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102. Inhaled versus systemic corticosteroids for acute exacerbations of COPD: a systematic review and meta-analysis.

Author

Papadopoulou, Efthymia, Safar, Sulaiman Bin, Khalil, Ali, Hansel, Jan, Ran Wang, Corlateanu, Alexandru, Kostikas, Konstantinos, Tryfon, Stavros, Vestbo, Jørgen, and Mathioudakis, Alexander G.

Abstract

This meta-analysis compares the efficacy and safety of inhaled versus systemic corticosteroids for COPD exacerbations. Following a pre-registered protocol, we appraised eligible randomised controlled trials (RCTs) according to Cochrane methodology, performed random-effects meta-analyses for all outcomes prioritised in the European Respiratory Society COPD core outcome set and rated the certainty of evidence as per Grading of Recommendations Assessment, Development and Evaluation methodology. We included 20 RCTs totalling 2140 participants with moderate or severe exacerbations. All trials were at high risk of methodological bias. Low-certainty evidence did not reveal significant differences between inhaled and systemic corticosteroids for treatment failure rate (relative risk 1.75, 95% CI 0.76–4.02, n=569 participants); breathlessness (mean change: standardised mean difference (SMD) −0.11, 95% CI −0.36– 0.15, n=239; post-treatment scores: SMD −0.18, 95% CI −0.41–0.05, n=293); serious adverse events (relative risk 1.47, 95% CI 0.56–3.88, n=246); or any other efficacy outcomes. Moderate-certainty evidence implied a tendency for fewer adverse events with inhaled compared to systemic corticosteroids (relative risk 0.80, 95% CI 0.64–1.0, n=480). Hyperglycaemia and oral fungal infections were observed more frequently with systemic and inhaled corticosteroids, respectively. Limited available evidence suggests potential noninferiority of inhaled to systemic corticosteroids in COPD exacerbations. Appropriately designed and powered RCTs are warranted to confirm these findings. [ABSTRACT FROM AUTHOR]

Published
2024
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103. Core outcome sets, developed collaboratively with patients, can improve the relevance and comparability of clinical trials

Author

Mathioudakis, Alexander G., primary, Khaleva, Ekaterina, additional, Fally, Markus, additional, Williamson, Paula R., additional, Jensen, Jens-Ulrik, additional, Felton, Tim W., additional, Brightling, Chris, additional, Bush, Andrew, additional, Winders, Tonya, additional, Linnell, John, additional, Ramiconi, Valeria, additional, Coleman, Courtney, additional, Welte, Tobias, additional, Roberts, Graham, additional, and Vestbo, Jørgen, additional

Published
2023
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109. The Association between Perceived Annoyances in the Indoor Home Environment and Respiratory Infections:A Danish Cohort Study with up to 19 Years of Follow-Up

Author

Kirkegaard, Anne Marie, Kloster, Stine, Davidsen, Michael, Christensen, Anne Illemann, Vestbo, Jørgen, Nielsen, Niss Skov, Ersbøll, Annette Kjær, and Gunnarsen, Lars

Subjects
Cohort Studies, respiratory infection, Home Environment, perceived annoyances, Asthma/epidemiology, Humans, Pneumonia/epidemiology, indoor environment, Pulmonary Disease, Chronic Obstructive/epidemiology, environmental epidemiology, Denmark/epidemiology, Follow-Up Studies
Abstract

The increasing prevalence of reported annoyances in the indoor environment threatens public health. This study aimed to investigate the association between perceived annoyances from the home environment and respiratory infections among individuals with and without asthma or chronic obstructive pulmonary disease (COPD). A total of 16,688 individuals from the Danish Health and Morbidity Survey initiated in 2000 were grouped according to their patterns of perceived annoyances. Information on respiratory infections (all causes, bacterial, viral, and those leading to hospital admissions) was obtained from Danish registers up to 19 years after the survey. Poisson regression of incidence rates (IRs) was applied to estimate incidence rate ratios (IRRs). Annoyances significantly increased the IR for respiratory infections of all causes and bacterial respiratory infections in individuals without asthma or COPD, adjusted IRR 1.16 (95% CI: 1.01, 1.34) and 1.15 (95% CI: 1.02, 1.31), respectively. However, no difference was observed for viral respiratory infections nor hospital admissions. Individuals with asthma or COPD and a high level of annoyances had a non-significantly increased IR in all four analyses of respiratory infections. These findings provide support for perceived annoyances as an important risk factor for respiratory infections.

