New Survey Shows Rise of U.S COPD

COPD, a disease of the lungs that obstructs regular breathing, is shown to be on the rise in the United States. Glaxosmithkline, (GSK) one of the worlds leading healthcare pharmaceutical companies, recently implemented a global survey for those living with COPD, the third leading cause of death. In the last decade, COPD has risen to affect approximately 6-7% of adults over the age of 40. It is beginning to affect more women and non-smokers than before. This could be a result of pollutants in the atmosphere but it is not for certain.

As patients, caregivers and the healthcare community come together in support of World COPD Day (November 19), a GSK global survey of people living with chronic obstructive pulmonary disease (COPD) sheds new light on the growing burden of COPD in the US. GSK’s “Continuing to Confront COPD International Patient Survey” explores changes in COPD prevalence and disease burden, comparing data from the current study with GSK’s original “Confronting COPD” survey conducted ten years ago.[1],[2]

COPD is a growing problem in the US and in one decade has risen from the fourth leading cause of death to the third, after heart disease and cancer.[3] Data from the survey suggest that COPD prevalence has also increased from a decade ago, from six to seven percent of adults ages 40 years and older.

The burden of COPD on patients and the US healthcare system was also high. Twenty-six percent of US participants reported visiting the emergency room as a result of their COPD, with an additional 17 percent hospitalized within the last year – a statistic similar to that reported in Mexico, and higher than those reported in most European countries surveyed.

The survey also revealed that many patients may be underestimating the severity of their symptoms. While more than half (54 percent) of US participants reported clinically significant dyspnea (shortness of breath), the majority (70 percent) classified their COPD as only mild or moderate in severity, demonstrating a disconnect between the level of symptoms and their own subjective assessment of the disease.

“Given GSK’s 40-year heritage in the respiratory disease area, we were keen to follow up on our decade-old landmark study—the first COPD cross-national, population-based survey of its kind—with an update that helps provide insights as to how the disease and its management have evolved over time,” said Kourtney Davis, PhD, MSPH, GSK’s lead global epidemiologist on the survey.

“From these findings we see that the face of COPD is changing,” added Davis. “Traditionally, COPD was considered to be a disease of elderly male smokers, but now, more women than men  report having COPD, and about a quarter of patients have never smoked.”

In the US, the number of females affected by COPD (7.1 percent), was notably higher than males (6.2 percent). As a result, physicians may want to consider additional evaluation when women present with respiratory symptoms, recurrent respiratory infections, or fatigue, to assess COPD and improve outcomes. The percentage of US participants who were identified as “never-smokers” was 25 percent – giving researchers reason to explore additional risk factors, such as environmental or occupational exposures, and asthma, as well as consider whether symptomatic non-smoking patients need early screening and access to recommended disease management.

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Vitamin D Could Potentially Benefit Asthmatics

vitamin d

FoxNews recently posted an article that discusses new research in regards to Vitamin D’s effect on asthmatics. The study, conducted in Iran, gave supplements of Vitamin D to asthmatics for 6 months. The patients had better lung function and were able to breath easier.

However, Dr. Mario Castro, a professor of Pulmonary and Critical Care Medicine at the Washington School of Medicine, said that the study didn’t measure the effect on symptoms which is equally, if not more, important.

The study, conducted at the Medical University in Tehran, examined 130 children and adults with mild to moderate asthma. It was published in  Annals of Allergy, Asthma and Immunology. The study, if done in a larger spectrum and measured additional factors, could provide doctors more information regarding Vitamin D and asthma.

Asthma sufferers who received vitamin D supplements for six months, in addition to their regular inhalers, could breathe a little easier than those who relied only on the inhalers, in a recent study in Iran.

The researchers say the results – if confirmed by larger studies – might help the many people who sometimes have troublesome asthma symptoms even though they use medication.

“It does build some on the growing amount of data that shows vitamin D might help those affected by asthma,” Dr. Mario Castro, who was not involved in the study, told Reuters Health.

But Castro, a professor of Pulmonary and Critical Care Medicine at Washington University School of Medicine in St. Louis, Missouri, pointed out that the researchers only measured patients’ lung function, and not whether or not their symptoms improved.

“Given that vitamin D is a relatively benign supplement,” the small improvement in lung function “would be worthwhile if it was confirmed with other improvements in asthma control,” he said, such as fewer symptoms or a reduced need for medication.

