Acute COPD exacerbations.

Exacerbations are important events for patients with chronic obstructive pulmonary disease (COPD) and key outcomes in COPD studies and trials. Exacerbations have an impact on health status and contribute to disease progression, and exacerbation prevention is a key goal of therapy in COPD. A majority of COPD exacerbations are triggered by respiratory viral infections and/or bacterial infections. Several pharmacologic therapies can prevent COPD exacerbations and reduce hospital admissions. Nonpharmacologic interventions for exacerbation prevention include pulmonary rehabilitation, long-term oxygen therapy, and home noninvasive ventilator support. Improved management of acute exacerbations also prolongs the time to the next exacerbation event.

[1]  R. Hubbard,et al.  Increased risk of myocardial infarction and stroke following exacerbation of COPD. , 2010, Chest.

[2]  S. Hurd,et al.  Global Strategy for the Diagnosis, Management and Prevention of COPD: 2003 update , 2003, European Respiratory Journal.

[3]  J. DiNicolantonio,et al.  Azithromycin for prevention of exacerbations of COPD. , 2011, The New England journal of medicine.

[4]  Liam Ck.  A 4-year trial of tiotropium in chronic obstructive pulmonary disease. , 2008 .

[5]  T. Seemungal,et al.  Long-term erythromycin therapy is associated with decreased chronic obstructive pulmonary disease exacerbations. , 2008, American journal of respiratory and critical care medicine.

[6]  T. Seemungal,et al.  Early therapy improves outcomes of exacerbations of chronic obstructive pulmonary disease. , 2004, American journal of respiratory and critical care medicine.

[7]  R. Herings,et al.  Antibiotic treatment is associated with reduced risk of a subsequent exacerbation in obstructive lung disease: an historical population based cohort study , 2008, Thorax.

[8]  Mm Jones.  Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care , 2010 .

[9]  T. Seemungal,et al.  COPD exacerbations: defining their cause and prevention , 2007, The Lancet.

[10]  S. Suissa,et al.  Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality , 2012, Thorax.

[11]  Louise Marston,et al.  Outdoor air pollution and respiratory health in patients with COPD , 2011, Thorax.

[12]  J. Wedzicha,et al.  Susceptibility to exacerbation in chronic obstructive pulmonary disease. , 2010, The New England journal of medicine.

[13]  K. Rabe,et al.  Tiotropium versus salmeterol for the prevention of exacerbations of COPD. , 2011, The New England journal of medicine.

[14]  J. Wedzicha,et al.  Detection and severity grading of COPD exacerbations using the exacerbations of chronic pulmonary disease tool (EXACT) , 2013, European Respiratory Journal.

[15]  M. Briel,et al.  Short-term vs conventional glucocorticoid therapy in acute exacerbations of chronic obstructive pulmonary disease: the REDUCE randomized clinical trial. , 2013, JAMA.

[16]  F. Martinez,et al.  Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials , 2009, The Lancet.

[17]  T. Seemungal,et al.  Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. , 2001, American journal of respiratory and critical care medicine.

[18]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[19]  R. Mcevoy,et al.  Nocturnal non-invasive nasal ventilation in stable hypercapnic COPD: a randomised controlled trial , 2009, Thorax.

[20]  N. Anthonisen,et al.  Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. , 1987, Annals of internal medicine.

[21]  J. Wedzicha,et al.  Analysis of chronic obstructive pulmonary disease exacerbations with the dual bronchodilator QVA149 compared with glycopyrronium and tiotropium (SPARK): a randomised, double-blind, parallel-group study. , 2013, The Lancet. Respiratory medicine.

[22]  J. Wedzicha,et al.  Efficacy of roflumilast in the COPD frequent exacerbator phenotype. , 2013, Chest.

[23]  J. Wedzicha,et al.  Usefulness of the Chronic Obstructive Pulmonary Disease Assessment Test to evaluate severity of COPD exacerbations. , 2012, American journal of respiratory and critical care medicine.

[24]  J. Wedzicha,et al.  Pulsed moxifloxacin for the prevention of exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial , 2010, Respiratory research.

[25]  Bartolome Celli,et al.  Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. , 2007, The New England journal of medicine.

[26]  K. Nichol,et al.  Effectiveness of influenza vaccine in the community-dwelling elderly. , 2007, The New England journal of medicine.

[27]  T. Seemungal,et al.  Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. , 1998, American journal of respiratory and critical care medicine.

[28]  P. Macfarlane,et al.  Diagnosis of myocardial infarction following hospitalisation for exacerbation of COPD , 2012, European Respiratory Journal.

[29]  J. Wedzicha,et al.  Mechanisms and impact of the frequent exacerbator phenotype in chronic obstructive pulmonary disease , 2013, BMC Medicine.

[30]  T. Seemungal,et al.  Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease , 2002, Thorax.

[31]  J. Wedzicha,et al.  Temporal clustering of exacerbations in chronic obstructive pulmonary disease. , 2010, American journal of respiratory and critical care medicine.