Publications
565 results found
Harari S, Humbert M, Blasi F, et al., 2015, Rare pulmonary diseases and orphan drugs: where do we stand and where are we going to?, EUROPEAN RESPIRATORY REVIEW, Vol: 24, Pages: 375-377, ISSN: 0905-9180
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- Citations: 6
Kouranos V, Hansell DM, Sharma R, et al., 2015, Advances in imaging of cardiopulmonary involvement in sarcoidosis, CURRENT OPINION IN PULMONARY MEDICINE, Vol: 21, Pages: 538-545, ISSN: 1070-5287
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- Citations: 11
Bajwah S, Ross JR, Wells AU, et al., 2015, Palliative care for patients with advanced fibrotic lung disease: a randomised controlled phase II and feasibility trial of a community case conference intervention, THORAX, Vol: 70, Pages: 830-839, ISSN: 0040-6376
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- Citations: 83
Patel AS, Siegert RJ, Bajwah S, et al., 2015, Rasch analysis and impact factor methods both yield valid and comparable measures of health status in interstitial lung disease, JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 68, Pages: 1019-1027, ISSN: 0895-4356
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- Citations: 9
Kouranos V, Wells AU, Sharma R, et al., 2015, Advances in radionuclide imaging of cardiac sarcoidosis., British Medical Bulletin, Vol: 115, Pages: 151-163, ISSN: 1471-8391
INTRODUCTION: Radionuclide imaging for the diagnosis and monitoring of cardiac involvement in sarcoidosis has advanced significantly in recent years. SOURCES OF DATA: This article is based on published clinical guidelines, literature review and our collective clinical experience. AREAS OF AGREEMENT: Gallium-67 scintigraphy is among the diagnostic criteria for cardiac involvement in systemic sarcoidosis, and it is strongly associated with response to treatment. However, fluorine-18, 2-fluoro-deoxyglucose (FDG) positron emission tomography (PET) is now preferred both for diagnosis and for assessing prognosis. AREAS OF CONTROVERSY: Most data are from small observational studies that are potentially biased. GROWING POINTS: Quantitative imaging to assess changes in disease activity in response to treatment may lead to FDG-PET having an important routine role in managing cardiac sarcoidosis. AREAS TIMELY FOR DEVELOPING RESEARCH: Larger prospective studies are required, particularly to assess the effectiveness of radionuclide imaging in improving clinical management and outcome.
Kouranos V, Tzelepis GE, Rapti A, et al., 2015, Utility of cardiac MRI in detecting myocardial involvement and predicting adverse events in sarcoidosis: A study in 330 patients, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 543-544, ISSN: 0195-668X
Wijsenbeek M, Bendstrup E, Ross J, et al., 2015, Cultural Differences in Palliative Care in Patients With Idiopathic Pulmonary Fibrosis, CHEST, Vol: 148, Pages: E56-E56, ISSN: 0012-3692
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- Citations: 10
Keir GJ, Nair A, Giannarou S, et al., 2015, Pulmonary vasospasm in systemic sclerosis: noninvasive techniques for detection, Pulmonary Circulation, Vol: 5, Pages: 498-505, ISSN: 2045-8940
In a subgroup of patients with systemic sclerosis (SSc), vasospasm affecting the pulmonary circulation may contribute to worsening respiratory symptoms, including dyspnea. Noninvasive assessment of pulmonary blood flow (PBF), utilizing inert-gas rebreathing (IGR) and dual-energy computed-tomography pulmonary angiography (DE-CTPA), may be useful for identifying pulmonary vasospasm. Thirty-one participants (22 SSc patients and 9 healthy volunteers) underwent PBF assessment with IGR and DE-CTPA at baseline and after provocation with a cold-air inhalation challenge (CACh). Before the study investigations, participants were assigned to subgroups: group A included SSc patients who reported increased breathlessness after exposure to cold air (n = 11), group B included SSc patients without cold-air sensitivity (n = 11), and group C patients included the healthy volunteers. Median change in PBF from baseline was compared between groups A, B, and C after CACh. Compared with groups B and C, in group A there was a significant decline in median PBF from baseline at 10 minutes (−10%; range: −52.2% to 4.0%; P < 0.01), 20 minutes (−17.4%; −27.9% to 0.0%; P < 0.01), and 30 minutes (−8.5%; −34.4% to 2.0%; P < 0.01) after CACh. There was no significant difference in median PBF change between groups B or C at any time point and no change in pulmonary perfusion on DE-CTPA. Reduction in pulmonary blood flow following CACh suggests that pulmonary vasospasm may be present in a subgroup of patients with SSc and may contribute to worsening dyspnea on exposure to cold.
