Do we really need asthma–chronic obstructive pulmonary disease overlap syndrome?

Dear Respiratory friends we are happy to present you exciting article from The Journal of Allergy and Clinical Immunology by our Italian friends Mario Cazzola and Paola Rogliani on Hot Topic: Do we really need asthma–chronic obstructive pulmonary disease overlap syndrome? 

The association of asthma and chronic obstructive pulmonary disease (COPD) in the same patient, which is designated as mixed asthma-COPD phenotype or overlap syndrome (ACOS), remains a controversial issue. This is primarily because many conflicting aspects in the definition of ACOS remain, and it is extremely difficult to summarize the distinctive features of this syndrome. Furthermore, we are realizing that asthma, COPD, and ACOS are not single diseases but rather syndromes consisting of several endotypes and phenotypes and, consequently, comprising a spectrum of diseases. The umbrella term ACOS blurs the lines between asthma and COPD and allows an approach that simplifies therapy. However, this approach contradicts the modern concept according to which we must move toward more targeted and personalized therapies to treat patients with these diseases.  

Therefore we argue that the term ACOS must be abandoned and ultimately replaced when new phenotypes and underlying endotypes are identified and a new taxonomy of airway diseases is generated.

Full text:

http://www.jacionline.org/article/S0091-6749(16)30368-2/fulltext

GOLD 2016 update on Asthma-COPD Overlap Syndrome (Link for free download)

Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent chronic diseases in the general population. Both are characterized by similar mechanisms: airway inflammation, airway obstruction and airway hyperresponsiveness. However, the distinction between the two obstructive disease is not always clear. Multiple epidemiological studies demonstrate that in elderly people with obstructive airway disease, as many as half or more may have overlapping diagnoses of asthma and COPD. A COPD-Asthma overlap syndrome is defined as an airflow obstruction that is not completely reversible, accompanied by symptoms and signs of increased obstruction reversibility. For the clinical identification of  overlap syndrome COPD-Asthma Spanish guidelines proposed six diagnostic criteria The major criteria include very positive bronchodilator test (increase in FEV1 ≥15% and ≥400 ml),  eosinophilia in sputum and personal history of asthma. Minor criteria include high total IgE, personal history of atopy and positive bronchodilator test (increase in FEV1 ≥12% and ≥200 ml) on two or more occasions. The overlap syndrome COPD-Asthma is associated with enhanced response to inhaled corticosteroids due to the predominance of eosinophilic bronchial inflammation.

 The furture clinical studies and multicenter clinical trials should lead to the investigation of disease mechanisms and simultaneous development of the novel treatment.

5th International Congress of Georgian Respiratory Association - Great success!

Dear Respiratory friends we are happy to share with you Great Respiratory event - 5th International Congress of Georgian Respiratory Association organized by our friends in Georgia, which take place last week in Batumi!!!

Georgian Respiratory Association with about 1000 members representing various disciplines of respiratory medicine together with world-renowned experts from Europe, America and Asia made this meeting a unique scientific event not only in Georgia but at the global level.

• The European Board for Accreditation in Pneumology (EBAP) accredited Congress with 12 credits of Continuing Medical Education (CME)!
• 1000 of participants from more than 25 countries!
• 38 International speakers from all over the world on Hot Topics in Respiratory Medicine!
• 25 scientific sessions covered all fields related to respiratory medicine including Asthma and Allergy, Respiratory Critical Care Medicine, Lung Cancer, Pulmonary Infections, Thoracic Imaging, Thoracic Surgery, Thoracic Oncology, Rare Lung Diseases, COPD, Interventional Bronchoscopy, and Pediatric Pulmonology!
•  All sessions were live in internet and you can view sessions at Official Facebook page of Georgian Respiratory Association: https://www.facebook.com/Georgian-Respiratory-Association-208587155871083/?fref=ts 

The event was of great success because it was organized by young and inspired team conducted by President of the Congress Ivane Chkhaidze, and Congress co-chairs:  Vakhtang Katsarava, Tamaz Maglakelidze and Kakha Vacharadze! 