Published
2023
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110. Additional file 3 of Fibrin degradation products and survival in patients with chronic obstructive pulmonary disease: a protocolized prospective observational study

Author

Kamstrup, Peter, Sivapalan, Pradeesh, Rønn, Christian, Rastoder, Ema, Modin, Daniel, Kristensen, Anna Kjaer, Bendstrup, Elisabeth, Sørensen, Rikke, Biering-Sørensen, Tor, Ulrik, Charlotte Suppli, Vestbo, Jørgen, and Jensen, Jens-Ulrik

Abstract

Additional File 3: Full information on the multiple linear regressions for pDAOH. Description of data: A table containing the full information in the multiple linear regression models mentioned in the manuscript.

Published
2023
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111. Additional file 2 of Fibrin degradation products and survival in patients with chronic obstructive pulmonary disease: a protocolized prospective observational study

Author

Kamstrup, Peter, Sivapalan, Pradeesh, Rønn, Christian, Rastoder, Ema, Modin, Daniel, Kristensen, Anna Kjaer, Bendstrup, Elisabeth, Sørensen, Rikke, Biering-Sørensen, Tor, Ulrik, Charlotte Suppli, Vestbo, Jørgen, and Jensen, Jens-Ulrik

Abstract

Additional File 2: Full information on the Cox proportional hazards regressions. Description of data: A table containing the full information on the Cox proportional hazards regressions mentioned in the manuscript.

Published
2023
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112. Additional file 4 of Fibrin degradation products and survival in patients with chronic obstructive pulmonary disease: a protocolized prospective observational study

Author

Kamstrup, Peter, Sivapalan, Pradeesh, Rønn, Christian, Rastoder, Ema, Modin, Daniel, Kristensen, Anna Kjaer, Bendstrup, Elisabeth, Sørensen, Rikke, Biering-Sørensen, Tor, Ulrik, Charlotte Suppli, Vestbo, Jørgen, and Jensen, Jens-Ulrik

Abstract

Additional File 4: Full information on the multiple linear regressions for the participants with 365 days possible follow-up. Description of data: A table containing the full information in the multiple linear regression models for the participants with 365 days possible follow-up, with the unit days.

Published
2023
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113. Additional file 1 of Fibrin degradation products and survival in patients with chronic obstructive pulmonary disease: a protocolized prospective observational study

Author

Kamstrup, Peter, Sivapalan, Pradeesh, Rønn, Christian, Rastoder, Ema, Modin, Daniel, Kristensen, Anna Kjaer, Bendstrup, Elisabeth, Sørensen, Rikke, Biering-Sørensen, Tor, Ulrik, Charlotte Suppli, Vestbo, Jørgen, and Jensen, Jens-Ulrik

Abstract

Additional File 1: Definition of diagnoses according to International Classification of Disease (ICD-10) codes and definition of treatments according to Anatomical Therapeutic Chemical (ATC)-codes. Description of data: A table containing definition of diagnoses (ICD-codes) and treatments (ATC-codes).

Published
2023
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117. Faster lung function decline in people living with HIV despite adequate treatment: a longitudinal matched cohort study

Author

Thudium, Rebekka Faber, primary, Ronit, Andreas, additional, Afzal, Shoaib, additional, Çolak, Yunus, additional, Forman, Julie Lyng, additional, Mendo, Fernando, additional, Chen, Fabian, additional, Estrada, Vicente, additional, Kumarasamy, Nagalingeswaran, additional, Nordestgaard, Børge G, additional, Lundgren, Jens, additional, Vestbo, Jørgen, additional, Kunisaki, Ken M, additional, and Nielsen, Susanne Dam, additional

Published
2023
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118. Prognostic factors for mortality, intensive care unit and hospital admission due to SARS-CoV-2: a systematic review and meta-analysis of cohort studies in Europe

