BACKGROUND: Mortality rates from lung cancer are known to vary considerably between countries. Differences in patients, disease, investigation and treatment are thought to account for some survival shortfalls but it is not known whether differences in collection or processing of data also contribute. METHODOLOGY: We searched recognised sources where information regarding mortality rates have been published for the United Kingdom, Europe and United States (US). Data regarding patient selection, demographics and mortality rates were extracted. RESULTS: Published international 5-year survival for patients with lung cancer varies from 5% to 16%. The survival figures quoted in the literature are based on data which varies widely in its collection and statistical analysis and this information is not always in the public domain. Data from the US suggests an overall 5-year survival rate of up to 16% although this figure covers only a quarter of the general population and excludes patients without histological confirmation. Many European countries report higher mortality rates although in most, data includes patients without proven histology. European datasets have variable population coverage. CONCLUSION: Selective data collection and variable population coverage may account for some of the differences in lung cancer survival between countries. More transparent description of data collection and analysis would be helpful but ideally a uniform method of reporting data is required in order to make valid comparisons in mortality rates.

Data Collection↗

PubMed2006

The expanding role of leukotriene receptor antagonists in chronic asthma.

OBJECTIVE: To provide a comprehensive review of studies that evaluate the effects of leukotriene receptor antagonists in adult chronic asthma. DATA SOURCES: A literature search using MEDLINE, Clinical Evidence, and the Cochrane Library was performed using the following keywords: randomized controlled trial, asthma, cysteinyl leukotriene, leukotriene receptor antagonist, antileukotriene, montelukast, zafirlukast, pranlukast, inflammation, lung function, exacerbations, and symptoms. STUDY SELECTION: Relevant peer-reviewed articles (mostly randomized controlled trials, meta-analyses, and reviews) published up to July 2006 were selected and extracted. RESULTS: Leukotriene receptor antagonists are beneficial across a range of asthma severities and may have a particular role in exercise-induced asthma, aspirin-sensitive asthma, and individuals with concomitant allergic rhinitis. CONCLUSION: In the management of chronic asthma, leukotriene receptor antagonists have emerged as a useful oral nonsteroidal anti-inflammatory adjunct both as monotherapy and in combination with other classes of drugs. Monitoring their effects in terms of lung function alone may result in clinicians missing beneficial effects on inflammatory biomarkers, airway hyperresponsiveness, and exacerbations.

Adrenal Cortex Hormones↗

PubMed2006

Invalid and irrelevant comparisons: apples or oranges?

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Acetates↗

PubMed2006

Evaluating the effects of "triple therapy" with inhaled corticosteroids, long-acting beta2-agonists, and leukotriene modifiers in asthma.

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Acetates↗

PubMed2006

Why SMART about second-line treatment when first-line treatment is being ignored?

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Adrenal Cortex Hormones↗

PubMed2006

Long-acting beta2-agonists in asthma: not so SMART?

Asthma is a worldwide chronic disorder that is characterised by airway inflammation and hyper-responsiveness, which results in intermittent airflow obstruction and subsequent perception of symptoms and exacerbations. Inhaled corticosteroids are a fundamental component in the prevention of the short- and long-term complications associated with inadequately controlled asthma. However, many individuals experience persistent symptoms and exacerbations despite receiving low-to-medium doses of an inhaled corticosteroid (400-800 microg/day of beclometasone or equivalent). In these symptomatic asthmatic patients, guidelines advocate the initiation of a long-acting beta2-adrenoceptor agonist (LABA) as additional second-line controller therapy. The recent SMART (Salmeterol Multi-centre Asthma Research Trial) study was designed to compare the effects of add-on salmeterol 42 microg (ex-actuator) twice daily with placebo over 28 weeks in a randomised, double-blind, parallel-group fashion, with the intention to enrol 60,000 asthmatic patients. However, the study was halted prematurely because preliminary data revealed an increased mortality associated with regular use of salmeterol. Moreover, concerning rates of respiratory-related deaths, asthma-related deaths and life-threatening events were observed among African Americans, who constituted up to 18% of the study population. This in turn prompted the US FDA to announce important safety information regarding inhalers containing LABAs and advise that new labelling be produced outlining the "small but significant risk in asthma-related deaths" associated with their regular use. This evidence-based review discusses the data from SMART and highlights potentially important drawbacks with regular use of LABAs in persistent asthma.

Administration, Inhalation↗

PubMed2006

Indacaterol Novartis/skyePharma.

In collaboration with SkyePharma, Novartis is developing a multidose dry powder inhaler formulation of indacaterol, a long-acting beta2 agonist and bronchodilator, for the potential treatment of asthma and chronic obstructive pulmonary disease. In January 2006, Novartis expected phase III clinical trials to start in early 2006, with submission planned for 2007.

Administration, Inhalation↗