Batumi, it is perfect place for Congress and great place to be!

Speakers of 5th International Congress of Georgian Respiratory Association

Dear Respiratory friends we are happy to invite you on Great Respiratory event - 5th International Congress of Georgian Respiratory Association organized by our friends in Georgia!!!

Georgian Respiratory Association with about 1000 members representing various disciplines of respiratory medicine together with world-renowned experts from Europe, America and Asia make this gathering a unique scientific event not only in Georgia but also in the region.
38 International speakers on Hot Topics in Respiratory Medicine!
http://congress.georanet.org.ge/uploads/files/foreign_speakers.pdf
The Scientific Committee is planning a very comprehensive program catering for all specialties of respiratory medicine that will deliver state of the art lectures, update presentations, postgraduate courses, and abstract presentations. The program covers all fields related to respiratory medicine including Asthma and Allergy, RespiratoryCritical Care Medicine, Lung Cancer, Pulmonary Infections, Thoracic Imaging, Thoracic Surgery, Thoracic Oncology, Rare Lung Diseases, COPD, Interventional Bronchoscopy, and Pediatric Pulmonology.

Final Program of 5th International Congress of Georgian Respiratory Asso

5th International Congress of Georgian Respiratory Association, Batumi, 23-25 june 2016

ciation, Batumi, 23-25 june 2016

 

 

Global Strategy for Diagnosis, Management, and Prevention of COPD GOLD 2016 reports now available for free download

In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) released a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD. It recommended a major revision in the management strategy for COPD that was presented in the original 2001 document. Updated reports released in January 2013, January 2014, January 2015, and December 2015 are based on scientific literature published since the completion of the 2011 document but maintain the same treatment paradigm. Assessment of COPD is based on the patient’s level of symptoms, future risk of exacerbations, the severity of the spirometric abnormality, and the identification of comorbidities. The January 2015 update added an Appendix on Asthma COPD Overlap Syndrome, material prepared jointly by the GOLD and GINA Science Committees.

The GOLD report is presented as a “strategy document” for health care professionals to use as a tool to implement effective management programs based on available health care systems. The quadrant management strategy tool is designed to be used in any clinical setting; it draws together a measure of the impact of the patient’s symptoms and an assessment of the patient’s risk of having a serious adverse health event in the future. Many studies have assessed the utility/relevance of this new tool. Evidence will continue to be evaluated by the GOLD committees and management strategy recommendations modified as required.

GOLD has been fortunate to have a network of international distinguished health professionals from multiple disciplines. Many of these experts have initiated investigations of the causes and prevalence of COPD in their countries, and have developed innovative approaches for the dissemination and implementation of the GOLD management strategy. The GOLD initiative will continue to work with National Leaders and other interested health care professionals to bring COPD to the attention of governments, public health officials, health care workers, and the general public to raise awareness of the burden of COPD and to develop programs for early detection, prevention and approaches to management.

Marc Decramer, MD
Chair, GOLD Board of Directors
Professor of Medicine
CEO University Hospital
University of Leuven, Leuven, Belgium

Claus Vogelmeier, MD
Chair, GOLD Science Committee
Director, Internal Medicine Clinic
University of Giessen and Marburg,
School of Medicine
Standort Marburg Baldingerstrasse
D-35043 Marburg, Germany

Official facebook page of the Global Initiative for Chronic Obstructive Lung Disease (GOLD):

https://www.facebook.com/worldcopdday/

Drug safety evaluation of roflumilast for the treatment of COPD: a meta-analysis (2016 article from Expert Opinion on Drug Safety)

Introduction:

Roflumilast is the only phosphodiesterase 4 inhibitor approved for the treatment of COPD patients with chronic cough and sputum, and a history of exacerbations, but the compliance to treatment is reduced by poorly tolerated adverse events (AEs).

Areas covered:

The synthesis of clinical evidences indicates that roflumilast 500μg once-daily increased the risk of AEs, with no impact on the risk of serious AEs (SAEs), compared with placebo. Gastrointestinal AEs were common in patients treated with roflumilast, that may also induce headache, backpain and insomnia. Roflumilast protects against COPD related AEs. The frequency of very SAEs was rare but greater in patients treated with roflumilast than placebo, although factors other than the study drug were related with these SAEs.

