Evaluation of a Spanish language version of the Asthma Trigger Inventory.

Background: Perceptions of asthma triggers provide important guidance for patients' disease management. A psychometrically valid instrument, the Asthma Trigger Inventory (ATI), is available in English and German language versions, however, a version in Spanish as major world language has been missing.Method: A Spanish-language version of the ATI was evaluated in 339 adult patients with asthma, 223 of these in Peru and 107 in the USA. Principal Component analysis (PCA) with Varimax rotation was used to identify coherent trigger domains across and within samples. Resulting subscales were evaluated for internal consistency.Results: PCA suggested differences in factor structures between sites. Whereas the USA sample largely replicated original factors for animal allergens, pollen allergens, physical activity, air pollution/irritants, infections, and psychology, the initial analysis of the Peru sample suggested substantial overlap of air pollution/irritant, infection, and allergen items. Subsequent analysis of an expanded research form of the ATI for the Peru site culminated in extraction of five factors related to psychology, climate/temperature, combined pollen and animal allergens, physical activity, and infection. Internal consistencies were in an acceptable to excellent range (α = 0.74 to 0.94). Additional free trigger responses confirmed the importance of climate variables for patients in Peru. Psychological triggers were reported by 26% (Peru) and 31% (USA) of patients.Conclusion: Coherent trigger domains are readily identified and measured reliably by a Spanish-language ATI version. However, factor structures vary between samples from different Hispanic/Latino cultural and geographic domains. Culturally adapted versions of this instrument are therefore required for Hispanic/Latino population studies.

Fevipiprant, an oral prostaglandin DP2 receptor (CRTh2) antagonist, in allergic asthma uncontrolled on low-dose inhaled corticosteroids.

Dose-related efficacy and safety of fevipiprant (QAW039), an oral DP2 (CRTh2) receptor antagonist, was assessed in patients with allergic asthma uncontrolled by low-dose inhaled corticosteroids (ICS).Adult patients were randomised to 12 weeks' treatment with once-daily (1, 3, 10, 30, 50, 75, 150, 300 or 450 mg q.d) or twice-daily (2, 25, 75 or 150 mg b.i.d) fevipiprant (n=782), montelukast 10 mg q.d (n=139) or placebo (n=137). All patients received inhaled budesonide 200 µg b.i.dFevipiprant produced a statistically significant improvement in the primary end-point of change in pre-dose forced expiratory volume in 1 s at week 12 (p=0.0035) with a maximum model-averaged difference to placebo of 0.112 L. The most favourable pairwise comparisons to placebo were for the fevipiprant 150 mg q.d and 75 mg b.i.d groups, with no clinically meaningful differences between q.d and b.i.d Montelukast also demonstrated a significant improvement in this end-point. No impact on other efficacy end-points was observed. Adverse events were generally mild/moderate in severity, and were evenly distributed across doses and treatments.Fevipiprant appears to be efficacious and well-tolerated in this patient population, with an optimum total daily dose of 150 mg. Further investigations into the clinical role of fevipiprant in suitably designed phase III clinical trials are warranted.

[Characteristics of chronic obstructive pulmonary disease due to tobacco consumption in pneumology patients in lima and callao]. / Características de enfermedad pulmonar obstructiva crónica por consumo de tabaco en pacientes de servicios de neumología de Lima y Callao.

The aim of the study was to describe the clinical characteristics of patients with COPD receiving treatment at the pneumology units of specialized care centers in Lima and Callao. A cross-sectional study was performed on 196 patients, with a mean age of 69 years, interquartile range of 63-75 years. Of these patients, 31.1% was classified in the GOLD 1/ mild group (FEV1 ≥80%); 41.8% in the GOLD 2/moderate group (50%≤FEV1<80%); 22.5% in the GOLD 3/severe group (30%≤FEV1<50%), and 4.6% in the GOLD 4/very severe group (FEV1 <30%). A 93.9% of patients used some type of medication for COPD. The most-frequently used therapy was the combination of long-acting beta agonists and inhaled corticosteroids (LABA/ICS) (31.1%). A preliminary characterization has been obtained for COPD patients treated in these centers, but it is essential to complement these findings with longitudinal studies.

El objetivo del estudio fue describir las características clínicas de pacientes con enfermedad pulmonar obstructiva crónica (EPOC), atendidos en los servicios de Neumología de centros especializados de Lima y Callao. Se realizó un estudio transversal en 196 pacientes, con una mediana de edad de 69 años, rango intercuartil 63-75 años. El 31,1 % de los pacientes se encontró en el grupo GOLD 1/leve (VEF1 ≥80 %), el 41,8 % en el grupo GOLD 2/moderado (50 %≤VEF1<80 %), el 22,5 % en el grupo GOLD 3/severo (30 %≤VEF1<50 %), y el 4,6 % en el grupo GOLD 4/muy severo (VEF1 <30 %). El 93,9 % usaba algún tipo de medicación para EPOC, la terapia más usada fue la combinación de beta agonistas de acción larga/corticoides inhalados (LABA/ICS) con 31,1 %. Se ha obtenido una primera caracterización de pacientes con EPOC atendidos en estos centros. Es imprescindible complementar lo encontrado con estudios longitudinales.

Características de enfermedad pulmonar obstructiva crónica por consumo de tabaco en pacientes de servicios de neumología de Lima y Callao / Characteristics of chronic obstructive pulmonary disease due to tobacco consumption in pneumology patients in lima and callao

RESUMEN El objetivo del estudio fue describir las características clínicas de pacientes con enfermedad pulmonar obstructiva crónica (EPOC), atendidos en los servicios de Neumología de centros especializados de Lima y Callao. Se realizó un estudio transversal en 196 pacientes, con una mediana de edad de 69 años, rango intercuartil 63-75 años. El 31,1 % de los pacientes se encontró en el grupo GOLD 1/leve (VEF1 ≥80 %), el 41,8 % en el grupo GOLD 2/moderado (50 %≤VEF1<80 %), el 22,5 % en el grupo GOLD 3/severo (30 %≤VEF1<50 %), y el 4,6 % en el grupo GOLD 4/muy severo (VEF1 <30 %). El 93,9 % usaba algún tipo de medicación para EPOC, la terapia más usada fue la combinación de beta agonistas de acción larga/corticoides inhalados (LABA/ICS) con 31,1 %. Se ha obtenido una primera caracterización de pacientes con EPOC atendidos en estos centros. Es imprescindible complementar lo encontrado con estudios longitudinales.

ABSTRACT The aim of the study was to describe the clinical characteristics of patients with COPD receiving treatment at the pneumology units of specialized care centers in Lima and Callao. A cross-sectional study was performed on 196 patients, with a mean age of 69 years, interquartile range of 63-75 years. Of these patients, 31.1% was classified in the GOLD 1/ mild group (FEV1 ≥80%); 41.8% in the GOLD 2/moderate group (50%≤FEV1<80%); 22.5% in the GOLD 3/severe group (30%≤FEV1<50%), and 4.6% in the GOLD 4/very severe group (FEV1 <30%). A 93.9% of patients used some type of medication for COPD. The most-frequently used therapy was the combination of long-acting beta agonists and inhaled corticosteroids (LABA/ICS) (31.1%). A preliminary characterization has been obtained for COPD patients treated in these centers, but it is essential to complement these findings with longitudinal studies.