PMID- 28182151
OWN - NLM
STAT- MEDLINE
DCOM- 20171011
LR  - 20181113
IS  - 1178-2005 (Electronic)
IS  - 1176-9106 (Print)
IS  - 1176-9106 (Linking)
VI  - 12
DP  - 2017
TI  - Patterns and characterization of COPD exacerbations using real-time data 
      collection.
PG  - 427-434
LID - 10.2147/COPD.S126158 [doi]
AB  - INTRODUCTION: Patients with chronic obstructive pulmonary disease often 
      experience exacerbations. These events are important as they are a major cause of 
      morbidity and mortality. Recently, it has been increasingly recognized that 
      patients may experience symptoms suggestive of an exacerbation but do not seek 
      treatment, which are referred to as unreported or untreated exacerbations. 
      Symptom diaries used in clinical trials have the benefit of identifying both 
      treated and untreated exacerbation events. METHODS: The Kamada study was a 
      multicenter, double-blind randomized controlled trial of inhaled augmentation 
      therapy in alpha-1 antitrypsin deficiency (AATD). A retrospective review of daily 
      electronic symptom diary cards was undertaken from the two leading centers to 
      identify symptomatic episodes consistent with a definition of an exacerbation. 
      The aims were to explore the relationship between exacerbation events and 
      classical "Anthonisen" symptoms and to characterize treated and untreated 
      episodes. RESULTS: Forty-six AATD patients with airflow obstruction and history 
      of exacerbations were included in the analysis. Two hundred thirty-three 
      exacerbation episodes were identified: 103 untreated and 130 treated. Untreated 
      episodes were significantly shorter (median 6 days; interquartile range [IQR] 
      3-10 days) than the treated episodes (median 10 days; IQR 5-18.25 days: P<0.001). 
      Using logistic regression analysis, Anthonisen type and length of dyspnea were 
      significant predictors of the treatment of an exacerbation event. CONCLUSION: 
      Real-time electronic diary cards provide valuable information about the 
      characterization of exacerbations. Untreated episodes are common and are 
      significantly shorter in duration than the treated episodes. Dyspnea is the most 
      important single Anthonisen symptom in the prediction and/or driver of treatment.
FAU - Ejiofor, Stanley I
AU  - Ejiofor SI
AD  - Centre for Translational Inflammation Research, University of Birmingham; ADAPT 
      Project, University Hospital Birmingham, Birmingham, UK.
FAU - Stolk, Jan
AU  - Stolk J
AD  - Leiden University Medical Centre, Leiden, the Netherlands.
FAU - Fernandez, Pablo
AU  - Fernandez P
AD  - Independent consultant, Penn, UK.
FAU - Stockley, Robert A
AU  - Stockley RA
AD  - Centre for Translational Inflammation Research, University of Birmingham; ADAPT 
      Project, University Hospital Birmingham, Birmingham, UK.
LA  - eng
PT  - Journal Article
DEP - 20170125
PL  - New Zealand
TA  - Int J Chron Obstruct Pulmon Dis
JT  - International journal of chronic obstructive pulmonary disease
JID - 101273481
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Bronchodilator Agents)
RN  - 0 (alpha 1-Antitrypsin)
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenal Cortex Hormones/*administration & dosage/adverse effects
MH  - Adult
MH  - Anti-Bacterial Agents/*administration & dosage/adverse effects
MH  - Bronchodilator Agents/*administration & dosage/adverse effects
MH  - Chi-Square Distribution
MH  - Disease Progression
MH  - Dyspnea/etiology/physiopathology
MH  - Electronic Health Records
MH  - England
MH  - *Enzyme Replacement Therapy/adverse effects
MH  - Female
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Logistic Models
MH  - Lung/*drug effects/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Multicenter Studies as Topic
MH  - Netherlands
MH  - Pulmonary Disease, Chronic Obstructive/diagnosis/*drug 
      therapy/etiology/physiopathology
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vital Capacity
MH  - alpha 1-Antitrypsin/*administration & dosage/adverse effects
MH  - alpha 1-Antitrypsin Deficiency/complications/diagnosis/*drug 
      therapy/physiopathology
PMC - PMC5279955
OTO - NOTNLM
OT  - COPD
OT  - alpha-1 antitrypsin deficiency
OT  - exacerbations
COIS- SIE was funded by a noncommercial grant from CSL Behring. The authors report no 
      other conflicts of interest in this work.
EDAT- 2017/02/10 06:00
MHDA- 2017/10/12 06:00
PMCR- 2017/01/25
CRDT- 2017/02/10 06:00
PHST- 2017/02/10 06:00 [entrez]
PHST- 2017/02/10 06:00 [pubmed]
PHST- 2017/10/12 06:00 [medline]
PHST- 2017/01/25 00:00 [pmc-release]
AID - copd-12-427 [pii]
AID - 10.2147/COPD.S126158 [doi]
PST - epublish
SO  - Int J Chron Obstruct Pulmon Dis. 2017 Jan 25;12:427-434. doi: 
      10.2147/COPD.S126158. eCollection 2017.