Author

Vardavas, Constantine I., primary, Mathioudakis, Alexander G., additional, Nikitara, Katerina, additional, Stamatelopoulos, Kimon, additional, Georgiopoulos, Georgios, additional, Phalkey, Revati, additional, Leonardi-Bee, Jo, additional, Fernandez, Esteve, additional, Carnicer-Pont, Dolors, additional, Vestbo, Jørgen, additional, Semenza, Jan C., additional, Deogan, Charlotte, additional, Suk, Jonathan E., additional, Kramarz, Piotr, additional, Lamb, Favelle, additional, and Penttinen, Pasi, additional

Published
2022
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123. The Effect of Fatigue and Fatigue Intensity on Exercise Tolerance in Moderate COPD

Author

Al-shair, Khaled, Kolsum, Umme, Singh, Dave, and Vestbo, Jørgen

Subjects
Chronic obstructive lung disease -- Complications and side effects -- Diagnosis -- Care and treatment -- Research, Fatigue -- Physiological aspects -- Research, Exercise -- Physiological aspects -- Research, Health
Abstract

Introduction Fatigue is one of the most disabling symptoms in COPD, but little is known about the impact of fatigue on functional disability. We explored the impact of fatigue and fatigue intensity on exercise tolerance after adjusting for other factors using multivariate analysis and compared it to that of dyspnoea. Methods A total of 119 patients with mainly moderate-severe stable COPD (38 % women, mean age 66 years) were enrolled. We used the Medical Research Council dyspnoea scores (MRC), Manchester COPD fatigue scale (MCFS) and its three dimensions, Borg scales for fatigue and dyspnoea, six-minute walk distance (6MWD), St George's Respiratory Questionnaire, the BODE index, and the Centre for Epidemiological Study on Depression scale (CES-D), and we measured spirometry, blood gases, systemic inflammatory markers and fat-free mass index (FFMI). Results Fatigue measured using the MCFS was associated with 6MWD and explained 22 % of the variability in 6MWD (p < 0.001). Fatigue remained associated with 6MWD after adjusting for MRC dyspnoea, FFMI and FEV.sub.1, FVC, PaO.sub.2, PaCO.sub.2, CES-D, TNF-alpha, smoking status, age and gender. We found that 33, 50 and 23 % of patients reported an increase by 2 scores on Borg scales for fatigue, dyspnoea or both at the end of the 6MWT. Fatigue scores (both before and after the 6MWT) were negatively correlated with 6MWD after adjusting for FEV.sub.1, FFMI, CES-D score and age (p = 0.007 and 0.001, respectively). Conclusion In moderate stable COPD, fatigue may be a central driver of functional disability, to the same extent as dyspnoea., Author(s): Khaled Al-shair[sup.1] [sup.2] , Umme Kolsum[sup.1] , Dave Singh[sup.1] , Jørgen Vestbo[sup.1] Author Affiliations: (1) Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health [...]

Published
2016
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124. Prediction of non-recovery from ventilator-demanding acute respiratory failure, ARDS and death using lung damage biomarkers: data from a 1200-patient critical care randomized trial