Expert opinion:

The safety profile of roflumilast administered in combination with further drugs for the treatment of COPD should be investigated through specifically designed RCTs, and the post-marketing surveillance might help to characterize the real risk of very SAEs. Roflumilast may provide more benefit than harm in patients at high risk of severe exacerbations, and the therapy discontinuation may be reduced by a correct education of patients on the generally transient and mild-to-moderate nature of gastrointestinal AEs induced by this drug.

Full text:

http://www.tandfonline.com/doi/abs/10.1080/14740338.2016.1199683http://www.tandfonline.com/doi/abs/10.1080/14740338.2016.1199683

Final Program of 5th International Congress of Georgian Respiratory Association, Batumi, 23-25 june 2016

Dear Respiratory friends we are happy to invite you on Great Respiratory event - 5th International Congress of Georgian Respiratory Association organized by our friends in Georgia!!!

The Scientific Committee is planning a very comprehensive program catering for all specialties of respiratory medicine that will deliver state of the art lectures, update presentations, postgraduate courses, and abstract presentations. The program covers all fields related to respiratory medicine including Asthma and Allergy, RespiratoryCritical Care Medicine, Lung Cancer, Pulmonary Infections, Thoracic Imaging, Thoracic Surgery, Thoracic Oncology, Rare Lung Diseases, COPD, Interventional Bronchoscopy, and Pediatric Pulmonology.

Enjoy Great Congress and Wonderful city Batumi!  

Final program:

http://congress.georanet.org.ge/uploads/files/scientific_programm.pdf

GOLD COPD Continuum of Care: 16 November 2016

Global Strategy for the Diagnosis, Management and Prevention of COPD (GOLD) presents Conference GOLD COPD Continuum of Care on 16 November 2016!

A one day comprehensive educational symposium on the Global Strategy for the Diagnosis, Management and Prevention of COPD. This educational program will feature GOLD strategy authors and contributors providing expert opinion into best practice COPD management. This program is open to all healthcare providers involved in the care and management of patients with COPD, and is being held in conjunction with World COPD Day activities.
Faculty Speakers
Please check back later as we will be updating this information.
Dr. Gerard Criner, Philadelphia, PA
Dr. Roberto Rodriguez-Roisin, Barcelona, Spain
Dr. Jadwiga Wedzicha, London, United Kingdom
Dr. Claus Vogelmeier, Marburg, Germany
Dr. Nicolas Roche, Paris, France
Dr. David Halpin, Devon, United Kingdom
Please register early; on-site registration is $25.00 higher than pre-registration cost

Visit official GOLD Global Strategy for the Diagnosis, Management and Prevention of COPD (GOLD) facebook page: 

https://www.facebook.com/worldcopdday/?qsefr=1

Management of chronic obstructive pulmonary disease beyond the lungs (Lancet 2016 article)

Chronic obstructive pulmonary disease (COPD) is an umbrella term that covers many clinical subtypes with clearly different pulmonary and extra-pulmonary characteristics, but with persistent airflow limitation in common. This insight has led to the development of a more personalised approach in bronchodilator therapy, prevention of exacerbations, and advanced treatments (such as non-invasive ventilation and lung volume reduction techniques). However, systemic manifestations and comorbidities of COPD also contribute to different clinical phenotypes and warrant an individualised approach as part of integrated disease management. Alterations in bodyweight and composition, from cachexia to obesity, demand specific management. Psychological symptoms are highly prevalent, and thorough diagnosis and treatment are necessary. Moreover, prevention of exacerbations requires interventions beyond the lungs, including treatment of gastro-oesophageal reflux disease, reduction of cardiovascular risks, and management of dyspnoea and anxiety. In this Review, we discuss the management of COPD beyond the respiratory system and propose treatment strategies on the basis of the latest research and best practices.

full text:

http://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2816%2900097-7/abstract