The implications of boosting Omalizumab treatment (OT) in patients with severe allergic asthma (SAA) remain unclear. The study aimed to explore and compare the 12-month effectiveness between continuous, at least 10-month OT (continuation group) and four-month boost of Omalizumab (boost group) in adult patients with SAA. In this retrospective cohort study, clinical data were collected for further analysis. Of all participants (n = 124), a significant reduction in annual exacerbations (baseline = 0.8 ± 1.5, follow-up = 0.5 ± 1.0, p = 0.047 *) and improvement in small airway ventilation as evaluated by forced expiratory flow at 25–75% (baseline = 55.1 ± 11.1%, follow-up = 59.4 ± 8.4%, p < 0.001 *) were found in the continuation group (n = 110). By contrast, the boost group (n = 14) had significantly increased annual exacerbations (baseline = 0.7 ± 1.4, follow-up = 2.9 ± 3.6, p = 0.031 *) and impaired small airway function (baseline = 55.3 ± 12.9, follow-up = 52.1 ± 12.5, p = 0.026 *). Furthermore, the continuation group rather than the boost group had significant decreases in the frequency of oral corticosteroid (OCS) use as controllers (baseline = 32.7%, follow-up = 20.0%, p = 0.047 *; baseline = 50.0%, follow-up = 21.4%, p = 0.237, respectively) and OCS maintenance dose (mg/month) (baseline = 85.9 ± 180.8, follow-up = 45.8 ± 106.6, p = 0.020 *; baseline = 171.4 ± 221.5, follow-up = 50.0 ± 104.3, p = 0.064, respectively), and increases in asthma control test scores (baseline = 16.0 ± 3.0, follow-up = 19.8 ± 4.4, p < 0.001 *; baseline = 14.6 ± 3.8, follow-up = 19.7 ± 4.7, p = 0.050, respectively). Continuous OT would be beneficial for adult patients with SAA, while boost of Omalizumab would worsen their long-term outcomes.

Lung cancer remains a challenge in daily practice. Chemotherapy is first considered for advanced lung adenocarcinoma bearing no active driver mutations. Maintaining drug efficacy and overcoming drug resistance are essential. This study aimed to explore the real-world use of anti-diabetic agent metformin in combination with pemetrexed-based platinum doublets in a first-line setting. We retrospectively collected data during 2004~2013 from TaiwaN′s National Health Insurance Research Database to access the survival benefit of metformin combined with pemetrexed-based platinum doublets as a first-line therapy for diabetic patients with advanced lung adenocarcinoma. Demographic data and information regarding platinum reagents, diabetes medications, and metformin doses were gathered, and overall survival status regarding metformin use was analyzed. Overall survival status based on the daily dose and the calculated cumulative defined daily dose (DDD) of metformin prescribed during the first 3 months after lung cancer was diagnosed was also assessed. A total of 495 patients were enrolled with a mean age of 67 years old, and the majority of the patients were male. After adjusting for age, sex, diabetes medication, and platinum reagents used, the adjusted hazard ratio (HR) for the metformin-user group was 0.61 (95% confidence interval (CI); 0.46~0.79; p < 0.001). The metformin-user group had a survival benefit (log-rank p < 0.001). We analyzed metformin dosing during the first 3 months after lung cancer diagnosis, and for a daily dose ≥ 1500 mg, the adjusted hazard ratio (aHR) was 0.42 (95% CI; 0.27~0.65; p < 0.001). Regarding the cumulative DDD of metformin, a DDD equal to or exceeding 21 resulted in aHR of 0.48 (95% CI; 0.34~0.69; p < 0.001). In this study, we found that the combination of metformin and pemetrexed-based platinum doublets provides a robust survival benefit as a first-line therapy for diabetic patients with advanced lung adenocarcinoma. It is worth conducting a large and randomized clinical trial to further investigate the antitumor effects of metformin on advanced lung adenocarcinoma when used as a first-ling therapy, including in non-diabetic patients.

