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      Thursday, March 23, 2023
      News & Perspective Drugs & Diseases CME & Education Academy Video Decision Point
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      CPD

      Patient With Shortness of Breath and Fever: A Practical Approach to Treatment Optimization in COPD

      • Authors: Daiana Stolz, MD, PhD
      • CPD Released: 5/17/2022
      • Valid for credit through: 5/17/2023
      Start Activity

      • Credits Available

        Non-US Physicians - maximum of 1.00 CPD

        You Are Eligible For

        • Letter of Completion

      Target Audience and Goal Statement

      This educational activity is intended for an international audience of non-US physicians, specifically primary care physicians and pulmonologists.

      The goal of this activity is that learners will be better able to improve early recognition of exacerbations of chronic obstructive pulmonary disease (COPD) and optimize therapy with the goal of improving patient outcomes.

      Upon completion of this activity, participants will:

      • Have increased knowledge regarding the
        • Impact of exacerbations on patients with COPD
        • Evidence from clinical trials for efficacy and safety of triple bronchodilation therapy in patients with COPD
      • Have greater competence related to
        • Assessment for COPD exacerbation 
        • Pharmacologic management for prevention of COPD exacerbation 

      Disclosures

      WebMD Global requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

      All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships with ineligible companies.

      Faculty

      • Daiana Stolz, MD, PhD

        Professor of Respiratory Medicine
        University Hospital
        Basel, Switzerland

        Disclosures

        Disclosure: Daiana Stolz, MD, PhD, has the following relevant financial relationships:
        Consultant or advisor for: Merck Sharp & Dohme Corp
        Speaker or member of speakers bureau for: AstraZeneca AG; GlaxoSmithKline AG; Novartis AG; Pfizer; Schwabe Pharma AG; Zambon
        Research funding from: AstraZeneca AG; Boston Scientific AG; Curetis AG; Circassia Pharmaceuticals

      Editors

      • Gillian Griffith, BA (Mod), MA

        Medical Education Director, WebMD Global, LLC

        Disclosures

        Disclosure: Gillian Griffith, BA (Mod), MA, has no relevant financial relationships.

      • Christina T. Loguidice, BA

        Medical Education Director, Medscape, LLC

        Disclosures

        Disclosure: Christina T. Loguidice, BA, has no relevant financial relationships.

      Compliance Reviewer

      • Susan L. Smith, MN, PhD

        Associate Director, Accreditation and Compliance

        Disclosures

        Disclosure: Susan L. Smith, MN, PhD, has no relevant financial relationships.

      Peer Reviewer

      This activity has been peer reviewed and the reviewer has no relevant financial relationships.

      Accreditation Statements

        For Physicians

      • The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.0 continuing professional development credits (CPD).

        Contact WebMD Global

      For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

      Instructions for Participation and Credit

      There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

      This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

      Follow these steps to claim a credit certificate for completing this activity:

      1. Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
      2. Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

      We encourage you to complete an Activity Evaluation to provide feedback for future programming.

      You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

      *The credit that you receive is based on your user profile.

      From Medscape Education
      CPD

      Patient With Shortness of Breath and Fever: A Practical Approach to Treatment Optimization in COPD

      Authors: Daiana Stolz, MD, PhDFaculty and Disclosures

      CPD Released: 5/17/2022

      Valid for credit through: 5/17/2023

      processing....

