Publications by authors named "Alcazar-Navarrete B"

Objective: This study aimed to evaluate clinical control in chronic obstructive pulmonary disease (COPD), the consequences in terms of treatment decisions, and their potentially associated factors during follow-up of patients in real-life clinical practice.

Methods: EPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care provided to patients with a diagnosis of COPD in respiratory clinics in Spain and multivariable logistic regression models to assess the relationships between clinical control and clinical inertia.

Results: 4225 patients from 45 hospitals in Spain were audited.

View Article and Find Full Text PDF

Introduction: Non-small cell lung cancer (NSCLC) is the most common type of lung neoplasm. Despite surgical resection, it has a high relapse rate, accounting for 30-55% of all cases. Next-generation sequencing (NGS) based on a customized gene panel and the analysis of circulating tumor cells (CTCs) can help identify heterogeneity, stratify high-risk patients, and guide treatment decisions.

View Article and Find Full Text PDF

Intrathecal drug delivery (IDD) is part of the fourth analgesic step. Evidence on the quality of life of patients with refractory chronic non-cancer pain (CNCP) using these devices and their long-term outcomes is scarce. This study aims to evaluate patients with IDD to assess their HRQoL.

View Article and Find Full Text PDF
Article Synopsis
  • The ANTES B+ study evaluates whether adding an inhaled corticosteroid (ICS) to a combination of long-acting beta agonist (LABA) and long-acting muscarinic antagonist (LAMA) improves clinical control in GOLD B COPD patients who are still symptomatic despite current treatment.
  • It will involve 1028 patients who will either continue their current LABA/LAMA regimen or switch to a new triple therapy for a year, measuring outcomes like clinical control, exacerbation rates, and lung function.
  • The study is significant as it is the first to test this approach in a specific COPD patient group and to use a composite index to measure primary outcomes, with results expected by early 2026.
View Article and Find Full Text PDF

Background: Idiopathic pulmonary fibrosis (IPF) is a rare disorder associated with increased mortality and morbidity. There are currently two drugs approved for IPF but their safety and efficacy profile in real-world settings in Spain is not well understood.

Methods: An observational, multicentre, prospective study was carried out among patients with IPF who started treatment with pirfenidone or nintedanib from 2015 to 2021.

View Article and Find Full Text PDF
Article Synopsis
  • Alpha-1 antitrypsin deficiency (AATD) is a common inherited disorder linked to chronic obstructive pulmonary disease (COPD), yet it remains underdiagnosed; a recent audit aimed to evaluate AAT testing rates among COPD patients in Spain from 2021-2022 and compare results with a similar audit from 2014-2015.! -
  • The audit analyzed 4,225 COPD patients and found that 39.5% had AAT levels tested, with higher testing likelihood associated with patients under 55, those treated at specialized clinics, and those with severe COPD, while factors like higher Charlson index and lack of AATD genotyping availability were linked to lower testing rates.!
View Article and Find Full Text PDF

Melatonin acute treatment limits obesity of young Zücker diabetic fatty (ZDF) rats by non-shivering thermogenesis (NST). We recently showed melatonin chronically increases the oxidative status of vastus lateralis (VL) in both obese and lean adult male animals. The identification of VL skeletal muscle-based NST by uncoupling of sarcoendoplasmic reticulum Ca-ATPase (SERCA)- sarcolipin (SLN) prompted us to investigate whether melatonin is a SERCA-SLN calcium futile cycle uncoupling and mitochondrial biogenesis enhancer.

View Article and Find Full Text PDF
Article Synopsis
  • * Patients with COPD showing signs of CVD or vice versa should be referred to the appropriate specialist, especially if they exhibit specific symptoms like palpitations or excessive dyspnea.
  • * Treatment for patients with both conditions may include specific medications, such as long-acting bronchodilators for COPD and cardioselective beta-blockers for CVD, tailored to the severity and frequency of exacerbations.
View Article and Find Full Text PDF

COPD is a typical example of chronic disease. As such, treatment adherence tends to be as low as between 30% and 50%, with specific issues in COPD due to the use of inhaled therapies. Decreased adherence in COPD is associated with worse outcomes, with increased risk for exacerbations and long-term mortality.

View Article and Find Full Text PDF

Introduction: Mortality from COPD has decreased in Spain in recent years, but it is unknown whether this decline has been homogeneous among the different regions.

Methods: From the Statistical Portal of the Ministry of Health of Spain we obtained the age-adjusted mortality rates/100,000 inhabitants for men and women in Spain and the Autonomous Communities for the years 1999-2019, using the coding of the International Classification of Diseases (ICD 10, sections J40-J44). With the adjusted rates we performed a jointpoint regression analysis to estimate an annual percentage change (APC), as well as identify possible points of trend change.

