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Clinical Highlights from the ATS Conference
The American Thoracic Society hosted its 104th International Conference May 16-21 in Toronto. The conference featured more than 5,600 podium and poster presentations, as well as a lecture from Grace Anne Dorney Koppel on COPD.
Here are a few clinical highlights from the show:
• Data from three clinical trials were presented that support the value of Perforomist Inhalation Solution (nebulized formoterol fumarate) for the treatment of COPD. One presentation indicated a significant improvement in dyspnea, COPD symptoms and rescue medication using Perforomist Inhalation Solution with tiotropium compared to tiotropium alone. The other two presentations compare the clinical effect of two types of drug delivery — nebulization vs. DPI — when treating COPD patients with formoterol fumarate.
• A 660-person study of patients with both allergies and asthma found that patients who were treated with Advair had significantly better lung function than similar patients treated with Singulair alone. Adding Singulair to Advair provided no additional benefit, but adding an inhaled corticosteroid to Advair did provide better allergy relief than Advair alone.
• The use of Advair Diskus 250/50 (fluticasone propionate and salmeterol inhalation powder) demonstrated a 30-percent reduction in exacerbations in patients with COPD who have a history of exacerbations as compared with salmeterol alone. The randomized study, which was used in the FDA's review, included 797 patients.
• GlaxoSmithKline presented the results of a survey of more than 81,000 households that gives a clear picture of the asthma landscape in the United States. In brief, the survey found that 41 percent of adults with asthma are not well-controlled, suggesting a large population of undertreated patients. Children, too, are often at risk, with 31 percent of those ages 4-11 and 25 percent of those ages 12-17 reporting poor control. The survey also found that those patients were significantly more likely to end up in the hospital or emergency room or require oral steroid to get their asthma under control.
• According to a study presented by the VA, patients with COPD who are in their final years of survival do not get the same benefits from pulmonary rehabilitation as patients who have more years left to live — regardless of their age, complicating illnesses or lung function. Patients who lived longer than two years obtained more positive results. Researchers studied 106 COPD patients.
• Researchers in Spain studied 394 patients with high blood pressure and non-sleepy OSA and found that treatment of OSA with CPAP may lower blood pressure among hypertensive adults.
• Stroke victims with OSA die sooner than stroke victims without sleep apnea or who have central sleep apnea, according to Swedish researchers who followed 132 stroke patients over 10 years. They found that those with an obstructive apnea-hypopnea index of 15 or greater were 76 percent more likely to die earlier. Those with a lower apena-hypopnea index of 10 also were at greater risk of early death.
• A study showed that noninvasive ventilation (NIV) may be more effective at reducing breathing difficulty than standard oxygen therapy for patients with end-stage lung cancer. NIV has the added advantage of reducing patients' reliance on morphine, thus improving lucidity in their final days.
• OSA in very young children may cause some of the adverse cardiovascular health consequences seen in older children and adults with the condition, according to researchers in Israel.
