The most-read chronic obstructive pulmonary disease (COPD) articles of the year covered use of inhaled corticosteroids, palliative care for advanced COPD, and off-label prescribing of COPD therapies.
The top 5 most-read articles on chronic obstructive pulmonary disease (COPD) published on AJMC.com evaluated the use of inhaled corticosteroids (ICS), palliative care in advanced COPD, and off-label prescribing of COPD therapies in the United Kingdom.
Here are the most-read COPD articles of 2021.
5. Specialized Palliative Care Often More Effective for Advanced COPD, Study Suggests
At the end of life, patients with COPD have a heavy symptom burden. This study from Sweden found that patients with late-stage COPD received more controlled palliative care when they were treated in specialized palliative care compared with a hospital.
The authors noted that patients with COPD admitted to specialized palliative care needed fewer emergency department visits and were less likely to die in a hospital setting.
4. ICS Withdrawal Not Found to Increase Risk of COPD-Related Exacerbations
Patients with COPD who have an exacerbation are often prescribed ICS, but these drugs are frequently overprescribed. To prevent adverse effects, ICS withdrawal is recommended for those patients who are not indicated to be treated with ICS.
This study analyzed 1046 patients who would stop taking ICS and 21,577 controls who would continue to use ICS. The researchers found that the cessation group and the control group had nearly equal amounts of exacerbations. However, they did identify a subgroup of patients with more frequent courses of oral corticosteroids and high blood eosinophil counts who should not be withdrawn from ICS.
3. UK Study Finds Off-Label Prescribing of COPD Therapies Is Low
A study on the prescribing patterns for umeclidinium bromide (UMEC) and umeclidinium and vilanterol (UMEC/VI) found that these therapies are rarely prescribed to patients without COPD. The researchers did find that 3.4% of UMEC users and 3.1% of UMEC/VI users had asthma.
Compared with the clinical trial findings, real-world data show that the safety profiles of UMEC and UMEC/VI were unchanged.
2. Improving COPD Care With Remote Patient Monitoring
Remote patient monitoring (RPM) is an efficient way to diagnose and treat COPD, according to this paper. Because patients may not recognize changes that indicate a decline, worsening COPD symptoms are often underreported; however, RPM represents an objective way to measure patients and their changes.
The paper demonstrates the successful utilization of RPM for COPD by describing the case of an 84-year-old man in whom the clinical care team identified physiological changes and were able to proactively engage and assess the patient.
1. Analysis Buttresses Idea That Inhaled Corticosteroids in COPD Guard Against Lung Cancer
Patients with COPD have an increased risk of developing lung cancer, but a meta-analysis found that ICS may provide some protection against lung cancer for patients with COPD. The analysis of 9 studies from around the world found ICS has a protective effect against lung cancer in patients with COPD.
The authors suggested the reason for the protective effect may be because ICS prevents epithelial-mesenchymal transition in airways of patients with COPD.