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News briefs from the February issue of Chest

American College of Chest Physicians

BENEFITS OF ICS FOR COPD MAY BE OVERSTATED

Inhaled corticosteroids (ICS) are widely used for the treatment of chronic obstructive pulmonary disease (COPD). However, new research suggests that ICS may only provide a modest benefit in reducing exacerbations in patients with COPD. Researchers from India conducted a metaanalysis of 11 studies (8,164 patients) that reported the efficacy of ICS versus placebo in prevention of COPD exacerbations. The use of ICS was associated with a modest reduction in the occurrence of exacerbations, with a subgroup analysis revealing only a benefit in patients with a FEV1 less than 50 percent. Upon further analysis using metaregression, the researchers found no demonstrable linear relationship between the efficacy of ICS and prevention of COPD exacerbation that was related to the level of stable lung function. Researchers conclude that the role of ICS in preventing COPD exacerbations warrants reexamination. This article is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):318-325.

MAJORITY OF TB PATIENTS DO NOT COMPLETE THERAPY

New research shows that less than half of patients starting treatment for latent TB infection (LTBI) actually complete therapy. Researchers from several major medical institutions, including Boston University School of Public Health, found that at 32 clinics in the United States and Canada, 123 of 720 patients tested and offered treatment for LTBI declined. Furthermore, of 1,994 patients who started treatment for LTBI in 68 US and Canadian clinics, 1,045 failed to complete therapy. Employees at health-care facilities were most likely to decline treatment altogether, while those in congregate settings, such as nursing homes and jail, were least likely to complete therapy. The article is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):401-409.

PATIENTS WITH COPD HAVE INCREASED RISK FOR DEPRESSION

A new study provides further evidence that patients with chronic obstructive pulmonary disease (COPD) are at an increased risk for developing depression. Researchers from Switzerland compared the prevalence of depression among 35,722 patients with COPD with 35,722 patients who were COPD-free. Results showed that the prevalence of diagnosed depression prior to the first COPD diagnosis was higher in the COPD population (23.1 percent) than among patients without COPD (16.8 percent). In addition, the incidence rate of a new-onset diagnosis of depression after the first COPD diagnosis was 16.2/1,000 person-years in the COPD group, compared with 9.4/1,000 person-years in the group without COPD. Patients with severe COPD had the highest risk of developing depression. This study is published in the February issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2010; 137(2):341-347.

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