View Article and Find Full Text PDF

Objective: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. While two approved fixed-dose inhaled corticosteroid/long-acting muscarinic antagonist (LAMA)/long-acting β-agonist (LABA) triple therapies reduce all-cause mortality (ACM) versus dual LAMA/LABA therapy in patients with COPD, head-to-head studies have not compared the effects of these therapies on ACM. We compared ACM in adults with moderate-to-very severe COPD receiving budesonide/glycopyrrolate/formoterol fumarate (BGF) in ETHOS versus fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) in IMPACT using a matching-adjusted indirect comparison (MAIC).

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to analyze how inhaled maintenance therapy for COPD is prescribed based on patient risk levels and factors influencing the decision to use inhaled corticosteroids (ICS) alongside bronchodilators in real-world settings.
  • A large audit called EPOCONSUL 2021 reviewed over 4,200 COPD patients across Spain, finding that 74.5% were classified as high risk.
  • Results indicated that ICS were commonly prescribed for low-risk patients under specific conditions, while high-risk patients more often received triple therapy; however, adherence to guidelines in treatment adjustments during follow-ups was not consistent.
View Article and Find Full Text PDF

Introduction: The aim of our work has been to describe the results of the clinical audit carried out in 2021 and to compare the results with 2015 EPOCONSUL audit.

Methods: EPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care provided to patients with a diagnosis of chronic obstructive pulmonary disease (COPD) in respiratory clinics in Spain with prospective recruitment between April 15, 2021, and January 31, 2022.

Results: A total of 45 hospitals participated in the 2021 audit and 4.

View Article and Find Full Text PDF

Background: COPD is a leading cause of death and disability. COPD therapy goals include reducing exacerbations and improving symptom control. Single-inhaler triple therapy (SITT) or multiple-inhaler triple therapy (MITT) is indicated for patients with frequent exacerbations despite bronchodilator therapy.

View Article and Find Full Text PDF

Introduction: Type 2 (T2) biomarkers such as blood eosinophil count (BEC) and FeNO have been related to a higher risk of exacerbations in COPD. It is unknown whether combining these biomarkers could be useful in forecasting COPD exacerbations.

Methods: COPD patients were enrolled in this prospective, multicenter, observational study and followed up for 1 year, during which BEC were analysed at baseline (V0) while FeNO analyses were performed at baseline (V0), 6 months (V1) and 12 months (V2).

View Article and Find Full Text PDF

In recent years, personalized or precision medicine has made effective inroads into the management of diseases, including respiratory diseases. The route to implementing this approach must invariably start with the identification and validation of biological biomarkers that are closely related to the diagnosis, treatment, and prognosis of respiratory patients. In this respect, biological biomarkers of greater or lesser reliability have been identified for most respiratory diseases and disease classes, and a large number of studies are being conducted in the search for new indicators.

View Article and Find Full Text PDF

Background: The cost of chronic obstructive pulmonary disease (COPD) in Spain has been studied from different perspectives, but parameters such as the patient's phenotype have seldom been considered. Our aim was to describe the disease burden of COPD patients with frequent exacerbator phenotype, treated with triple therapy.

Methods: An observational, multicenter study was carried out from December 2017 to November 2018 in pulmonology services among patients ≥40 years with COPD confirmed diagnosis receiving triple therapy (ICS/LAMA/LABA) and history of ≥2 moderate or ≥1 severe exacerbation in the 12 months prior to the inclusion visit.

View Article and Find Full Text PDF

Background: The concept of clinical control has been proposed as an instrument for evaluating patients with COPD. However, the possible association between clinical control, reduced symptom severity and HRQoL has yet to be confirmed.

Methods: This multicentre, prospective and observational study was carried out in 15 pulmonology clinics in Spain.

View Article and Find Full Text PDF

Introduction: Despite the evidence provided by clinical trials, there are some uncertainties and controversies regarding the use of triple inhaled therapy. With the aim of evaluating clinical practice in specialized respiratory units, a Delphi consensus document was implemented on the use of single-inhaler fixed-dose triple therapies after 1 year of use in Spain.

Methods: A scientific committee of COPD experts defined a thematic index, guided a systematic literature review and helped design the Delphi questionnaire.

View Article and Find Full Text PDF

Background: Hospital workers have been the most frequently and severely affected professional group during the COVID-19 pandemic, and have a big impact on transmission. In this context, innovative tools are required to measure the symptoms compatible with COVID-19, the spread of infection, and testing capabilities within hospitals in real time.

Objective: We aimed to develop and test an effective and user-friendly tool to identify and track symptoms compatible with COVID-19 in hospital workers.

View Article and Find Full Text PDF