Abstract:
PURPOSE OF REVIEW:Time to clinical worsening (TTCW) can be used to assess disease progression associated with pulmonary arterial hypertension (PAH). As a consequence, it is highly relevant to patients, clinicians, and regulatory agencies. The majority of clinical trials of PAH-specific drug therapies have included TTCW as a secondary endpoint; this article summarizes the results of randomized controlled clinical trials in PAH, specifically with respect to the clinical worsening endpoint. RECENT FINDINGS:Some trials have demonstrated a treatment-related delay in TTCW and others have not. Recent results suggest that TTCW shows particular promise in detecting disease progression, even in mildly affected patients. Definitions of clinical worsening have also varied across clinical trials; although all have agreed on the inclusion of all-cause death and hospitalization due to PAH in the definition, the inclusion of additional parameters defining 'disease progression' has differed. SUMMARY:There is a need for a clear and uniform definition of TTCW that can be tailored to the study population being investigated; the endpoint may require adaptation for patients in different functional classes and with different causes. Consistency of event reporting within a trial may be improved by employing a committee to adjudicate events. Trials are beginning to include TTCW as a primary endpoint; the results will be important in establishing the validity of whether this parameter should become the endpoint of choice in PAH trials in the future.
journal_name
Curr Opin Pulm Medjournal_title
Current opinion in pulmonary medicineauthors
Galiè N,Simonneau G,Barst RJ,Badesch D,Rubin Ldoi
10.1097/01.mcp.0000370206.61003.7esubject
Has Abstractpub_date
2010-05-01 00:00:00pages
S11-9eissn
1070-5287issn
1531-6971pii
00063198-201005001-00002journal_volume
16 Suppl 1pub_type
杂志文章,评审abstract::The neurotrophins are a family of peptides that promote survival, growth, and differentiation of neurons. Neurotrophins may also influence the function of nonneuronal cell types, including immune cells. The development and maintenance of asthma is thought to involve the nervous system and the immune system, but the ro...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200101000-00001
更新日期:2001-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Matrix metalloproteinases (MMPs) are a family of over 20 zinc-dependent proteases with different biological and pathological activities, and many have been implicated in several diseases. Although nonselective MMP inhibitors are known to induce serious side-effects, targeting individual MMPs may offer...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000743
更新日期:2021-01-01 00:00:00
abstract::Staging of sarcoidosis needs a synthesis of clinical features, histology, radiology, biochemical changes, and immunologic aberrations to distinguish this disease from nonspecific sarcoid-tissue reactions. The main aim of this report is to offer readers an overview on immunologic markers that have been evaluated in the...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200209000-00017
更新日期:2002-09-01 00:00:00
abstract::Lung volume reduction surgery and lung transplantation have been shown to improve lung function, exercise capacity, and quality of life in patients with advanced emphysema. Because the indications for both surgical procedures overlap, lung volume reduction surgery may be used as an alternative treatment or as a "bridg...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200103000-00007
更新日期:2001-03-01 00:00:00
abstract::Many individuals are now surviving their injuries to face the consequences of an activated immunoinflammatory system and the complications of supportive therapy. The pulmonary system bears the force of this insult. An understanding of the epidemiology of acute respiratory failure, as well as a greater knowledge of the...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199705000-00008
更新日期:1997-05-01 00:00:00
abstract::In this review, three aspects of pleural disease are discussed. Although it was thought for many years that the origin of pleural fluid was the capillaries in the parietal or visceral pleura, recent evidence suggests that in many cases the origin of pleural fluid is the interstitial space of the lung. The interstitial...
journal_title:Current opinion in pulmonary medicine
pub_type: 社论,评审
doi:
更新日期:1995-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Microscopic polyangiitis is a systemic necrotizing vasculitis that affects small vessels, resulting in a wide spectrum of organ involvement including the kidneys and the lungs. This paper reviews recent insights and observations into the pathogenesis, clinical manifestations, and treatment of pulmonar...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000170520.63874.fb
更新日期:2005-09-01 00:00:00
abstract::Bronchial carcinoids and hamartomas are, respectively, the most common malignant and benign unusual primary lung neoplasms. These tumors are often asymptomatic but can cause central airway obstruction. Helical computed tomographic and radionuclide scintigraphic advances in their detection and evolution, together with ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200107000-00012
更新日期:2001-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Dornase alfa (Pulmozyme) is one of the most commonly used medications to treat the lung disease of cystic fibrosis (CF). As other respiratory medications have entered the clinical market, understanding the proper use and indication for dornase alfa is increasingly important. In addition, dornase alfa ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328358d51f
更新日期:2012-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to highlight seminal and current literature that informs our understanding of the clinical and investigative utility of biomarkers in asthma. Biomarkers derive from a variety of sources [bronchiolar lavage (BAL), sputum, exhaled breath, and blood], and have widely variant...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32831de235
更新日期:2009-01-01 00:00:00
abstract::In reviewing recent advances in upper respiratory tract infections, we focus on five key topics. First, the use of ribavirin in the treatment of respiratory syncytial virus infection has been limited to the immunosuppressed. Prophylaxis in high-risk patients with specific immunoglobulin is effective and a new monoclon...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199905000-00006
更新日期:1999-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) affects over 12 million adults in the United States and is the third leading cause of 30-day readmissions. COPD is costly with almost $50 billion in direct costs annually. Total COPD costs can be up to double the identified direct costs because of comorbid ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000454
更新日期:2018-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) and lung cancer are the leading causes of morbidity and mortality worldwide. The current research is focused on identifying the common and disparate events involved in epigenetic modifications that concurrently occur during the pathogenesis of COPD and lung...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283477533
更新日期:2011-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Coal mine workers are at risk for a range of chronic respiratory diseases including coal workers' pneumoconiosis, diffuse dust-related fibrosis, and chronic obstructive pulmonary disease. The purpose of this review is to describe coal mining processes and associated exposures to inform the diagnostic ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000251
更新日期:2016-03-01 00:00:00
abstract::As the number of inhaled drugs available for cystic fibrosis grows, there is increasing awareness of delivery device issues. Current jet and ultrasonic nebulizers are inefficient at delivering drugs to the lower respiratory tract. There are large differences in output characteristics between nebulizers and high inters...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199711000-00005
更新日期:1997-11-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we describe the 'state-of-the-art' in our knowledge of asthma and what gaps exist, which can be exploited in the future for effective translation of our knowledge from the bench or population studies to diagnosis and therapy. RECENT FINDINGS:The advent of microbiome research has expan...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32834dccc0
更新日期:2012-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Malignant central airway obstruction heavily impacts patients' quality of life and its management continues to be a challenge. The current article will review the use of airway stents in this population. RECENT FINDINGS:Airway stenting is highly effective in palliating symptoms of airway obstruction....