About one in 12 individuals, or 25 million people, have asthma in the U.S. alone. In the last decade, the number of people with asthma has grown by about 15 percent.

Higher rates of asthma in northern climates have led some researchers to suspect that less sunlight – and therefore less vitamin D – could be playing a role. Several studies have shown a link between low vitamin D levels and asthma.

The new study, by Dr. Saba Arshi at the Medical University of Tehran and colleagues, involved 130 children and adults with mild-to-moderate asthma.

Everyone received asthma medication in a dry powder inhaler (budesonide, sold in the U.S. as Pulmicort, or budesonide plus formoterol, sold in the U.S. as Symbicort).

In addition, half the group was randomly chosen to receive high doses of vitamin D for six months. The first dose, 100,000 units, was given by injection; then patients were instructed to take 50,000 units orally once a week.

After eight weeks, when the researchers measured the amount of air patients could exhale in one second, both groups had improved to roughly the same extent. But after 28 weeks, that amount had improved by about 20 percent in the patients who received vitamin D supplements, versus about 7 percent among those who only used the inhaler.

The authors did not respond to questions about the study, which was published in Annals of Allergy, Asthma and Immunology.

Castro thinks the patients in the study weren’t particularly deficient in vitamin D.

“This is another weakness as they enrolled patients with normal vitamin D levels, so (they’re) unlikely to see a treatment effect,” Castro said.

He would not recommend that patients with asthma take vitamin D supplements based on this study and one of his own studies, though his research found some people with deficient levels improved after supplementation.

Dr. Doug Brugge, a professor of public health and community medicine at Tufts School of Medicine in Boston, said he thought the study added to the field of asthma and vitamin D research.

“I think it adds some evidence that vitamin D may be beneficial in terms of treating asthma, which in turn contributes some evidence that vitamin D is a factor in asthma,” Brugge, who wasn’t involved in the study, told Reuters Health.

He noted that most asthma research has focused on children, but this one included adults. “There really is a need for more research on asthma in adults,” he said.

But Brugge, who has studied the possible environmental causes of childhood asthma, said the study would have been more convincing if researchers had checked whether patients took their medication as prescribed (other than asking by phone) and included any exposure to environmental triggers of asthma.

“It leaves a little doubt in my mind . . . what if the intervention group was adhering to the medication more than the control group? I think it’s unlikely but it would have been nice to see that a little more clearly addressed,” said Brugge.

“Adherence is a big problem,” said Brugge, referring to medication use in general. “Non-adherence is more common than adherence.”

Brugge too thinks more studies are needed before anyone can assume that vitamin D would help people with asthma.

“I think it’s a reasonable hypothesis and their study and some other studies provide evidence it might be true. But I don’t think it’s proven yet,” said Brugge.

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Non-Adherence Biggest Issue in Asthma Management Today

Adherence to medication is the main method of prevention in chronic asthma cases. Asthma symptoms can be suppressed rather successfully with a consistent approach to medication usage. Neglecting to follow a medication regime is one of leading causes of hospitalization and even death for asthma sufferers. BBC published a recent study showing that almost one third of asthma patients in the U.K miss important hospital check-ups. This prevents doctors and healthcare professionals from being able to monitor their patients. Studies also show that a similar percentage of asthma patients in the U.S do not show up to their medical check-ups.

More than a million people suffering from asthma are missing out on key yearly checks. New analysis by charity Asthma UK found that 31% of asthma patients did not receive an “essential” annual review to check whether they are on the right medicine.

The charity said that its review of GP data for 2012/13 showed that there were 3,359,612 people in England who should have received an asthma review but 1,025,539 patients missed out.

NHS guidance suggests that everyone with asthma should get an annual review, an asthma action plan and their inhaler technique checked.

“With the worrying scale of prescribing errors identified by the National Review of Asthma Deaths, it’s vital that doctors and nurses do everything they can to follow up with patients to review their medicines, especially as asthma can vary hugely over the year.

“There is also an unacceptably large variation in the numbers of people attending annual reviews, which ranges from only 52% to 79% across the UK,” a spokeswoman said.

Read the original article here.

