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This action of thinning the mucus and reducing inflammation, plus a clinical trial using NAC 1200 mg/day that reduced the rate of exacerbations and improved quality of life in chronic obstructive pulmonary disease patients, suggests that it could be helpful for those with bronchiectasis as well.
Starting with the emergency department, the diagnosis was COPD exacerbation with no differential diagnosis in any note.
Patients who were >40 ages, who were previously diagnosed as COPD by spirometry (forced expiratory volume in 1 s [FEV1]/forced vital capacity [FVC] <%70) and hospitalized at least once due to COPD exacerbation, who had medical record that was taken in stable phase of the disease, and who had at least 3 months between exacerbation period and stable phase were enrolled into the study.
M2 EQUITYBITES-October 12, 2018-Boehringer Ingelheim passes US FDA's for new label for Stiolto Respimat Inhalation Spray for reduction in COPD exacerbations
Goals of COPD management are to relieve symptoms, improve exercise tolerance and QoL, and reduce exacerbation risk and severity.
Between treatments, there was no difference in the annualized rate of moderate or severe COPD exacerbations (rate ratio, 1.08; 95 percent confidence interval, 0.83 to 1.4).
There is an association between eosinophilia and thromboembolism, and eosinophil activation increases the possibility of thrombosis formation.[42],[43],[44],[45],[46],[47] However, whether eosinophil activation markers can predict PE in patients with COPD exacerbation is still unclear.
He acknowledged certain limitations of the study, including its 6-month duration, which is shorter than most exacerbation studies.
Information was collected regarding potential factors causing frequent exacerbation including patient education about disease and treatment, upper respiratory tract infections (URTI), allergen exposure, drug history, treatment step, medication compliance, inhaler technique, emotions, exercise, hormonal influences, recent hospital and previous ICU admission, afterhours' hospital visit, smoking, diabetes mellitus (DM), sinusitis, GERD, obesity, obstructive sleep apnea(OSA) and depression.
The evaluation of COPD longitudinally to identify predictive surrogate endpoints (ECLIPSE) study first identified frequent exacerbators as the subgroup of COPD patients undergoing 2 or more exacerbation episodes per year (Reinhold et al., 2017).
In a study by Majak et al1 it was found that exacerbation in bronchial asthma caused by respiratory tract infections can be prevented by vitamin D supplementation.
The exacerbation at baseline was present in all 120(100%) patients and at 6th month was reduced to 4(3.3%).