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32833a260
更新日期:2010-07-01 00:00:00
abstract::The author describes a current status of nuclear imaging in interstitial lung disease. A number of tests have been proposed for the evaluation of disease activity. The only one that is used in many centers, however, is 67Ga scan. If the goal is the evaluation of functional impairment, 99mTc-penta-acetic acid aerosol m...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199709000-00010
更新日期:1997-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite the fact that primary pulmonary lymphoma (PPL) is a rare lung tumour, significant advances addressing clinical features, histological diagnosis, prognostic criteria and therapeutic management of this disease have been made within the past decade. RECENT FINDINGS:Monoclonality and phenotyping ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000180
更新日期:2015-07-01 00:00:00
abstract::Pulmonary function changes in interstitial lung disease are characterized by loss of lung volume, increase in ratio of forced expiratory volume in 1 second to forced vital capacity, and decrease in carbon monoxide diffusion capacity. Recent developments in the assessment of respiratory mechanics in infiltrative lung d...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199609000-00005
更新日期:1996-09-01 00:00:00
abstract:PURPOSE OF THE REVIEW:Recently, studies on large diverse populations have described important ethnic/racial differences in venous thromboembolism incidence, and sex has been reported as an important predictor of recurrence. We review the influence of race/ethnicity and sex on venous thromboembolism, concentrating on ar...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3281eb8ef0
更新日期:2007-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Advances in imaging technologies and biomarker research offer hope that the incidence and mortality of lung cancer can be reduced by screening similar to what have been achieved for cancer of the cervix, breast, and colon. RECENT FINDINGS:Spiral computed tomography with multitrack scanners and autofl...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000166592.10666.d1
更新日期:2005-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) imposes a large burden on the global population and even more so for the elderly who face significant obstacles in the diagnosis, management, and psychosocial effects of the disease. This review describes the current challenges and key points in the managem...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章
doi:10.1097/MCP.0000000000000750
更新日期:2021-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Diagnosis of sleep apnoea was performed in sleep laboratories with polysomnography. This requires a room with supervision and presence of technologists and trained sleep experts. Today, clinical guidelines in most countries recommend home sleep apnoea testing with simple systems using six signals only...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章
doi:10.1097/MCP.0000000000000726
更新日期:2020-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Adherence to asthma therapies is poor leading to unnecessary morbidity and increased use of emergency and hospital resources. Strategies to improve adherence have not been successful. RECENT FINDINGS:Asthma adherence disease management is a clinical method to improve adherence for asthma patients. Th...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000128
更新日期:2015-01-01 00:00:00
abstract::Lung volume reduction surgery (LVRS) is a palliative surgical procedure for patients with severe emphysema. Resection of nonfunctional emphysematous lung tissue has been reported to relieve breathlessness and to improve quality of life for many patients by improving lung elastic recoil, respiratory muscle function, an...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200003000-00006
更新日期:2000-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Accurate diagnosis of interstitial lung diseases (ILDs) can be challenging, and a substantial percentage of ILD patients remain unclassifiable even after thorough assessment by an experienced multidisciplinary team. In this review, we summarize the recent literature on the definition, prevalence, diag...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000509
更新日期:2018-09-01 00:00:00
abstract::Uvulopalatopharyngoplasty has limited efficacy in treating obstructive sleep apnea, with excellent results achieved in fewer than half of patients who undergo this procedure. Attempting to select patients who have only retropalatal collapse of the pharynx increases the likelihood of a successful outcome. Although this...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199511000-00013
更新日期:1995-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Survival for patients with cystic fibrosis (CF) continues to improve. The proportion of CF patients over the age of 18 years is nearly 50%, and care providers will need to better understand this patient population. Despite these improvements, young females continue to have a worse prognosis and lower ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328365af49
更新日期:2013-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Need for intensive care in the patient with pulmonary arterial hypertension is associated with high mortality. This review will provide an overview of causes of ICU admission for patients with pulmonary hypertension and provide guidance on management. RECENT FINDINGS:There is a paucity of evidence-ba...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章
doi:10.1097/MCP.0000000000000713
更新日期:2020-09-01 00:00:00