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Study: Asthma Inhaler use in Children Stunts Growth

Child with inhaler

The Guardian recently covered two asthma studies regarding inhaler usage and growth in children. The studies were conducted by Francine Ducharme, a pediatrician at the University of Montreal. The first study analyzed published inhaler usage trials of over 8,400 children. Results showed that the growth rate for children under 18 without steroid usage exceeded the growth rate for children using steroids by approximately half a centimeter per year.

The second study followed children who were taking medication doses between 50 to 200 micrograms of inhalable steroids. The children who took higher doses were at an increased risk of stunted growth.

Children who use inhalable steroids for asthma grow slower than their peers in the first year of taking the medication, researchers say.

But doctors said the effect was so small it was easily outweighed by the clear benefits of taking the drugs, which prevent serious asthma attacks and even deaths from the breathing disorder.

Children who used the common corticosteroids to alleviate their asthma symptoms grew on average half a centimetre less over the course of a year, compared with children who did not take the medicine.

The steroids seemed to affect children’s growth only in the first year and had even less of an impact on their growth rate when used in low doses of no more than 100 micrograms.

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New Inhaled Drug Could Potentially Relieve Asthma and Allergy Symptoms

WebMDreports a new drug called quilizumab has the potential to treat mild asthma and allergy symptoms. The drug, targets blood cells that produce immunoglobulin type E (IgE), a protein that causes allergic reactions. In an initial study, the drug reduced total levels of IgE in patients suffering from mild asthma or allergic reactions. The levels of IgE were kept low for a month on the drug. Results also show that production of IgE was not only reduced but stopped in some cases. In early stages of testing, the drug only seems to be working with mild asthma and not with moderate to severe cases. Quilizumab is aiming to replace its rival, omalizumab, which requires one to three injections every two to four weeks. Quilizumab, on the other hand, only requires one inhalation approximately every three months.

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, July 2, 2014 (HealthDay News) — A new inhaled medication has the potential to treat mildasthma andallergies by interrupting the production of an immune system protein that triggers allergic reactions, a new study reports.

The drug, quilizumab, targets the blood cells that produce a protein called immunoglobulin type E (IgE), that serves a key role in allergies.

Quilizumab lowered total levels of IgE in theblood of people with allergies and mild asthma, and kept them low for a month, researchers report in the July 2 issue of the journal Science Translational Medicine.

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Asthma Symptoms and Spring Time

Asthma symptoms vary depending on a few major factors, one of them being seasonal change. With spring time approaching and children going outside to play in warmer weather, it is important to review prevention methods. A recent article posted by Dr. Michael Rosenthal on Delaware online provides a good overview.  Spring brings with it a slew of new triggers that can impact asthma. These include air pollution, pollen and increased exposure to animals. Thus, medication adherence is especially important during this time as it could prevent dangerous symptoms.

 

Childhood asthma is the most common chronic disease in children, and can occur year-round. Now that spring has arrived and children are heading outside to play, it’s a good time to consider the impact and dangers of this disease, as well as how to protect against asthma attacks.

Asthma is a chronic lung disease that inflames and narrows the airways, causing wheezing, shortness of breath and coughing. The smaller airways within the lungs have a hard time moving air in and out, making breathing difficult.

Causes of asthma range from genetics to allergens and pollutants. No cure for asthma exists, although some children have fewer symptoms as they get older only to have it recur later in life due to certain triggers.

More than 7 million children nationwide have asthma. The disease accounts for more hospitalizations than any other childhood illness and more than 3,000 childhood deaths each year.

Aside from the health problems, asthma can affect learning and school performance. Among children ages 5 to 17, it is the leading cause of absences from school related to a chronic illness. Children with asthma miss an average of eight days per year, according to the Asthma and Allergy Foundation of America.

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Study Aims to Curb Asthma Over-Medication

NBC published an article covering new research currently being carried out by Dr. John Mastronarde and his team at the Ohio State Medical Center. The study aims to find the optimal amount of medication for each asthma patient. This research is essential in the asthma medication space due to over-medication creating unnecessary costs and health hazards. The study will examine combinations of inhalers and medicines to find the most effective dose levels at various situations.

“With 26 million Americans taking asthma medicines at a cost of $150 million a day, a new study seeks to determine how to change the fact that many of those patients are taking too much medicine.

Dr. John Mastronarde and his colleagues at Ohio State University Medical Center are researching how to get patients on the lowest dose of asthma medicine possible.

He said the drugs can cost patients between $3 and $500 per month.

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