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Toronto Notes 2019 Landmark Respirology Trials Respirology R39 Landmark Respirology Trials
Trial
ARDS Network
Berlin Criteria CPAP and Apnea
EINSTEIN-PE
Emphysema Treatment Trial IELCAP
Lung Health
OSCILLATE ILD
POET-COPD REDUCE ROFLUMILAST TORCH
UPLIFT
Reference
NEJM 2000;342:1301-8 JAMA 2012;307:2526-33
NEJM 2005;353:2025-33 NEJM 2012;366:1287-97 NEJM 2003;348:2059-73 NEJM 2006;355:1763-71 JAMA 1994;272:1497-505
NEJM 2013;368: 795-805 NEJM 1978;298:801-9
NEJM 2011;364:1093-103 JAMA 2013;309: 2223-2231 Lancet 2009;374:695-703 NEJM 2007;356:775-89
NEJM 2008;359:1543-54
Results
Mortality decreased in ARDS patients ventilated with a low tidal volume strategy
The new definition of ARDS, better predicts mortality
CPAP ameliorates symptoms of sleep apnea but does not affect mortality in CHF
Fixed dose of rivoxabarin was non-inferior to standard therapy (Vit K antagonist) initial and long-term treatment of PE
Lung volume reduction surgery benefits patients with upper lobe disease and low exercise capacity
High survival rate in patients with early stage lung cancer detected by low dose CT screening
Aggressive smoking intervention significantly decreases the age- related decline in FEV1 in middle-aged smokers with mild airways obstruction
Early high-frequency oscillatory ventilation in patients with moderate to severe ARDS might increase in-hospital mortality
Interstitial lung disease subsets have different prognoses and response to treatment (e.g. desquamative but not usual interstitial pneumonia respond well to corticosteroids)
Tiotropium decreases the number of moderate-to-severe exacerbations in comparison to salmeterol
5 d course of glucocorticoids is non-inferior to a 14 d course for treatment of acute COPD exacerbations
Phosphodiesterase-4 inhibitor improves FEV1 when used as add-on therapy in COPD patients on tiotropium or salmeterol
Combination of inhaled steroids and long-acting β2-agonists improves COPD symptoms, reduces exacerbations, and shows a trend to lowers mortality
Tiotropium improves symptoms of COPD with fewer exacerbations, but does not affect FEV1 decline