Corte TJ, Collard H, Wells AU, 2015, Idiopathic interstitial pneumonias in 2015: A new era, RESPIROLOGY, Vol: 20, Pages: 697-698, ISSN: 1323-7799
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- Citations: 3
Collard HR, Bradford WZ, Cottin V, et al., 2015, A new era in idiopathic pulmonary fibrosis: considerations for future clinical trials, EUROPEAN RESPIRATORY JOURNAL, Vol: 46, Pages: 243-249, ISSN: 0903-1936
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- Citations: 44
Jenkins RG, Simpson JK, Saini G, et al., 2015, Longitudinal change in collagen degradation biomarkers in idiopathic pulmonary fibrosis: an analysis from the prospective, multicentre PROFILE study, Lancet Respiratory Medicine, Vol: 3, Pages: 462-472, ISSN: 2213-2619
Idiopathic pulmonary fibrosis, a progressive and inevitably fatal disorder, has a highly variable clinical course. Biomarkers that reflect disease activity are urgently needed to inform patient management and for use as biomarkers of therapeutic response (theragnostic biomarkers) in clinical trials. We aimed to determine whether dynamic change in markers of extracellular matrix (ECM) turnover predicts progression of idiopathic pulmonary fibrosis as determined by change in forced vital capacity and death.
Hansell DM, Goldin JG, King TE, et al., 2015, CT staging and monitoring of fibrotic interstitial lung diseases in clinical practice and treatment trials: a Position Paper from the Fleischner Society, LANCET RESPIRATORY MEDICINE, Vol: 3, Pages: 483-496, ISSN: 2213-2600
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- Citations: 119
Wells A, 2015, Combination therapy in idiopathic pulmonary fibrosis: the way ahead will be hard, EUROPEAN RESPIRATORY JOURNAL, Vol: 45, Pages: 1208-1210, ISSN: 0903-1936
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- Citations: 8
Spagnolo P, Wells AU, Collard HR, 2015, Pharmacological treatment of idiopathic pulmonary fibrosis: an update, DRUG DISCOVERY TODAY, Vol: 20, Pages: 514-524, ISSN: 1359-6446
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- Citations: 23
Bonifazi M, Bravi F, Gasparini S, et al., 2015, Sarcoidosis and Cancer Risk Systematic Review and Meta-analysis of Observational Studies, CHEST, Vol: 147, Pages: 778-791, ISSN: 0012-3692
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- Citations: 93
Loveman E, Copley VR, Colquitt J, et al., 2015, The clinical effectiveness and cost-effectiveness of treatments for idiopathic pulmonary fibrosis: a systematic review and economic evaluation., Health Technol Assess, Vol: 19, Pages: i-336
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a life-limiting lung disease that generally affects people over 60 years old. The main symptoms are shortness of breath and cough, and as the disease progresses there is a considerable impact on day-to-day life. Few treatments are currently available. OBJECTIVES: To conduct a systematic review of clinical effectiveness and an analysis of cost-effectiveness of treatments for IPF based on an economic model informed by systematic reviews of cost-effectiveness and quality of life. DATA SOURCES: Eleven electronic bibliographic databases, including MEDLINE, EMBASE, Web of Science, and The Cochrane Library and the Centre for Reviews and Dissemination databases, were searched from database inception to July 2013. Reference lists of relevant publications were also checked and experts consulted. METHODS: Two reviewers independently screened references for the systematic reviews, extracted and checked data from the included studies and appraised their risk of bias. An advisory group was consulted about the choice of interventions until consensus was reached about eligibility. A narrative review with meta-analysis was undertaken, and a network meta-analysis (NMA) was performed. A decision-analytic Markov model was developed to estimate cost-effectiveness of pharmacological treatments for IPF. Parameter values were obtained from NMA and systematic reviews. Univariate and probabilistic sensitivity analyses were undertaken. The model perspective is NHS and Personal Social Services, and discount rate is 3.5% for costs and health benefits. RESULTS: Fourteen studies were included in the review of clinical effectiveness, of which one evaluated azathioprine, three N-acetylcysteine (NAC) (alone or in combination), four pirfenidone, one BIBF 1120, one sildenafil, one thalidomide, two pulmonary rehabilitation, and one a disease management programme. Study quality was generally good, with a low risk of bias. The current evidence suggests t
