Mucus Plugs Linked to Higher Mortality in COPD
A study led by researchers from Brigham and Women’s Hospital suggests treating the mucus plugs common in people with COPD could help reduce mortality from the disease.
The investigation, which was published in JAMA and presented at the recent American Thoracic Society meeting, consisted of an observational retrospective analysis of data on 4,000 people taking part in the COPDGene study. Chest CT scans from the first visit the participants made to the clinic were analyzed to determine which patients had mucus plugs. Over the course of the study, the researchers found a 34% mortality rate among participants without mucus plugs vs. 46.7% for those with mucus plugs.
Patients who had mucus plugs in three or more segments of the lungs had a mortality rate of 54.1%.
While the study authors note they don’t know what is driving the association between mucus plugs and mortality, they believe therapies to break these plugs up could lead to better outcomes for people with COPD. They also believe clinicians should consider whether more patients could benefit from a CT-scan to look for mucus plugs. Read More
New Antibiotic for Deadly Hospital-Acquired Pneumonia May Be on the Way
A new antibiotic aimed at treating a particularly deadly strain of pneumonia most often acquired during a hospital stay could be available as early as this fall.
Researchers from Rutgers and the Robert Wood Johnson Medical School have found that the combination antibiotic sulbactam-durlobactam is at least as effective in treating carbapenem-resistant Acinetobacter baumannii–calcoaceticus complex (ABC) as the current best treatment, colistin.
In the trial, 181 patients with laboratory-confirmed ABC received imipenem–cilastatin, then were randomized to additional treatment with either sulbactam–durlobactam or colistin. Mortality after day 28 was 19% in the sulbactam–durlobactam group vs. 32% in the colistin group.
The combination drug was also less likely to cause kidney injury and adverse events than the single drug and can be administered to all patients at the same injectable dose, while colistin must be dosed according to weight.
The researchers believe these results are promising, but say a larger study is needed to see if the finding persists in a real world setting.
An FDA expert committee believes it is worth a shot. The committee unanimously recommended to the FDA that it approve the new drug combination.
The authors note the drug combination isn’t a wide spectrum antibiotic but it does work well against this very dangerous strain. “If all moves quickly, infected patients could begin receiving sulbactam-durlobactam as part of normal clinical care the second half of this year,” said study author Keith Kaye, chief of the Division of Allergy, Immunology and Infectious Disease at Robert Wood Johnson Medical School.
The study was published in The Lancet Infectious Diseases. Read More
Home Oscillometry May Help Ward Off AECOPD
Could home oscillometry (OSC) provide an early warning system for AECOPD? According to researchers presenting at the recent American Thoracic Society meeting, the answer may be yes.
They reached that conclusion after conducting a six-month, double-blind study involving 18 patients who performed unsupervised OSC measurements at home based on 30 to 60 seconds of tidal breathing using a portable device. The patients were not able to see the results of the test. They all completed the COPD Assessment Test (CAT) twice a day for more than 30 days as well.
The investigators kept track of acute exacerbations of COPD (AECOPD) that occurred in the group, finding 15 moderate-to-severe AECOPD events during the study period. Significant changes were seen in the OSC regression parameter five to seven days prior to the start of the AECOPD.
Lower variability was seen for the OSC measurement than for the CAT scores, leading the researchers to conclude that daily oscillometry may a better way to “identify a window of opportunity for preventing exacerbations of COPD.”
Patients in the study were age 40 or older and were suffering from GOLD classification II-III, C-D, COPD. Standard of care for COPD management continued throughout the study for all participants. Read More
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