News briefs: May issue of the journal Chest

May 05, 2008

LATEST REVIEW SUGGESTS LABAs ARE SAFE AND EFFECTIVE FOR COPD

Previous research has linked the use of long-acting β2-agonists (LABA) to increased risk for adverse events or respiratory-related death in patients with stable, moderate to severe chronic obstructive pulmonary disease (COPD); however, a recent article shows this may not be the case. In a new metaanalysis, researchers from Spain, Argentina, and Uruguay reviewed the results of 27 randomized controlled clinical trials that met the following criteria: (1) study patients were over the age of 35 with stable COPD; (2) intervention included inhaled LABAs vs placebo, inhaled ipratropium bromide, or inhaled tiotropium; (3) studies were of at least 4 weeks' duration; and (4) primary outcomes included severe exacerbations, all-cause mortality, and respiratory-related death. The review found that compared with placebo, LABAs reduced severe exacerbations by 21%, and patients given LABAs did not differ in all-cause or respiratory-related mortality. The review also found that LABA treatment was associated with significantly more severe COPD exacerbations compared with tiotropium. This study is published in the May issue of the journal CHEST.

ARDS MORTALITY RATES DECLINING

New research shows that, over the last decade, mortality rates for patients with acute respiratory distress syndrome (ARDS) or acute lung injury (ALI) have steadily declined. In a metaanalysis, Belgian researchers reviewed 72 studies published between 1994 and 2006 that reported mortality rates for patients with ARDS or ALI. Mortality rates ranged from 15 to 72%, with the overall pooled mortality rate being 43%. Further analysis showed a significant decrease in overall mortality rates of approximately 1.1% per year over the decade analyzed. The decrease in mortality was more pronounced for hospital mortality than for mortality in the ICU. Researchers speculate that the decline in mortality may be the result of improvements in the treatment of patients with ARDS/ALI. This study is published in the May issue of the journal CHEST.

SMOKING PATTERN LINKED TO RARE PNEUMONIA

Acute eosinophilic pneumonia (AEP), a rare lung condition, may be associated with recent changes in smoking patterns. In a new study, Japanese researchers reviewed the smoking history and current smoking habits of 33 patients with AEP. All but one patient (97%) were current smokers. Alterations in smoking habits, such as initiating the smoking habit or increasing the number of cigarettes smoked, were seen in 87.9% of patients. Furthermore, a cigarette smoke provocation test was performed in nine patients, and all tested positive. Data suggest that cigarette smoking, particularly changes in smoking habits, is a possible AEP etiologic factor. This study is published in the May issue of the journal CHEST.
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American College of Chest Physicians

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