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Titre : Effects of varenicline on smoking cessation in mild-to moderate COPD : a randomized controlled trial Type de document : texte imprimé Auteurs : D.P. Tashkin, Auteur ; Stephen I Rennard, Auteur ; J. Taylor Hays, Auteur Editeur : American College of Chest Physicians Année de publication : 2010 Collection : Chest, ISSN 0012-3692 Importance : 30 p. Présentation : tab. Langues : Français (fre) Catégories : [TABAC] étude
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche pharmacologique:varéniclineIndex. décimale : TA 6.2.3.1.4 Autres substituts nicotiniques Résumé : BACKGROUND:
Smoking is the most important risk factor for COPD and accelerates its progression. Despite the health implications, a large proportion of patients with COPD continue to smoke, so finding effective smoking cessation interventions for this population is paramount. To our knowledge, this is the first randomized clinical trial to compare the efficacy and safety of varenicline tartrate vs placebo in smokers with mild to moderate COPD.
METHODS:
In a 27-center, double-blind, multinational study, 504 patients with mild to moderate COPD (postbronchodilator FEV1/FVC, <70%; FEV1 percent predicted normal value, ≥50%) and without known psychiatric disturbances were randomized to receive varenicline (n=250) or placebo (n=254) for 12 weeks, with a 40-week nontreatment follow-up. The primary end point was carbon monoxide-confirmed continuous abstinence rate (CAR) for weeks 9 to 12. A secondary end point was CAR for weeks 9 to 52.
RESULTS:
CAR for weeks 9 to 12 was significantly higher for patients in the varenicline group (42.3%) than for those in the placebo group (8.8%) (OR, 8.40; 95% CI, 4.99-14.14; P<.0001). CAR in the patients treated with varenicline remained significantly higher than in those treated with placebo through weeks 9 to 52 (18.6% vs 5.6%) (OR, 4.04; 95% CI, 2.13-7.67; P<.0001). Nausea, abnormal dreams, upper-respiratory tract infection, and insomnia were the most commonly reported adverse events (AEs) for patients in the varenicline group. Serious AEs were infrequent in both treatment groups. Two patients in the varenicline group and one patient in the placebo group died during the study. Reports of psychiatric AEs were similar for both treatment groups.
CONCLUSIONS:
Varenicline was more efficacious than placebo for smoking cessation in patients with mild to moderate COPD and demonstrated a safety profile consistent with that observed in previous trials.Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=7933 Exemplaires (1)
Code-barres Cote Support Localisation Section Disponibilité TA 005474 TA 6.2.3.1.4 TAS E Article/Périodique Bibliothèque FARES Tabac Consultation sur place
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The effect of smoking intervention and an inhaled bronchodilator on airways reactivity in COPD / Robert A. Wise (2003)
Titre : The effect of smoking intervention and an inhaled bronchodilator on airways reactivity in COPD Type de document : document électronique Auteurs : Robert A. Wise, Auteur ; Richard E. Kanner, Auteur ; Paula Lindgren, Auteur Editeur : American College of Chest Physicians Année de publication : 2003 Collection : Chest, ISSN 0012-3692 num. 124(2) Importance : p. 448-459 Présentation : graph.; tab. Langues : Anglais (eng) Catégories : [DIVERS] personne:par âge:adulte
[TABAC] étude
[TABAC] sevrage tabagique:effet du sevrage
[TABAC] tabagisme:pathologie:pathologie respiratoire:broncho-pneumopathie chronique obstructiveIndex. décimale : TA 6.10 Conséquences / effets à long-terme du sevrage Résumé : Background:
The Lung Health Study (LHS), a 5-year, randomized, prospective clinical trial, studied the effects of smoking intervention and therapy with inhaled anticholinergic bronchodilators on FEV(1) in participants who were 35 to 60 years of age and had mild COPD. Participants were randomized into the following three groups: usual care; smoking cessation plus inhaled ipratropium bromide; and smoking cessation plus placebo inhaler. This report evaluates the effects of these interventions, demographic characteristics, smoking status, and FEV(1) changes on airway responsiveness (AR).