      References

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      3. Oliveira AS, et al. Identification and assessment of COPD exacerbations. Pulmonology. 2017;S2173-5115(17)30165-3.
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      31. Wei YF, et al. Impact of overweight and obesity on acute exacerbations of COPD - subgroup analysis of the Taiwan Obstructive Lung Disease cohort. Int J Chron Obstruct Pulmon Dis. 2017;12:2723-2729.
      32. Lee AL, Goldstein RS. Gastroesophageal reflux disease in COPD: links and risks. Int J Chron Obstruct Pulmon Dis. 2015;10:1935-1949.
      33. De Matteis S, et al. The occupations at increased risk of COPD: analysis of lifetime job-histories in the population-based UK Biobank Cohort. Eur Respir J. 2019;54:1900186.
      34. Dement JM, et al. COPD risk among older construction workers-updated analyses 2020. Am J Ind Med. 2021;64:462-475.
      35. Heibati B, et al. Occupational exposures and respiratory symptoms and lung function among hairdressers in Iran: a cross-sectional study. Int Arch Occup Environ Health. 2021;94:877-887.
      36. Au DH, et al. The effects of smoking cessation on the risk of chronic obstructive pulmonary disease exacerbations. J Gen Intern Med. 2009;24:457-463.
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      39. Kerkhof M, et al. Blood eosinophil count and exacerbation risk in patients with COPD. Eur Respir J. 2017;50:1700761.
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      41. Dransfield MT, et al. Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;195:324-330.
      42. Kerkhof M, et al. Association between COPD exacerbations and lung function decline during maintenance therapy. Thorax. 2020;75:744-753.
      43. Donaldson GC, et al. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax. 2002;57:847-852.
      44. Anzueto A. Impact of exacerbations on COPD. Eur Resp Rev. 2010;19:113-118.
      45. Seemungal TA, et al. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;161:1608-1613.
      46. Wageck B, et al. Recovery following acute exacerbations of chronic obstructive pulmonary disease - a review. COPD. 2019;16:93-103.
      47. Donaldson GC, et al. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Chest. 2010;137:1091‐1097.
      48. Kunisaki KM, et al. Exacerbations of chronic obstructive pulmonary disease and cardiac events. A post hoc cohort analysis from the SUMMIT randomized clinical trial. Am J Respir Crit Care Med. 2018;198:51-57.
      49. Sato M, et al. Impact of mild exacerbation on COPD symptoms in a Japanese cohort. Int J Chron Obstruct Pulmon Dis. 2016;11:1269-1278.
      50. Barnes N, et al. Chronic obstructive pulmonary disease and exacerbations: patient insights from the global Hidden Depths of COPD survey. BMC Pulm Med. 2013;13:54.
      51. Teixeira PJ, et al. Post-traumatic stress symptoms and exacerbations in COPD patients. COPD. 2015;12:90-95.
      52. Pei Z, et al. Estimating mortality among inpatients with acute exacerbation of chronic obstructive pulmonary disease using registry data. NPJ Prim Care Respir Med. 2020;30:28.
      53. Suissa S, et al. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax. 2012;67:957-963.
      54. Corhay JL, et al. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy. Int J Chron Obstruct Pulmon Dis. 2014;9:27-39.
      55. Jiang XQ, et al. Air pollution and chronic airway diseases: what should people know and do? J Thorac Dis. 2016;8:E31-E40.
      56. Rawal G, et al. Nutrition in chronic obstructive pulmonary disease: a review. J Transl Int Med. 2015;3:151-154.
      57. Hanson C, et al. Chronic obstructive pulmonary disease: a 2019 evidence analysis center evidence-based practice guideline. J Acad Nutr Diet. 2021;121:139-165.e15.
      58. Mammen MJ, et al. Dual LABA/LAMA therapy versus LABA or LAMA monotherapy for chronic obstructive pulmonary disease. A systematic review and meta-analysis in Support of the American Thoracic Society Clinical Practice Guideline. Ann Am Thorac Soc. 2020;17:1133-1143.
      59. Nannini LJ, et al. Combined corticosteroid and long-acting beta(2)-agonist in one inhaler versus long-acting beta(2)-agonists for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;2012(9):CD006829.
      60. Suissa S, et al. Comparative effectiveness and safety of LABA-LAMA vs LABA-ICS treatment of COPD in real-world clinical practice. Chest. 2019;155:1158-1165.
      61. Cortijo Gimeno J, et al. Perfil farmacológico del roflumilast [Pharmacological profile of roflumilast]. Arch Bronconeumol. 2010;46(suppl 10):19-24.
      62. Rabe KF, et al. Effect of roflumilast in patients with severe COPD and a history of hospitalisation. Eur Respir J. 2017;50:1700158.
      63. Rabe KF, et al. Triple inhaled therapy at two glucocorticoid doses in moderate-to-very-severe COPD. N Engl J Med. 2020;383:35-48.
      64. Martinaez FJ, et al. Reduced all-cause mortality in the ETHOS trial of budesonide/glycopyrrolate/formoterol for chronic obstructive pulmonary disease. A randomized, double-blind, multicenter, parallel-group study. Am J Respir Crit Care Med. 2021;203:553-564.
      65. Lipson DA, et al; IMPACT Investigators. Once-daily single-inhaler triple versus dual therapy in patients with COPD. N Engl J Med. 2018;378:1671-1680.
      66. Lipson DA, et al. Reduction in all-cause mortality with fluticasone furoate/umeclidinium/vilanterol in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2020;201:1508-1516.
      67. Ferguson GT, et al. Triple therapy with budesonide/glycopyrrolate/formoterol fumarate with co-suspension delivery technology versus dual therapies in chronic obstructive pulmonary disease (KRONOS): a double-blind, parallel-group, multicentre, phase 3 randomised controlled trial. Lancet Respir Med. 2018;6:747-758.
      68. Papi A, et al. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Lancet. 2018;391:1076-1084.
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