Fernando Martinez

Populations with COPD demonstrate higher survival in overweight and obese compared with normal weight; the “obesity paradox”. Relationships in less-severe COPD are unclear, as is the impact of cardiovascular risk, and few studies include individuals at extremes of obesity. We examined the relationship between body mass index (BMI; defined as underweight: <20 kg·m−2, normal: 20–25 kg·m−2, overweight: 25– <30 kg·m−2, obese class I: 30– <35 kg·m−2, class II: 35– <40 kg·m−2 and class III: ≥40 kg·m−2), morbidity, and mortality in the SUMMIT trial population (n=16 485), characterised by moderate COPD and heightened cardiovascular risk with a substantial proportion with class III obesity. The association between BMI category and time to event was modelled via proportional hazards (reference normal weight) adjusted for demographics and cardiorespiratory disease. Consistent with the …

Methods: KRONOS was a randomized, double-blind, multicenter, 24-week study (NCT02497001) including patients with symptomatic moderate-to-very severe COPD (CAT-score≥ 10) despite≥ 2 inhaled maintenance therapies. We analyzed data from the modified intent-to-treat population receiving BGF MDI 320/18/9.6 μg (n= 639), GFF MDI 18/9.6 μg (n= 625), BFF MDI 320/9.6 μg (n= 314), or open-label budesonide/formoterol dry powder inhaler 400/12 μg (BUD/FORM DPI; n= 318). Of these patients, 74% had not experienced an exacerbation in the previous year. Annualized rate of moderate/severe COPD exacerbations was analyzed using negative binomial regression, adjusting for baseline post-bronchodilator% predicted FEV1, baseline eosinophil count, treatment, season, treatment by season interaction, baseline COPD exacerbation history, country, and ICS use at screening. Seasons were defined as …

Aspects of the disclosure relate to a method for treating idiopathic pulmonary fibrosis (IPF) in a patient with N-ace tylcysteine (NAC) comprising administering NAC to a patient after a sample from the patient has been genotyped and determined to be any one of: a) homozygous or het erozygous for a thymine at the single nucleotide polymor phism rs3750920; b) homozygous or heterozygous for gua nine at the single nucleotide polymorphism rs5743894; or c) homozygous or heterozygous for thymine at the single nucleotide polymorphism rs35705950.

Aim: To assess whether baseline BNP influenced the effects of nintedanib plus sildenafil vs. nintedanib alone.Methods: In post-hoc analyses, patients with baseline BNP≤ vs.> median were compared on changes from baseline in BNP at week 24 and in SGRQ total score and FVC at weeks 12 and 24; time to absolute FVC≥ 5% predicted or death; and time to relative FVC decline≥ 10% predicted or death.Results: At baseline, median BNP was 52 ng/L; 140 patients had BNP≤ 52 ng/L and 133 had BNP> 52 ng/L. All endpoints showed numerical benefits of nintedanib plus sildenafil vs. nintedanib alone in both subgroups. Compared with patients with baseline BNP below the median, the combination provided a significantly greater benefit on BNP levels and a numerical benefit on FVC in patients with higher baseline BNP.Conclusions: In patients with IPF and severely impaired gas exchange, the benefit of …

Methods: Changes from baseline in St Georgeʼs Respiratory Questionnaire (SGRQ) total score, FVC at weeks 12 and 24, BNP at week 24; time to absolute FVC≥ 5% predicted or death; and time to relative FVC decline≥ 10% predicted or death were assessed in patients with and without signs of RHD at baseline.Results: In total, 117 patients (nintedanib plus sildenafil 61; nintedanib 56) had signs of RHD and 156 (76; 80) did not. In both subgroups, nintedanib plus sildenafil had a numerically greater effect on change in SGRQ at week 24 and all endpoints related to FVC versus nintedanib alone. There was a significant treatment-by-subgroup-by-time (TST) interaction for change in BNP at week 24, indicating a significantly greater effect of nintedanib plus sildenafil versus nintedanib alone in patients with RHD at baseline ([Table 1]). Significant TST interactions were also observed for change in BNP at week 24 in …