Riley J, Branford R, Droney J, et al., 2015, Morphine or Oxycodone for Cancer-Related Pain? A Randomized, Open-Label, Controlled Trial, JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, Vol: 49, Pages: 161-172, ISSN: 0885-3924
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- Citations: 44
Conti C, Montero-Fernandez A, Nicholson AG, et al., 2015, Distribution Of Mucins Muc5b And Muc5ac In Distal Airways And Honeycomb Spaces: Comparison Between Uip And Other Ild Patterns, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
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- Citations: 3
Kouranos V, Ward S, Kokosi M, et al., 2015, Uncoupling Of Restrictive And Obstructive Pattern Definitions In Lung Function Tests Of Sarcoidosis Patients, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Raghu G, Wells A, Nicholson AG, et al., 2015, Consistent Effect Of Nintedanib On Decline In FVC In Patients Across Subgroups Based On Hrct Diagnostic Criteria: Results From The Inpulsis® Trials In Ipf, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
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- Citations: 10
Russell A-M, Sanderson T, Wells AU, et al., 2015, Development Of A Patient Reported Outcome Measure (prom) In Idiopathic Pulmonary Fibrosis (ipf): An Iterative Process, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Antoniou KM, Symvoulakis EK, Anyfantakis D, et al., 2015, New Treatments for Idiopathic Pulmonary Fibrosis: 'Die Another Day' if Diagnosed Early?, RESPIRATION, Vol: 90, Pages: 352-352, ISSN: 0025-7931
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- Citations: 5
Salisbury M, Zhou Y, Murray S, et al., 2015, Ability Of Gender-Age-Physiology Index Stage To Predict Future Rate Of Pulmonary Function Decline In Idiopathic Pulmonary Fibrosis, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Wells AU, Costabel U, Poletti V, et al., 2015, CHALLENGES IN IPF DIAGNOSIS, CURRENT MANAGEMENT AND FUTURE PERSPECTIVES, SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES, Vol: 32, Pages: 28-35, ISSN: 1124-0490
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- Citations: 12
Lammi MR, Baughman RP, Birring SS, et al., 2015, Outcome Measures for Clinical Trials in Interstitial Lung Diseases, CURRENT RESPIRATORY MEDICINE REVIEWS, Vol: 11, Pages: 163-174, ISSN: 1573-398X
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- Citations: 26
Russell AM, Sanderson T, Fleming S, et al., 2014, DEVELOPMENT OF AN IDIOPATHIC PULMONARY FIBROSIS (IPF) PATIENT REPORTED OUTCOME MEASURE (PROM): AN ITERATIVE APPROACH TO ITEM GENERATION, Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A219-A220, ISSN: 0040-6376
Wells AU, Denton CP, 2014, Interstitial lung disease in connective tissue disease-mechanisms and management, NATURE REVIEWS RHEUMATOLOGY, Vol: 10, Pages: 728-739, ISSN: 1759-4790
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- Citations: 124
Wuyts WA, Antoniou KM, Borensztajn K, et al., 2014, Combination therapy: the future of management for idiopathic pulmonary fibrosis?, LANCET RESPIRATORY MEDICINE, Vol: 2, Pages: 933-942, ISSN: 2213-2600
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- Citations: 117
Hopkinson NS, Boutou AK, Nair A, et al., 2014, A Combined Pulmonary Function and Emphysema Score Prognostic Index for Staging in Chronic Obstructive Pulmonary Disease, PLOS One, Vol: 9, ISSN: 1932-6203
