLEMENT TO JAPI february 2012 VOL. 60 Newer Therapies for Chronic Obstructive Pulmonary Disease Rahul Kodgule *, Abhijit Vaidya **, Sundeep Salvi *** Introduction The thick cloud cover over the understanding
More informationJames F. Kravec, M.D., F.A.C.P
James F. Kravec, M.D., F.A.C.P Chairman, Department of Internal Medicine, St. Elizabeth Health Center Chair, General Internal Medicine, Northeast Ohio Medical University Associate Medical Director, Hospice
More informationElectronic patient diaries in clinical research
Topics Electronic diaries in Clinical Trials Electronic diaries versus Paper Electronic patient diaries in clinical research Case Study: Novel detection of exacerbations of COPD with patient reported outcome
More informationNational Learning Objectives for COPD Educators
National Learning Objectives for COPD Educators National Learning Objectives for COPD Educators The COPD Educator will be able to achieve the following objectives. Performance objectives, denoted by the
More informationCLINICAL PATHWAY. Acute Medicine. Chronic Obstructive Pulmonary Disease
CLINICAL PATHWAY Acute Medicine Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Table of Contents (tap to jump to page) INTRODUCTION 1 Scope of this Pathway 1 Pathway Contacts
More informationCDISC Asthma Therapeutic Area Data Standards User Guide Yes, it is interesting! Paul Terrill
CDISC Asthma Therapeutic Area Data Standards User Guide Yes, it is interesting! Paul Terrill Rather dry no statistics here Standards matter Must have been a lot of hard work! 2 What I am not going to talk
More informationPulmonary rehabilitation
29 Pulmonary rehabilitation Background i Key points There is a sound evidence base showing the effects of pulmonary rehabilitation on chronic obstructive pulmonary disease symptoms and health-related quality
More informationChronic Obstructive Pulmonary Disease
Page 1 of 10 View this article online at: patient.info/health/chronic-obstructive-pulmonary-disease-leaflet Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease (COPD) is an umbrella
More informationMarilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL
Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT
More informationStephen R. Veach, M.D.
Stephen R. Veach, M.D. Memorial Sloan-Kettering Cancer Center International Oncology Programs 160 E. 53 rd Street New York, NY 10022 212-610 610-08780878 - tel 212-308 308-7063 - fax veachs@mskcc.org SCREENING
More informationPipeline: Respiratory, Inflammation & Autoimmunity (RIA) Inhaled therapeutic leadership; spearheading immunology biologics
Pipeline: Respiratory, Inflammation & Autoimmunity (RIA) Inhaled therapeutic leadership; spearheading immunology biologics Bing Yao, Head of MedImmune Respiratory, Inflammation & Autoimmunity imed Respiratory:
More informationDefending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing
Defending the Rest Basics on Lung Cancer, Other Cancers and Asbestosis: Review of the B-Read and Pulmonary Function Testing ASBESTOSIS November 2013 Bruce T. Bishop Lucy L. Brandon Willcox & Savage 440
More informationAsthma POEMs. Patient Orientated Evidence that Matters
ASTHMA POEMs Asthma POEMs Patient Orientated Evidence that Matters Developed by the Best Practice Advocacy Centre Level 8, 10 George Street PO Box 6032 Dunedin Phone 03 4775418 Fax 03 4772622 Acknowledgement
More informationLogistics. Registration for free continuing education (CE) hours or certificate of attendance through TRAIN at: https://tx.train.
. DSHS Grand Rounds Logistics Registration for free continuing education (CE) hours or certificate of attendance through TRAIN at: https://tx.train.org Streamlined registration for individuals not requesting
More informationMedication and Devices for Chronic Obstructive Pulmonary Disease (COPD)
Medication and Devices for Chronic Obstructive Pulmonary Disease (COPD) Patients with COPD take a wide variety of medicines to manage their symptoms these include: Inhaled Short Acting Bronchodilators
More informationHospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care
Hospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care Charley P. Starnes, RRT, RCP Clinical Respiratory Specialist- COPD Education Important Milestones July 2011-
More information3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients
Faculty Disclosures COPD Disease Management Tackling the Transition Dr. Cappelluti has no actual or potential conflicts of interest associated with this presentation. Jane Reardon has no actual or potential
More informationLung Cancer. Public Outcomes Report. Submitted by Omar A. Majid, MD
Public Outcomes Report Lung Cancer Submitted by Omar A. Majid, MD Lung cancer is the most common cancer-related cause of death among men and women. It has been estimated that there will be 226,1 new cases
More informationForced vital capacity: maximal volume of air exhaled with maximally forced effort from a maximal inspiration.