Author

Jensen, Jens-Ulrik S., Itenov, Theis S., Thormar, Katrin M., Hein, Lars, Mohr, Thomas T., Andersen, Mads H., Løken, Jesper, Tousi, Hamid, Lundgren, Bettina, Boesen, Hans Christian, Johansen, Maria E., Ostrowski, Sisse R., Johansson, Pär I., Grarup, Jesper, Vestbo, Jørgen, Lundgren, Jens D., Steensen, M., Thornberg, K., Bestle, M., Strange, D., Lauritsen, A. Ø., Søe-Jensen, P., Reiter, N., Drenck, N. E., Fjeldborg, P., Fox, Z., Kjær, J., Kristensen, D., Rasmussen, M. B., Hallas, C. S.v., Zacho, M., Østergaard, C., Petersen, P. L., Hougaard, S., Mantoni, T., Nebrich, L., Bendtsen, A., Andersen, L. H., Bærentzen, F., Eversbusch, Andreas, Bømler, B., Martusevicius, R., Nielsen, T., Bådstøløkken, P. M., Grevstad, U., Hallas, P., Lindhardt, A., Galle, T., Graeser, K., Hohwu-Christensen, E., Gregersen, P., Pedersen, L. M., Rye, I., Cordtz, J., Madsen, K. R., Kirkegaard, P. R. C., Findsen, L., Nielsen, L. H., Pedersen, D. H., Andersen, J. H., Albrechtsen, C., Jacobsen, A., Jansen, T., Jensen, A. G., Jørgensen, H. H., Vazin, M., Lipsius, L., Skielboe, M., Thage, B., Thoft, C., Uldbjerg, M., Anderlo, E., Engsig, M., Hani, F., Jacobsen, R. B., Mulla, L., Skram, U., Waldau, T., Faber, T., Andersen, B., Gillesberg, I., Christensen, A., Hartmann, C., Albret, R., Dinesen, D. S., Gani, K., Ibsen, M., Petersen, J. A., Carl, P., Gade, E., Solevad, D., Heiring, C., Jørgensen, M., Ekelund, K., Afshari, A., Hammer, N., Bitsch, M., Hansen, J. S., Wamberg, C., Clausen, T. D., Winkel, R., Huusom, J., Buck, D. L., Grevstad, U., Lenz, K., Mellado, P., Karacan, H., Hidestål, J., Høgagard, J., Højbjerg, J., Højlund, J., Hestad, S., Østergaard, M., Wesche, N., Nielsen, S. A., Christensen, H., Blom, H., Jensen, C. H., Nielsen, K., Holler, N. G., Rossau, C. D., Glæemose, M., Wranér, M. B., Thomsen, C. B., Rasmussen, B., Lund-Rasmussen, C., Bech, B., Bjerregaard, K., Spliid, L., Nielsen, L. L. W., Larsen, K. M., Goldinger, M., Illum, D., Jessen, C., Christiansen, A., Berg, A., Elkmann, T., Pedersen, J. A. K., Simonsen, M., Joensen†, H., Alstrøm, H., Svane, C., Engquist, A., and For The Procalcitonin And Survival Study (PASS) Group

Published
2016
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125. Dwelling type and risk of chronic obstructive lung disease

Author

Kloster, Stine, primary, Kirkegaard, Anne Marie, additional, Davidsen, Michael, additional, Illemann Christensen, Anne, additional, Vestbo, Jørgen, additional, Skov Nielsen, Niss, additional, Gunnarsen, Lars, additional, and Kjær Ersbøll, Annette, additional

Published
2022
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127. Biomarkers of Clot Activation and Degradation and Risk of Future Major Cardiovascular Events in Acute Exacerbation of COPD: A Cohort Sub-Study in a Randomized Trial Population

Author

Kamstrup, Peter, primary, Sand, Jannie Marie Bülow, additional, Ulrik, Charlotte Suppli, additional, Janner, Julie, additional, Rønn, Christian Philip, additional, Rønnow, Sarah Rank, additional, Leeming, Diana Julie, additional, Jensen, Sidse Graff, additional, Wilcke, Torgny, additional, Mathioudakis, Alexander G., additional, Miravitlles, Marc, additional, Lapperre, Therese, additional, Bendstrup, Elisabeth, additional, Frikke-Schmidt, Ruth, additional, Murray, Daniel D., additional, Itenov, Theis, additional, Bossios, Apostolos, additional, Nielsen, Susanne Dam, additional, Vestbo, Jørgen, additional, Biering-Sørensen, Tor, additional, Karsdal, Morten, additional, Jensen, Jens-Ulrik, additional, and Sivapalan, Pradeesh, additional

Published
2022
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135. The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: a prospective analysis from the ECLIPSE study

Author

Coxson, Harvey O, Dirksen, Asger, Edwards, Lisa D, Yates, Julie C, Agusti, Alvar, Bakke, Per, Calverley, Peter MA, Celli, Bartolome, Crim, Courtney, Duvoix, Annelyse, Fauerbach, Paola Nasute, Lomas, David A, MacNee, William, Mayer, Ruth J, Miller, Bruce E, Müller, Nestor L, Rennard, Stephen I, Silverman, Edwin K, Tal-Singer, Ruth, Wouters, Emiel FM, and Vestbo, Jørgen

Published
2013
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146. Prognosis of Patients with COPD Not Eligible for Major Clinical Trials

Author

Çolak, Yunus, Nordestgaard, Børge G, Lange, Peter, Vestbo, Jørgen, and Afzal, Shoaib

