Heterogeneity within and between physician-diagnosed asthma and/or COPD: NOVELTY cohort.

Background: Studies of asthma and chronic obstructive pulmonary disease (COPD) typically focus on these diagnoses separately, limiting understanding of disease mechanisms and treatment options. NOVELTY is a global, 3-year, prospective observational study of patients with asthma and/or COPD from real-world clinical practice. We investigated heterogeneity and overlap by diagnosis and severity in this cohort.

Prospective observational study in patients with obstructive lung disease: NOVELTY design.

Asthma and chronic obstructive pulmonary disease (COPD) have overlapping clinical features and share pathobiological mechanisms but are often considered distinct disorders. Prospective, observational studies across asthma, COPD and asthma-COPD overlap are limited. NOVELTY is a global, prospective observational 3-year study enrolling ∼12 000 patients ≥12 years of age from primary and specialist clinical practices in 19 countries (ClinicalTrials.

The effect of DPP-4 inhibitors on asthma control: an administrative database study to evaluate a potential pathophysiological relationship.

Rationale: DPP-4 may regulate immunological pathways implicated in asthma. Assessing whether DPP-4 inhibitor (DPP-4i) use might affect asthma control is clinically important because DPP-4i use in type 2 diabetes mellitus management (T2DM) is increasing. This study evaluated associations between DPP-4i use and asthma control.

Colds as predictors of the onset and severity of COPD exacerbations.

Rationale: Common colds are associated with acute respiratory symptom exacerbations in COPD patients.

Objective: To determine exacerbation risk and severity in COPD patients with/without coincident self-reported colds.

Methods: Global initiative for chronic Obstructive Lung Disease stage I-IV COPD patients electronically transmitted respiratory symptom diaries to research staff daily between December 2006 and April 2009.

Association of knee pain and different definitions of knee osteoarthritis with health-related quality of life: a population-based cohort study in southern Sweden.

Background: While the impact of knee pain and knee osteoarthritis (OA) on health-related quality of life (HRQoL) has been investigated in the literature, there is a lack of knowledge on the impact of different definitions of OA on HRQoL. The main aim of this study was to measure and compare the impact of knee OA and its different definitions on HRQoL in the general population.

Methods: A random sample of 1300 participants from Malmö, Sweden with pain in one or both knees in the past 12 months with duration ≥4 weeks and 650 participants without were invited to clinical and radiographic knee examination.

Asthma and Chronic Obstructive Pulmonary Disease Overlap Syndrome: Doubled Costs Compared with Patients with Asthma Alone.

Background: Patients with asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) have more rapid disease progression and more exacerbations than do those with either condition alone. Little research has been performed, however, in these patients.

Objective: The objective was to summarize the health care utilization, costs, and comorbidities of patients with uncontrolled asthma and patients with ACOS.

Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort.

U-BIOPRED is a European Union consortium of 20 academic institutions, 11 pharmaceutical companies and six patient organisations with the objective of improving the understanding of asthma disease mechanisms using a systems biology approach.This cross-sectional assessment of adults with severe asthma, mild/moderate asthma and healthy controls from 11 European countries consisted of analyses of patient-reported outcomes, lung function, blood and airway inflammatory measurements.Patients with severe asthma (nonsmokers, n=311; smokers/ex-smokers, n=110) had more symptoms and exacerbations compared to patients with mild/moderate disease (n=88) (2.

Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care.

Objective: The aim of this study was to estimate the prevalence of frequent knee pain in radiographic, symptomatic and clinically defined knee OA in middle-aged and elderly patients and the proportion that seeks medical care.

Methods: In 2007 a random sample of 10 000 56- to 84-year-old residents of Malmö, Sweden, were questioned about knee pain. We classified subjects reporting knee pain with a duration of at least 4 weeks as having frequent knee pain.

Blood biomarkers and measures of pulmonary function--a study from the Swedish twin registry.

Objective: There is great need of biomarkers for research and clinical purposes in COPD. This study explored the relationships between ten putative plasma biomarkers of COPD and physiological measures of reduced lung function.

Methods: FEV(1), FVC, residual volume/total lung capacity (RV/TLC) and CO diffusion capacity (D(L)CO) were assessed in 357 subjects from the Swedish Twin Registry.

Effect of leisure time physical activity on severe knee or hip osteoarthritis leading to total joint replacement: a population-based prospective cohort study.

Background: Studies on leisure time physical activity as risk factor or protective factor for knee or hip osteoarthritis (OA) show divergent results. Longitudinal prospective studies are needed to clarify the association of physical activity with future OA. The aim was to explore in a prospective population-based cohort study the influence of leisure time physical activity on severe knee or hip OA, defined as knee or hip replacement due to OA.

The Christmas season as a risk factor for chronic obstructive pulmonary disease exacerbations.

Background: Epidemics of hospitalization for chronic obstructive pulmonary disease (COPD) occur annually during the Christmas holidays, and COPD exacerbations commonly coincide with respiratory viral infections.

Objective: To compare the incidence and determinants of COPD exacerbations occurring between the Christmas holiday period and the remainder of the winter season.

Methods: Seventy-one subjects with COPD of mixed severity faxed daily symptom diaries to a computer monitoring system from December 1, 2006, to April 30, 2007.

Twins studies as a model for studies on the interaction between smoking and genetic factors in the development of chronic bronchitis.

