Nintedanib reduced worsening of symptoms in patients with progressive pulmonary fibrosis

A recent study suggests that nintedanib reduces worsening of dyspnoea, fatigue and cough and the impacts of interstitial lung disease (ILD) over 52 weeks in patients with progressive pulmonary fibrosis (PPF). The findings of this study were published in the European Respiratory Journal.

The INBUILD trial included 663 patients with fibrosing interstitial lung disease (ILD) of >10% extent on high-resolution computed tomography (HRCT). These subjects met the criteria for ILD progression within the prior 24 months. The patients were randomized in a 1: 1 ratio to receive either nintedanib or placebo. The impact of pulmonary fibrosis in patients with progressive pulmonary fibrosis (PPF) was assessed using the Living with Pulmonary Fibrosis (L-PF) questionnaire.

At the end of the study (52 weeks), it was found that there was significantly smaller worsenings in adjusted mean L-PF questionnaire total scores in the nintedanib group when compared to the placebo (0.5 versus 5.1), symptoms (1.3 versus 5.3), fatigue (0.7 versus 4.0), and dyspnoea (4.3 versus 7.8). A decrease in the L-PF questionnaire cough score was observed in the nintedanib group, while an increase was noted in the placebo group (-1.8 versus 4.3). L-PF questionnaire impacts score also decreased slightly in the nintedanib group and increased in the placebo group (-0.2 versus 4.6).

Based on the above results, it can be concluded that changes in L-PF questionnaire scores may show that nintedanib reduces worsening of dyspnoea, fatigue, and cough and may also impact ILD over 52 weeks in patients with PPF.

Doxycycline is safe and prevents the severity in COVID-19

A latest study reported that doxycycline is safe, inexpensive and reduces the need for ICU admission when added to SoC in covid-19 patients. This study was published in the Journal, PLos One.

This randomized, controlled, open labelled, parallel group study included 387 patients aged 40-90 years were randomised to receive treatment with SoC plus doxycycline or SoC only. The primary outcome was the need for ICU admission as judged by the attending physicians.

Doxycycline was associated with a relative risk reduction (RRR) and absolute risk reduction (ARR) were Intent to treat 31.6% RRR, 7.4% ARR, Per protocol  40.7% RRR, 9.6% ARR, As treated 43.2% RRR, 10.8% ARR.

Based on the results of the study, it can be concluded that doxycycline reduces the need for ICU admission when added to SoC.

Oscillatory positive expiratory pressure devices improve the quality of life in COPD patients

According to a new study, oscillatory positive expiratory pressure (OPEP) devices were found to improve the symptoms and quality of life in COPD patients. This study was published in the journal, Thorax.

A randomized controlled trial enrolled 122 stable patients with COPD, who reported sputum production every day or on most days. This trial compared 61 participants for a period 3 months of using an OPEP device (test group) against 61 participants getting usual care (control group).

The use of OPEP devices was associated with an improvement in the cough-related quality of life in the test group when compared to the control group measured using the Leicester Cough Questionnaire (LCQ). The Functional Assessment of Chronic Illness Therapy (FACIT score) and generic quality of life demonstrated improved symptoms, an improvement in cough frequency was also seen in the OPEP group compared to the control group.

Late and early persistent coughs without a cold are associated with atopic diseases

According to a recent study, late and early persistent coughs without a cold are positively associated with atopic respiratory diseases and food allergies. The journal, Clinical and Experimental Allergy published these results.

The study aimed to record the latent class trajectories of cough from one to 10 years old and analyse their association with wheezing, atopy, and allergic diseases. Questions about cough, wheeze, and allergic diseases were asked at 1, 1.5, 2, 3, 4, 5, 6, and 10 years of age. At 10 years of age, specific IgE assays were performed. A cough latent class model was developed over time in response to questions about a cough without a cold.

Of the 961 patients included in the study, apart from the never/infrequent trajectory, eight other trajectories of cough without a cold were identified. The other trajectories were significantly associated with wheezing, asthma, and allergic rhinitis when compared to the never/infrequent trajectory.

Thus, it was found that late and early persistent coughs were linked to atopic respiratory diseases and food allergies. In addition, children with recurrent coughs without a cold may benefit from an asthma and allergy assessment.