Introduction: Chronic Obstructive Pulmonary Disease (COPD) is characterized by high morbidity and mortality. Lung computed tomography parameters, individually or as part of a composite index, may provide more prognostic information than pulmonary function tests alone. Aim: To investigate the prognostic value of emphysema score and pulmonary artery measurements compared with lung function parameters in COPD and construct a prognostic index using a contingent staging approach. Material-Methods: Predictors of mortality were assessed in COPD outpatients whose lung computed tomography, spirometry, lung volumes and gas transfer data were collected prospectively in a clinical database. Univariate and multivariate Cox proportional hazard analysis models with bootstrap techniques were used. Results: 169 patients were included (59.8% male, 61.1 years old; Forced Expiratory Volume in 1 second % predicted: 40.5619.2). 20.1% died; mean survival was 115.4 months. Age (HR = 1.098, 95% Cl = 1.04–1.252) and emphysema score (HR = 1.034, 95% CI = 1.007–1.07) were the only independent predictors of mortality. Pulmonary artery dimensions were not associated with survival. An emphysema score of 55% was chosen as the optimal threshold and 30% and 65% as suboptimals. Where emphysema score was between 30% and 65% (intermediate risk) the optimal lung volume threshold, a functional residual capacity of 210% predicted, was applied. This contingent staging approach separated patients with an intermediate risk based on emphysema score alone into high risk (Functional Residual Capacity $210% predicted) or low risk (Functional Residual Capacity ,210% predicted). This approach was more discriminatory for survival (HR = 3.123; 95% CI = 1.094–10.412) than either individual component alone.Conclusion: Although to an extent limited by the small sample size, this preliminary study indicates that the composite Emphysema score-Functional Residual Capacity index might provide a better sep
Molyneaux PL, Cox MJ, Willis-Owen SAG, et al., 2014, The role of bacteria in the pathogenesis and progression of idiopathic pulmonary fibrosis, American Journal of Respiratory and Critical Care Medicine, Vol: 190, Pages: 906-913, ISSN: 1535-4970
Rationale:Idiopathic pulmonaryfibrosis (IPF)isa progressivelung diseaseof unknown cause that leads to respiratory failure and death within 5 yearsof diagnosis. Overt respiratory infection and immunosuppression carrya high morbidity and mortality, and polymorphisms in genes related toepithelial integrity and host defense predispose to IPF.Objectives: To investigate the role of bacteria in the pathogenesisand progression of IPF.Methods: We prospectively enrolled patients diagnosed with IPFaccording to international criteria together with healthy smokers,nonsmokers, and subjectswithmoderate chronic obstructive pulmonarydisease as control subjects. Subjects underwent bronchoalveolarlavage (BAL), from which genomic DNA was isolated. The V3–V5region of the bacterial 16S rRNA gene was amplified, allowingquantification of bacterial load and identification of communities by 16SrRNA quantitative polymerase chain reaction and pyrosequencing. Measurements and Main Results: Sixty-five patients with IPFhad double the burden of bacteria in BAL fluid compared with 44 controlsubjects. Baseline bacterial burden predicted the rate of decline in lungvolume and risk of death and associated independently with thers35705950 polymorphism of the MUC5B mucin gene, a proven hostsusceptibilityfactorfor IPF. Sequencing yielded912,883 high-quality readsfrom all subjects.WeidentifiedHaemophilus, Streptococcus,Neisseria, andVeillonella spp. to be more abundant in cases than control subjects.Regression analyses indicated that these specific operational taxonomicunits as well as bacterial burden associated independently with IPF.Conclusions: IPF is characterized by an increased bacterial burdenin BAL that predicts decline in lung function and death. Trials ofantimicrobial therapy are needed to determine if microbial burdenis pathogenic in the disease.
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