Methods and results:
Of 5,887 participants, 4,201 underwent methacholine challenge testing both at study entry and study completion. All groups increased AR during the 5-year period. The increase in AR was greatest in continuing smokers and was associated with a greater FEV(1) decline. An intent-to-treat analysis indicated no significant differences in AR changes among the three groups.
Conclusions:
Changes in AR over a 5-year period in the LHS were primarily related to changes in the FEV(1). The greater the decline in FEV(1), the greater the increase in AR. Smoking cessation had a small additional benefit in AR beyond its favorable effects on FEV(1) changes.En ligne : https://doi.org/10.1378/chest.124.2.449 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10535 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Vaping-induced secondary organizing pneumonia versus e-cigarette or vaping product usa-associated lung injury (evali) : different spectrum of the same entity? Type de document : document électronique Auteurs : Sameer M. Javed, Auteur ; Sina Moridzadeh, Auteur ; Fernando Fuentes, Auteur Editeur : American College of Chest Physicians Année de publication : 2023 Collection : Chest, ISSN 0012-3692 num. 164 Importance : 2 p. Langues : Anglais (eng) Catégories : [TABAC] CANDIDATS:e-cigarette
[TABAC] tabagisme:pathologie:pathologie respiratoireIndex. décimale : TA 1.1.1 Cigarettes (« normales », électroniques, aromatisées,…) Résumé : INTRODUCTION:
Cryptogenic Organizing Pneumonia (COP) is a form of interstitial lung disease characterized histologically by patchy filling of alveoli and bronchioles with loose plugs of connective tissue, termed Masson bodies. Secondary organizing pneumonia (SOP) is defined when there is an identified cause (1). Vaping-induced SOP is not extensively defined in literature, with e-cigarette or vaping use-associated lung injury (EVALI) in the differential diagnosis, it is difficult to distinguish EVALI from vaping-induced SOP due to overlapping clinical, radiologic, and histopathologic findings with the provocative thought that they could be the same entity but a different spectrum of the disease? In this case report, we present such a diagnostic challenge and
dilemma.
CASE PRESENTATION:
A 36-year-old woman who presented with 2 weeks of shortness of breath, wheezing, cough, malaise/ fatigue, ageusia and congestion, progressed to acute hypoxic respiratory failure requiring admission. Social history was significant for a pet cockatiel, 1 pack-year history, and recent new use of THC vaporizer roughly 5 weeks prior to admission. An extensive work up was negative including COVID-19, respiratory viral panel, fungal and connective tissue disease panels, and hypersensitivity pneumonitis studies. A CTA chest showed scattered patchy ground glass pulmonary infiltrates (Figure 1). Bronchoscopy showed dynamic airway collapse of distal trachea, diffuse erythema, mild edema of all airway mucosa, and degenerated mixed inflammation and mucoid debris. Histology also showed fibroblastic tissue within the airspace consistent with organizing pneumonia as well as a focus of chronic inflammation (Figure 2). No lipid-laden macrophages were seen.
DISCUSSION:
The number of vape consumers is continually increasing, with the e-cigarette market projected to reach 104.51 billion US dollars by 2028 (2). However, with the rise of the COVID-19 pandemic, the incidence or reports of vaping-related pulmonary disease decreased substantially following its peak in September 2019. The CDC decided to discontinue the collection of EVALI case reports in February 2020, this in turn has caused a paucity in literature regarding vaping-related pulmonary disease. Although differentiating vaping-induced SOP and EVALI can diagnostically be difficult, a distinction can be made with presence of lipid-laden macrophages (LLM) on biopsy findings seen in greater than 80% of patients with EVALI as well as the presence of
gastrointestinal (GI) symptoms seen in 90% of patients during EVALI's clinical course according to the literature (3). Our case therefore was defined as vaping-induced SOP, but it seems hard to ignore that this could represent the same entity with a different spectrum of the disease.
CONCLUSIONS:
Algorithmic approaches to COP have been proposed in the literature (1). However, a good quality evidencebased process to the diagnosis of EVALI is lacking in this setting. Although our patient's presentation and work-up was more consistent with the diagnosis of vaping-induced SOP, the gray area between COP, SOP, and EVALI necessitates further research as the use of vaping devices continues to rise.En ligne : http://dx.doi.org/10.1016/j.chest.2023.07.2151 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10276 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