SOP Spirometry 1. General considerations Spirometry serves as a physiological test to quantify pulmonary disease severity and to assess clinical change in respiratory function over time. Standard spirometric
More informationU.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER)
Guidance for Industry Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With Chronic Obstructive Pulmonary Disease: Developing Antimicrobial Drugs for Treatment U.S. Department of Health
More informationAdherence to the Swiss Guidelines. Experience of a Swiss Teaching Hospital
Original article Peer reviewed article SWISS MED WKLY 2005;135:116 121 www.smw.ch 116 Adherence to the Swiss Guidelines for Management of COPD: Experience of a Swiss Teaching Hospital K. Fritsch, M.-L.
More informationStudy design considerations in a large COPD trial comparing effects of tiotropium with salmeterol on exacerbations
ORIGINAL RESEARCH Study design considerations in a large COPD trial comparing effects of tiotropium with salmeterol on exacerbations Kai-Michael Beeh 1 Bettina Hederer 2 Thomas Glaab 2 Achim Müller 2 Maureen
More informationReducing COPD Readmissions and Implications for Pulmonary Rehab. Janie Knipper, APN, MA, AE-C, FAACVPR jane-knipper@uiowa.edu
Reducing COPD Readmissions and Implications for Pulmonary Rehab Janie Knipper, APN, MA, AE-C, FAACVPR jane-knipper@uiowa.edu Statement of Disclosure I have no disclosures. The opinions expressed are my
More informationPrevention of Acute Exacerbations of COPD American College of Chest Physicians and Canadian Thoracic Society Guideline
[ Evidence-Based Medicine ] Prevention of Acute Exacerbations of COPD American College of Chest Physicians and Canadian Thoracic Society Guideline Gerard J. Criner, MD, FCCP ; Jean Bourbeau, MD, FCCP ;
More informationCOPD is a multicomponent disease that includes. Inhaled Combination Therapy With Long-Acting 2 -Agonists and Corticosteroids in Stable COPD*
Inhaled Combination Therapy With Long-Acting 2 -Agonists and Corticosteroids in Stable COPD* Mario Cazzola, MD, FCCP; and Ronald Dahl, MD Long-acting 2 -agonists (LABAs) have been shown to be effective
More informationPULMONARY ALLERGY DRUGS ADVISORY COMMITTEE MEETING
PULMONARY ALLERGY DRUGS ADVISORY COMMITTEE MEETING FDA Briefing Document March 7, 213 NDA 24-275: fluticasone furoate and vilanterol inhalation powder for the long-term, maintenance treatment of airflow
More informationThe Respiratory Therapist As Disease Manager
The Respiratory Therapist As Disease Manager Bill Pruitt, MBA, RRT, CPFT, AE-C, FAARC Director of Clinical Education, Senior Instructor Cardiorespiratory Care University of South Alabama Mobile Alabama
More informationSouthwark Clinical Commissioning Group Lambeth Clinical Commissioning Group
Getting the Vision Right: A multi-disciplinary approach to providing integrated care for respiratory patients Dr Noel Baxter, GP NHS Southwark CCG Dr Irem Patel, Integrated Consultant Respiratory Physician
More informationCURRICULUM VITAE KIRK GEORGE VOELKER, M.D.
PERSONAL INFORMATION DATE OF BIRTH December 29, 1961 PLACE OF BIRTH OFFICE ADDRESS E-MAIL Buffalo, NY. 1537 State St. 34236 (941) 330-1696 Dr.Voelker@comcast.net ACADEMIC RECORD UNDERGRADUATE MEDICAL SCHOOL
More informationMeasure #257 (NQF 1519): Statin Therapy at Discharge after Lower Extremity Bypass (LEB) National Quality Strategy Domain: Effective Clinical Care
Measure #257 (NQF 1519): Statin Therapy at Discharge after Lower Extremity Bypass (LEB) National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY
More information