Abstract

Rationale: Randomised controlled trials only include a subset of patients with chronic obstructive pulmonary disease(COPD) fulfilling strict inclusion criteria. Thus, most patients with COPD in a real-world setting do not have the necessary evidence to support treatment effectiveness. Objective: To test the hypotheses that most individuals with COPD in the general population are not represented in major clinical trials despite clinically significant disease with exacerbations and early death. Methods: In 105,630 adults from a Danish contemporary population-based cohort, we defined COPD as age≥40 years, chronic respiratory symptoms, history of smoking exposure, and airflow limitation with forced expiratory volume in 1 second(FEV1)/forced vital capacity(FVC)

Published
2022
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147. International Differences in the Frequency of COPD Exacerbations Reported in Three Clinical Trials

Author

Calverley, Peter M.a., Martinez, Fernando J., Vestbo, Jørgen, Jenkins, Christine R., Wise, Robert, Lipson, David A., Cowans, Nicholas J., Yates, Julie, Crim, Courtney, and Celli, Bartolome R

Abstract

Rationale: Exacerbations of chronic obstructive pulmonary disease are an important endpoint in multinational clinical treatment trials, but the observed event rate is often lower than anticipated and appears to vary between countries. Objectives: We investigated whether systematic differences in national exacerbation rates might explain this observed variation. Methods: We reviewed data from three large multicenter international randomized trials conducted over an 18-year period with different designs and clinical severities of chronic obstructive pulmonary disease, comparing bronchodilator and/or inhaled corticosteroids with bronchodilators alone and/or placebo. Exacerbations were defined by antibiotic and/or oral corticosteroid use (moderate) or need for hospitalization (severe). We calculated crude exacerbation rates in the 30 countries contributing 30 or more patients to at least two trials. We grouped data by exacerbation rate based on their first study contribution. Measurements and Main Results: For the 29,756 patients in 41 countries analyzed, the mean exacerbation rate was 2–3-fold different between the highest and lowest tertiles of the recruiting nations. These differences were not explained by demographic features, study protocol, or reported exacerbation history at enrolment. Of the 18 countries contributing to all studies, half of those in the highest and half in the lowest tertiles of exacerbation history remained in these groups across studies. Severe exacerbations showed a different rank order internationally. Conclusions: Countries contributing to chronic obstructive pulmonary disease trials differ consistently in their reporting of health care-defined exacerbations. These differences help explain why large studies have been needed to show differences between treatments that decrease exacerbation risk.

Published
2022
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149. Changes in lung function in European adults born between 1884 and 1996 and implications for the diagnosis of lung disease : a cross-sectional analysis of ten population-based studies

Author

Allinson, James P., Afzal, Shoaib, Çolak, Yunus, Jarvis, Debbie, Backman, Helena, van den Berge, Maarten, Boezen, H. Marike, Breyer, Marie-Kathrin, Breyer-Kohansal, Robab, Brusselle, Guy, Burghuber, Otto C., Faner, Rosa, Hartl, Sylvia, Lahousse, Lies, Langhammer, Arnulf, Lundbäck, Bo, Nwaru, Bright I., Rönmark, Eva, Vikjord, Sigrid A. Aalberg, Vonk, Judith M., Wijnant, Sara R. A., Lange, Peter, Nordestgaard, Børge G., Olvera, Nuria, Agusti, Alvar, Donaldson, Gavin C., Wedzicha, Jadwiga A., Vestbo, Jørgen, Vanfleteren, Lowie E. G. W., Allinson, James P., Afzal, Shoaib, Çolak, Yunus, Jarvis, Debbie, Backman, Helena, van den Berge, Maarten, Boezen, H. Marike, Breyer, Marie-Kathrin, Breyer-Kohansal, Robab, Brusselle, Guy, Burghuber, Otto C., Faner, Rosa, Hartl, Sylvia, Lahousse, Lies, Langhammer, Arnulf, Lundbäck, Bo, Nwaru, Bright I., Rönmark, Eva, Vikjord, Sigrid A. Aalberg, Vonk, Judith M., Wijnant, Sara R. A., Lange, Peter, Nordestgaard, Børge G., Olvera, Nuria, Agusti, Alvar, Donaldson, Gavin C., Wedzicha, Jadwiga A., Vestbo, Jørgen, and Vanfleteren, Lowie E. G. W.