Repurposing Metformin for Lung Cancer Management | InTechOpen, Published on: 2017-03-01. Authors: Chuan-Mu Chen, Jiun-Long Wang, Yi-Ting Tsai, et

Purpose: Chronic obstructive pulmonary disease (COPD) patients have multiple comorbidities and high all cause mortality and cardiovascular(CV) risk. Previously, Dietary Approaches to Stop Hypertension (DASH) diet showed beneficial effects on CV disease. The Mediterranean diet is associated to lung function improvement. However, the joint effect of Mediterranean diet and DASH diet on reduction COPD mortality is unknown. Materials and Method: We reviewed the data derived from the National Health and Nutrition Examination Survey (NHANES) cohort between 2007 and 2012. Total 12,060 cases were analyzed. Among them, 1610 cases diagnosed as obstructive lung disease. Adherence to DASH diet by DASH score ( >2 or less than 2) and adherence to Mediterranean diet (aMED >3 or less than 3) were recorded. Joint effects of adherence to DASH diet and aMED on mortality including all cause and cardiovascular(CV) were calculated separately. Results: Of the 12,060 cases, 1,610 belong to COPD group. In COPD group, the mean DASH score and aMED was 2.44 and 3.34 respectively. For good adherence to Mediterranean diet ( aMED>3 vs. less than 3 ), the adjusted hazard ratio(HR) for all cause and CV mortality reduced from 1.448 to 1.014 (p=0.0053) and 1.487 to 0.959 (p=0.16). When addition of DASH diet (score >2) to Mediterranean diet (aMED >3), the change of HR for all cause and CV mortality were 0.718 to 0.724 ( p=0.975 ) and 0.69 to 0.708 ( p=0.95 ) as compared Mediterranean diet alone. Conclusion: In our study, we found Mediterranean diet really reduce all cause and cardiovascular mortality for COPD group. The joint effect of DASH and Mediterranean diet did not provide additional survival benefit.

Purpose: Chronic obstructive pulmonary disease (COPD) bears high disease burden and causes high mortality. Besides pharmacologic therapy with inhaler, diet style and nutrition support also play important role. The Mediterranean diet is associated with lung function improvement. How about the beneficial and protective effects of Mediterranean diet on survival is unknown. What is the key component of Mediterranean diet is still under investigated. Materials and Method: We retrospectively reviewed the data derived from the National Health and Nutrition Examination Survey (NHANES) cohort during 2007 to 2012. All enrolled patients were aged above 18 years and total 1,610 cases with obstructive ventilation impairment (FEV1/FVC <70%) were analyzed. Alternative Mediterranean Diet Index (aMED) score was indicated the extend of adherence to Mediterranean diet. We tried to discover the association of aMED with mortality. Further key component of Mediterranean associated with mortality was also explored. Results: In our NHANES cohort, the mean age was 56.1 years and male was predominant (60.5 %). The smoking rate reached up to 71.3%. The average aMED score was 3.35. The hazard ratio (HR) of aMED with mortality was 0.67 (95% of CI: 0.51 ~0.87 and p=0.004). We found four key components for reducing mortality in COPD patients were nuts, fruits, vegetables and MUFA/SFA. Higher scores of above four components were associated with lower mortality. Conclusion: We found Mediterranean diet could reduce all-cause mortality for COPD group. The four key components of Mediterranean diet were nuts, fruits, vegetables and MUFA/SFA.

This study aims to assess the associations between lifestyle behaviors – including smoking, alcohol consumption, tea consumption, and leisure-time physical activity – and traditional Chinese Medicine (TCM) body constitutions (BCs), Yin deficiency, Yang deficiency, and phlegm stasis, among Taiwanese adults participating in the Taiwan Biobank Study. A total of 15,665 participants from the Taiwan Biobank Study were included in the analysis. Comprehensive data were collected on lifestyle behaviors (including smoking, alcohol consumption, tea consumption, and leisure-time physical activity) and family medical history. TCM BC types – Yin deficiency, Yang deficiency, and phlegm stasis – were assessed using a well-validated BC questionnaire. Associations between lifestyle behaviors and BC types were examined using multivariate logistic regression models to estimate odds ratios (ORs). The average age was 46.55 years (standard deviation: 12.17), with 5611 males (35.82%). Compared with nonsmokers, current smokers had a significantly higher likelihood of having Yang deficiency (OR [95% confidence interval (CI)]: 1.62 [1.39–1.89]), Yin deficiency (1.64 [1.41–1.90]), and phlegm stasis (1.88 [1.59–2.22]) after multivariate adjustment. Compared with nondrinkers, current drinkers had a significantly higher likelihood of having Yin deficiency (1.21 [1.02–1.44]) and phlegm stasis (1.27 [1.04–1.56]) after multivariate adjustment. Tea consumption was significantly associated with phlegm stasis (1.18 [1.08–1.29]). Regarding leisure-time physical activity, this habit was negatively associated with Yang deficiency, Yin deficiency, and phlegm stasis with multivariate adjustment (0.71 [0.65–0.78], 0.74 [0.68–0.81], and 0.63 [0.58–0.70], respectively). This study demonstrates that lifestyle behaviors are associated with imbalanced TCM BCs, particularly Yin deficiency, Yang deficiency, and phlegm stasis.