Pulmonary Function Testing Guidelines

By Dr Deepu

• Official ATS/ERS Technical Standards: Field walking tests in chronic respiratory disease (2014)
• An Official ATS/ERS Systematic Review: Measurement properties of field walking tests in chronic respiratory disease (2014)
  • Online supplement
• Standardisation of lung function testing: the authors’ replies to readers’ comments
• ATS/ERS Task Force Standardisation of Lung Function Testing: General considerations for lung function testing (2005)
• ATS/ERS Task Force Standardisation of Lung Function Testing: Interpretative strategies for lung function tests (2005)
• ATS/ERS Task Force Standardisation of Lung Function Testing: Standardisation of the measurement of lung volumes (2005)
• ATS/ERS Task Force Standardisation of Lung Function Testing: Standardisation of the single-breath determination of carbon monoxide uptake in the lung (2005)
• ATS/ERS Task Force Standardisation of Lung Function Testing: Standardisation of spirometry (2005)
• ATS/ACCP Statement on Cardiopulmonary Exercise Testing (2003)
• ATS Statement: Guidelines for the Six-Minute Walk Test (2002) Being revised.
• Guidelines for Methacholine and Exercise Challenge Testing-1999 (2000)
• ATS/ERS Statement on Respiratory Muscle Testing (2002)

Sleep Medicine guidelines

By Dr Deepu

• • An Official ATS Clinical Practice Guidelines: Sleep Apnea, Sleepiness, and Driving Risk (2013)
  • An Official ATS Statement: CPAP Adherence Tracking Systems (2013)
  • An Official ATS/ACCP/AASM/ERS Workshop report Research Priorities in Ambulatory Management of Adults with Obstructive Sleep Apnea (2011)
  • An Official ATS Statement: Position Statement on ATS Activities for the Promotion of Respiratory and Sleep/Wake Health and the Care of the Critically Ill in the United States (2009)
  • Curriculum and Competency Assessment Tools for Sleep Disorders in Pulmonary Fellowship Training Programs (2005)
  • Executive Summary on the Systematic Review and Practice Parameters for Portable Monitoring in the Investigation of Suspected Sleep Apnea in Adults (2004)
  • Statement on Health Outcomes Research in Sleep Apnea (1998)

FDA Approves Rolapitant to Prevent Nausea and Vomiting from Chemotherapy

By Dr Deepu
On September 1, the Food and Drug Administration (FDA) approvedrolapitant (Varubi®) to prevent delayed phase chemotherapy-induced nausea and vomiting in adult cancer patients. The approval is for the use of rolapitant in combination with two other antiemetic drugs given during initial or repeated courses of vomit-inducing chemotherapy.

Delayed phase nausea and vomiting—generally defined as nausea or vomiting that occurs from 24 to 120 hours or more after a course of chemotherapy—tends to be under-reported and thus underestimated, explained Ann O’Mara, Ph.D., head of Palliative Care Research in NCI’sDivision of Cancer Prevention.

“Patients generally experience delayed nausea and vomiting at home. They may forget to report this experience at their next doctor’s appointment or clinicians may forget to ask about it,” Dr. O’Mara said.

Rolapitant, which is taken as a pill, works by blocking the activation of neurokinin-1 receptors, which are particularly abundant in the area of the brain that is involved in nausea and vomiting.

The FDA approved rolapitant based on results from three large randomized clinical trials. In the trials, patients treated with highly or moderately  emetogenic chemotherapy who received rolapitant in combination with the antiemetic drugs granisetron and dexamethasone had greater reductions in delayed phase vomiting and nausea compared with patients treated with a placebo in combination with granisetron and dexamethasone.

The most common adverse reactions among patients receiving rolapitant were loss of appetite and low white blood cell count, or neutropenia, which increases the risk of infection. Other common adverse reactions included hiccups and dizziness.

“Although considerable progress has been made in the management of acute chemotherapy-induced nausea and vomiting, many patients receiving chemotherapy still experience delayed nausea,” Dr. O’Mara noted. Although the symptoms can persist for up to 7 days, she continued, they tend to peak 48 to 72 hours after chemotherapy.

Currently approved antiemetic agents generally target the acute phase of nausea and vomiting in the first 24 hours after the start of chemotherapy. “Rolapitant, because of its longer duration of action, has the ability to affect the delayed nausea and vomiting,” Dr. O’Mara concluded.

The FDA cautioned that rolapitant should not be taken with the antipsychotic drug thioridazine because this combination of drugs can cause a serious type of irregular heartbeat.
Source : National cancer institute

FDA Grants Fast Track Designation For Idiopathic Pulmonary Fibrosis Drug

By Dr Deepu

Healio (9/11) reports that the Food and Drug Administration gave fast track designation to tipelukast, MediciNova’s experimental drug “for the treatment of patients with idiopathic pulmonary fibrosis.” The drug “demonstrated anti-inflammatory and anti-fibrotic activity in preclinical models through leukotriene receptor antagonism, as well as inhibition of phosphodiesterases and 5-lipoxygenase.” According to a company press release, “5-lipoxygenase/leukotriene pathway is believed to be a pathogenic factor in development of fibrosis, so the inhibitory effects demonstrated by tipelukast may be a novel treatment approach.”

Study: Long-Lived Smokers May Be Biologically Distinct

By Dr Deepu

The Washington Post (9/11, Cha) reports that “in an intriguing study published this week by University of California at Los Angeles researchers delved into the genetic makeup of long-lived smokers...and found that their survival may be due to an innate resilience they were born with.” While “on average, smokers’ life expectancy is 10 years less than non-smokers...the long-lived smokers are the exception and the researchers said that their findings suggest that they may be a ‘biologically distinct group’ that is endowed with genetic variants that allow them to respond differently to exposure.”