Abstract

Background: During the past century, socioeconomic and scientific advances have resulted in changes in the health and physique of European populations. Accompanying improvements in lung function, if unrecognised, could result in the misclassification of lung function measurements and misdiagnosis of lung diseases. We therefore investigated changes in population lung function with birth year across the past century, accounting for increasing population height, and examined how such changes might influence the interpretation of lung function measurements. Methods: In our analyses of cross-sectional data from ten European population-based studies, we included individuals aged 20–94 years who were born between 1884 and 1996, regardless of previous respiratory diagnoses or symptoms. FEV1, forced vital capacity (FVC), height, weight, and smoking behaviour were measured between 1965 and 2016. We used meta-regression to investigate how FEV1 and FVC (adjusting for age, study, height, sex, smoking status, smoking pack-years, and weight) and the FEV1/FVC ratio (adjusting for age, study, sex, and smoking status) changed with birth year. Using estimates from these models, we graphically explored how mean lung function values would be expected to progressively deviate from predicted values. To substantiate our findings, we used linear regression to investigate how the FEV1 and FVC values predicted by 32 reference equations published between 1961 and 2015 changed with estimated birth year. Findings: Across the ten included studies, we included 243 465 European participants (mean age 51·4 years, 95% CI 51·4–51·5) in our analysis, of whom 136 275 (56·0%) were female and 107 190 (44·0%) were male. After full adjustment, FEV1 increased by 4·8 mL/birth year (95% CI 2·6–7·0; p<0·0001) and FVC increased by 8·8 mL/birth year (5·7–12·0; p<0·0001). Birth year-related increases in the FEV1 and FVC values predicted by published reference equations corroborated these findings. This heigh

Published
2022
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150. Plasma immunoglobulin E and risk of exacerbation and mortality in chronic obstructive pulmonary disease:A contemporary population-based cohort

Author

Çolak, Yunus, Sylvan Ingebrigtsen, Truls, Nordestgaard, Børge G., Marott, Jacob L., Lange, Peter, Vestbo, Jørgen, Afzal, Shoaib, Çolak, Yunus, Sylvan Ingebrigtsen, Truls, Nordestgaard, Børge G., Marott, Jacob L., Lange, Peter, Vestbo, Jørgen, and Afzal, Shoaib

Abstract

Background: Novel biomarkers and targeted treatments are needed for patients with chronic obstructive pulmonary disease (COPD). Objective: To test the hypothesis that high plasma immunoglobulin (Ig)E concentrations associate with increased risk of exacerbation and mortality in individuals with COPD in the general population. Methods: Among 46,598 adults in the Copenhagen General Population Study, we included 1559 with COPD, defined as forced expiratory volume in 1 second/forced vital capacity < 0.70 and forced expiratory volume in 1 second < 80% predicted in individuals aged ≥ 40 years with chronic respiratory symptoms and smoking exposure ≥ 10 pack-years, and without asthma. We assessed risk of future severe exacerbation and all-cause mortality according to baseline plasma IgE ≥ 76 IU/mL, a clinical cutoff for omalizumab treatment in severe asthma. Results: During 14 years of follow-up (median, 6.9; interquartile range, 3.4), we recorded 224 severe exacerbations and 434 deaths in 1559 individuals with COPD. Individuals with COPD with IgE ≥ 76 IU/mL vs those with < 76 IU/mL had a multivariable adjusted hazard ratio (HR) of 1.43 (95% confidence interval, 1.07-1.89) for severe exacerbation and 1.30 (1.05-1.62) for all-cause mortality. Compared with individuals with IgE < 76 IU/mL and blood eosinophils < 300 cells/µL, the multivariable adjusted HR for severe exacerbation was 1.12 (0.76-1.67) for those with IgE < 76 IU/mL and blood eosinophils ≥ 300 cells/µL, 1.62 (1.17-2.24) for IgE ≥ 76 IU/mL and blood eosinophils < 300 cells/µL, and 1.06 (0.63-1.77) for those with IgE ≥ 76 IU/mL and blood eosinophils ≥ 300 cells/µL. Corresponding HRs for all-cause mortality were 1.27 (0.99-1.63), 1.47 (1.14-1.88), and 1.17 (0.83-1.64), respectively. Conclusion: High plasma IgE was associated with an increased risk of severe exacerbation and all-cause mortality in individuals with COPD in the general population, independent of blood eosinophils.

Published
2022

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