MANAGEMENT OF COPD IN PATIENTS 慢性阻塞性肺疾病患者的药物治疗课件.pptVIP

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MANAGEMENT OF COPD IN PATIENTS 慢性阻塞性肺疾病患者的药物治疗课件.ppt

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MANAGEMENT OF COPD IN PATIENTS 慢性阻塞性肺疾病患者的药物治疗课件

CONCLUSIONS Beta–blockers and other cardiac drugs are safe in COPD Statins may improve COPD outcomes but proper trial data are needed Oral therapies produce more GI upset, oral corticosteroids long term are hazardous Inhaled corticosteroids do not seem to accelerate osteoporosis but some may induce pneumonia LAMA and LABA treatment is safe in COPD – anti-inflammatory therapy may improve cardiac outcomes On balance our treatments are more friend than foe * * SAFETY (BU) * Importantly, CCL3 and CXCL9 in lungs of patients afflicted from COPD were shown to correlate with COPD disease severity. (Freeman et al. AJPathol. 2007) and CXCL10 was found augmented in induced sputum of COPD patients (Costa et al. Chest. 2008). * * SAFETY (BU) * Objective: differential loss by BMI Punchline: Obese patients on roflumilast lose the greatest percentage of weight. Underweight lose the least amount of weight Speaker notes In the 6-month clinical study in which patients received Daxas? or placebo in addition to tiotropium, the mean weight loss was 2.1kg more in the Daxas? group compared with placebo group (95% CI -2.5, -1.7; p0.0001).1,2 BMI fell gradually in Daxas?-treated patients, until reaching a plateau at 18 weeks of treatment (mean decrease –0.73 kg/m2). No significant change in BMI was observed in patients taking placebo during the 24-week treatment period (mean decrease 0.03 kg/m2).2 The overall mean difference in BMI between Daxas?-treated and placebo-treated patients was –0.76 kg/m2 (95% CI –0.89, –0.62; p0.0001).2 Bioimpedance measurements indicated a decrease in fat free muscle mass during the first 4 weeks of Daxas? treatment. There was no significant difference between the change in FFMI in Daxas?-treated and placebo-treated patients (mean difference -0.311kg/m2, 95% CI -0.532 to -0.090; p=0.0059).2 These data indicate that the weight loss associated with Daxas? was primarily fat mass and probably not owing to continued loss of muscle mass. References Fabbri LM, Cal