Smoking is the main risk factor for COPD (chronic obstructive pulmonary disease) but genetic factors are of importance, since only a subset of smokers develops the disease. Sex differences have been suggested both in disease prevalence and response to environmental exposures. Furthermore, it has been shown that acquisition of 'addiction' to smoking is partly genetically mediated.

BP variability and cardiovascular autonomic function in relation to forced expiratory volume: a population-based study.

Background: Cardiovascular autonomic dysfunction is associated with increased incidence of cardiovascular diseases. This population-based study explored whether low FEV(1) or low vital capacity (VC) is associated with autonomic dysfunction, as measured by spontaneous heart rate variability (HRV) and systolic BP variability (SBPV).

Methods: SBPV and HRV were recorded during 5 min of controlled breathing in men and women who were 70 years of age.

The big three concept: a way to tackle the health care crisis?

Tobacco use is the leading preventable cause of death and morbidity in the world. Chronic obstructive pulmonary disease (COPD), lung cancer, and cardiovascular disease (CVD) are the three major smoking-induced diseases that co-exist and can be detected at an early stage by screening, but are usually recognized in an advanced stage and treated as single entities. New epidemiologic data indicate a common origin of these diseases in susceptible individuals, and potential disease modification.

Interaction between smoking and genetic factors in the development of chronic bronchitis.

Rationale: Smoking is a primary risk factor for chronic bronchitis, emphysema, and chronic obstructive pulmonary disease, but since not all smokers develop disease, it has been suggested that some individuals may be more susceptible to exogenous factors, such as smoking, and that this susceptibility could be genetically determined.

Objectives: The aim of the present study was to assess, in a population-based sample of twins, the following: (1) to what extent genetic factors contribute to the development of chronic bronchitis, including emphysema, taking sex into consideration, and (2) whether the genetic influences on chronic bronchitis, including emphysema, are separate from those for smoking behavior.

Methods: Disease cases and smoking habits were identified in 44,919 twins older than 40 years from the Swedish Twin Registry.

No association between inhaled corticosteroids and whole body DXA in postmenopausal women.

Purpose: Postmenopausal women treated with corticosteroids are regarded as a high-risk group due to the effect of both natural bone loss and possible adverse effects of treatment with inhaled corticosteroids (IC).

Objective: To compare bone mineral density (BMD) in postmenopausal women exposed only to IC (IC group, n = 106) with that of BMD in women not exposed to corticosteroids (n = 124) and women exposed to oral and/or intra-articular injections in addition to inhaled corticosteroids (OC group, n = 31). The women were recruited from a population-based prospective cohort study.

Outcome of pregnancy in a randomized controlled study of patients with asthma exposed to budesonide.

Background: Budesonide is the only inhaled corticosteroid to be given a category B pregnancy rating by the US Food and Drug Administration, based on observational data from the Swedish Medical Birth Registry. However, data from large randomized controlled trials are lacking.

Objective: To compare pregnancy outcomes among patients with recent-onset mild-to-moderate persistent asthma receiving low-dose budesonide vs placebo.

Hospital use for COPD patients during the last few years of their life.

Little is known about what happens to COPD patients during their final years of life, in particular in terms of hospital use. We linked the Swedish Mortality and Inpatient Registers to examine this research question during the period 1987-2000. In year 2000, 2331 fatalities were diagnosed with COPD as the underlying cause of death.

Use of inhaled corticosteroids and bone mineral density in a population based study: the Nord-Trøndelag Health Study (the HUNT Study).

Conflicting results have been reported of the long-term effects of treatment with inhaled corticosteroids (ICS) on bone. The objective of this study was to compare ICS users and non-users regarding bone mineral density (BMD) in a large population. A total of 65,225 adults participated in a cross-sectional study in the Nord-Trøndelag Health Study 1995-1997.

Normal pregnancy outcomes in a population-based study including 2,968 pregnant women exposed to budesonide.

Background: Inhaled corticosteroids are recommended as first-line therapy for pregnant women with moderate to severe asthma, although the effects on pregnancy outcome are uncertain. A low compliance with the recommendations might lead to inadequate control of asthma, which has been associated with adverse outcomes both for the mother and the infant.

Objective: To investigate whether the reported use of inhaled budesonide (Pulmicort) during pregnancy influences birth outcome.

Is there an association between inhaled corticosteroids and bone density in postmenopausal women?

Background: During the last decades, there has been increased concern about the association between oral corticosteroid (OC) therapy and osteoporosis.

Objective: The question currently discussed is whether inhaled corticosteroids (ICs) in recommended doses have any clinically relevant effects on bone mineral density (BMD).

Methods: We compared BMD in postmenopausal women exposed to corticosteroids only in inhaled form (IC group, n = 106) with that in women not exposed to corticosteroids (unexposed group, n = 674).

Budesonide-treated asthmatic adolescents attain target height: a population-based follow-up study from Sweden.

Purpose: To examine final height in relation to target height in asthmatic patients with and without glucocorticoid treatment while growing up compared with healthy individuals.

Methods: In 1990 and 1993, questionnaires were distributed to all individuals born in 1974 and 1977 in the counties of Jämtland and Gästrikland in Sweden. All individuals reporting use of anti-asthmatic drugs or symptoms indicating possible obstructive airway disease, and a sample of healthy volunteers were invited to a clinical examination.