A recent study showed that the use of respiratory distress symptom intervention (RDSI) has shown to be an effective and low-risk intervention in aiding the management of the respiratory distress symptom cluster in individuals diagnosed with lung cancer. This study’s findings were published in the journal, BMJ Supportive & Palliative Care.

A total of 263 patients diagnosed with lung cancer were enrolled in this clinical trial, with 132 patients assigned to receive RDSI and 131 patients assigned to receive standard care. To be eligible for the trial, participants had to self-report experiencing adverse effects in their daily lives from at least two out of the three symptoms, in any combination. The outcomes measured were the changes in each symptom within the cluster, namely Dyspnoea-12 (D-12), Functional Assessment of Chronic Illness-Fatigue, and Manchester Cough in Lung Cancer (MCLC) at the 12-week mark.

Nearly 60% of the participants reported experiencing all three symptoms at the baseline. By the end of the trial, there was a total attrition of 109 participants (41.4%). When compared to the control group, the RDSI group demonstrated a statistically significant improvement in D-12 (p=0.007) and MCLC (p<0.001). Each outcome reached the minimal clinically important difference (MCID): MCLC -5.49 (MCID >3), D-12 -4.13 (MCID >3), and FACIT-F 4.91 (MCID >4).

Thus, RDSI has proven its effectiveness and safety in supporting the management of the respiratory distress symptom cluster in patients with lung cancer. However, it is important to consider the significant attrition observed in the study while interpreting these findings.

According to a recent study, nintedanib exhibited reduced deterioration of dyspnoea, fatigue, and cough, along with the impact of interstitial lung disease (ILD) over a duration of 52 weeks in progressive pulmonary fibrosis (PPF) patients, as indicated by the changes in Living with Pulmonary Fibrosis (L-PF) questionnaire scores. This study's findings were published in the European Respiratory Journal.

This study included 663 patients who had a fibrosing[DKJ1] [SB2]  interstitial lung disease (ILD) other than idiopathic pulmonary fibrosis that affected more than 10% of their lungs on high-resolution computed tomography (HRCT) and met the interstitial lung disease progression criteria within before 24 months. They were randomly assigned in a 1:1 ratio to receive either nintedanib or placebo. Mixed models for repeated measures were used to analyze the variations in L-PF questionnaire scores from baseline to week 52.

The nintedanib group exhibited significantly smaller increases [worsening’s] in various measures when compared to the placebo group. The adjusted mean L-PF questionnaire total score showed a difference of 0.5 versus 5.1, symptoms score showed a difference of 1.3 versus 5.3, dyspnoea score showed a difference of 4.3 versus 7.8, and fatigue score showed a difference of 0.7 versus 4.0 at week 52. The nintedanib group exhibited a decrease in the L-PF cough score (-1.8) while the placebo group exhibited an increase in the cough score (4.3). Additionally, the L-PF impacts score exhibited a slight reduction (-0.2) in the nintedanib group while the placebo group exhibited an increase (4.6) in the impacts score. These findings were similar among patients with a usual interstitial pneumonia-like fibrotic pattern on HRCT as well as those with other fibrotic patterns on HRCT.

The above study demonstrated that nintedanib decreased the worsening of dyspnoea, fatigue, and cough, as well as the impact of ILD in patients with PPF throughout a 52-week period. This positive effect was measured by the changes observed in the scores of the L-PF questionnaire.

According to a recent study, maintaining an acceptable safety profile with the SVS treatment, produced statistically significant and clinically meaningful durable improvements for at least 24 months in lung function, respiratory symptoms, and quality-of-life (QOL), as well as a statistically significant reduction in dyspnea. This study was published in the Annals of the American Thoracic Society.

The EMPROVE was a multicenter randomized controlled trial that divided the participants into an SVS treatment group (n=102) and a control group (n=45). Lung function, quality-of-life (QOL), and respiratory symptoms were assessed for this study.

The results obtained at the end of the 24 months showed a significant improvement in forced expiratory volume in 1 second in the SVS treatment group. Numerous QOL measures, such as the COPD Assessment Test and the St. George's Respiratory Questionnaire, showed significant improvements. Less dyspnea was experienced by patients in the SVS treatment group, as depicted by the modified Medical Research Council dyspnea scale score. Acute chronic obstructive pulmonary disease exacerbation rates were 13.7% (n=14) and 15.6% (n=7) in the SVS treatment and control groups, respectively. Similarly, pneumothorax rates were 1.0% (n=1) and 0.0% (n=0) in the SVS treatment and control groups, respectively.

Based on the above results, it can be concluded that SVS treatment may result in durable improvements in lung function, respiratory symptoms, and QOL that are statistically significant and clinically meaningful. Also, there may be a statistically significant reduction in dyspnea for at least 24 months, with an acceptable safety profile.

In a recent study, it was shown that metoprolol significantly decreased the risk of bucking during extubation in patients who underwent general anesthesia when compared to the placebo. This study’s findings were published in the Brazilian journal of anesthesiology (Elsevier).

This was a double-blind, placebo-controlled randomized trial that included 207 patients, comprising both males and females aged between 18 and 80 years, with an American Society of Anesthesiologists (ASA) physical status I–III. These patients were randomly allocated into two groups: one group received intravenous metoprolol 5 mg IV (n=102) while the other group received a placebo (n=105) post-surgery. The primary endpoint of the study was to assess the percentage of patients who exhibited bucking as a result of endotracheal tube stimulation of the tracheal mucosa during extubation. Secondary outcomes evaluated included coughing, laryngospasm, bronchospasm, Heart Rate (HR) levels, and Mean Arterial Pressure (MAP).

At the end of the study, the incidence of bucking was significantly lower in patients who were received metoprolol (43.1% vs. 64.8%). In the metoprolol group, 6 (5.9%) patients experienced moderate/severe coughing, while 33 (31.4%) in the placebo group reported the same.

The above results demonstrated that in patients undergoing general anesthesia, metoprolol was found to significantly lower the risk of bucking during extubation when compared with the placebo.