Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome
ABSTRACT Background and objective The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivele...
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| Veröffentlicht in: | Respirology (Carlton, Vic.) Vic.), 2017-05, Vol.22 (4), p.708-713 |
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| creator | Kido, Takashi Muramatsu, Keiji Yatera, Kazuhiro Asakawa, Takeshi Otsubo, Hiroki Kubo, Tatsuhiko Fujino, Yoshihisa Matsuda, Shinya Mayumi, Toshihiko Mukae, Hiroshi |
| description | ABSTRACT
Background and objective
The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivelestat group and the non‐sivelestat group within 7 days of admission.
Methods
This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non‐sivelestat group.
Results
A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non‐sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75–0.93; P |
| doi_str_mv | 10.1111/resp.12969 |
| format | Article |
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Background and objective
The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivelestat group and the non‐sivelestat group within 7 days of admission.
Methods
This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non‐sivelestat group.
Results
A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non‐sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75–0.93; P < 0.002). Multiple regression analysis revealed that younger age, absence of cancer, no need for haemodialysis and no use of high‐dose methylprednisolone were significantly correlated with treatment success (survive).
Conclusion
These results of this retrospective and observational study suggest that administration of sivelestat within 7 days of admission may improve the prognosis of patients with ALI/ARDS. To our knowledge, this is the largest study to evaluate the efficacy of sivelestat on ALI/ARDS.
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are critical respiratory diseases. No effective pharmacotherapies have been established and the efficacy of sivelestat for ALI/ARDS remains uncertain. Our results suggest that early sivelestat administration may improve the prognosis of patients with ALI/ARDS.</description><identifier>ISSN: 1323-7799</identifier><identifier>EISSN: 1440-1843</identifier><identifier>DOI: 10.1111/resp.12969</identifier><identifier>PMID: 27990710</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>acute lung injury ; Acute Lung Injury - drug therapy ; acute respiratory distress syndrome ; Aged ; Cancer ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Elastase ; Female ; Follow-Up Studies ; Glycine - administration & dosage ; Glycine - analogs & derivatives ; Hemodialysis ; Humans ; inverse probability of treatment weighting ; Lungs ; Male ; Methylprednisolone ; Mortality ; Multiple regression analysis ; nationwide administrative database ; Prognosis ; Respiratory diseases ; Respiratory distress syndrome ; Respiratory Distress Syndrome, Adult - drug therapy ; Respiratory therapy ; Retrospective Studies ; Serine Proteinase Inhibitors - administration & dosage ; sivelestat ; Sulfonamides - administration & dosage ; Time Factors ; Treatment Outcome ; Ventilators</subject><ispartof>Respirology (Carlton, Vic.), 2017-05, Vol.22 (4), p.708-713</ispartof><rights>2016 Asian Pacific Society of Respirology</rights><rights>2016 Asian Pacific Society of Respirology.</rights><rights>2017 Asian Pacific Society of Respirology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4569-c1fabb073ce6fbfb00c8b330773f4cf4a4ef43b86f43bcbc643fa4ed605b93b93</citedby><cites>FETCH-LOGICAL-c4569-c1fabb073ce6fbfb00c8b330773f4cf4a4ef43b86f43bcbc643fa4ed605b93b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fresp.12969$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fresp.12969$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27990710$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kido, Takashi</creatorcontrib><creatorcontrib>Muramatsu, Keiji</creatorcontrib><creatorcontrib>Yatera, Kazuhiro</creatorcontrib><creatorcontrib>Asakawa, Takeshi</creatorcontrib><creatorcontrib>Otsubo, Hiroki</creatorcontrib><creatorcontrib>Kubo, Tatsuhiko</creatorcontrib><creatorcontrib>Fujino, Yoshihisa</creatorcontrib><creatorcontrib>Matsuda, Shinya</creatorcontrib><creatorcontrib>Mayumi, Toshihiko</creatorcontrib><creatorcontrib>Mukae, Hiroshi</creatorcontrib><title>Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome</title><title>Respirology (Carlton, Vic.)</title><addtitle>Respirology</addtitle><description>ABSTRACT
Background and objective
The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivelestat group and the non‐sivelestat group within 7 days of admission.
Methods
This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non‐sivelestat group.
Results
A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non‐sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75–0.93; P < 0.002). Multiple regression analysis revealed that younger age, absence of cancer, no need for haemodialysis and no use of high‐dose methylprednisolone were significantly correlated with treatment success (survive).
Conclusion
These results of this retrospective and observational study suggest that administration of sivelestat within 7 days of admission may improve the prognosis of patients with ALI/ARDS. To our knowledge, this is the largest study to evaluate the efficacy of sivelestat on ALI/ARDS.
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are critical respiratory diseases. No effective pharmacotherapies have been established and the efficacy of sivelestat for ALI/ARDS remains uncertain. Our results suggest that early sivelestat administration may improve the prognosis of patients with ALI/ARDS.</description><subject>acute lung injury</subject><subject>Acute Lung Injury - drug therapy</subject><subject>acute respiratory distress syndrome</subject><subject>Aged</subject><subject>Cancer</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>Elastase</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glycine - administration & dosage</subject><subject>Glycine - analogs & derivatives</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>inverse probability of treatment weighting</subject><subject>Lungs</subject><subject>Male</subject><subject>Methylprednisolone</subject><subject>Mortality</subject><subject>Multiple regression analysis</subject><subject>nationwide administrative database</subject><subject>Prognosis</subject><subject>Respiratory diseases</subject><subject>Respiratory distress syndrome</subject><subject>Respiratory Distress Syndrome, Adult - drug therapy</subject><subject>Respiratory therapy</subject><subject>Retrospective Studies</subject><subject>Serine Proteinase Inhibitors - administration & dosage</subject><subject>sivelestat</subject><subject>Sulfonamides - administration & dosage</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventilators</subject><issn>1323-7799</issn><issn>1440-1843</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkVtLBCEYhiWKdtu66QeE0E0Es-noHLyMZTvAQtHhWtTRcpnDpjPF_PucZuuii5IPlZfHVz9fAI4xmuMwLpz2mzmOWcp2wBRTiiKcU7Ib9iQmUZYxNgEH3q8RQiRByT6YxEFDGUZT8Lo0xiqhetgYqIUre-jtuy61b0ULRVHZ2vrWidY2NQwlVNdqWHb1C7T1unM9FHWxVYd32IA2QS2GU9p76Pu6cE2lD8GeEaXXR9t1Bp6vlk-Lm2h1d327uFxFiiYpixQ2QkqUEaVTI41ESOWSEJRlxFBlqKDaUCLzdJiVVCklJmhFihLJSKgZOBt9N65560IbvLJe6bIUtW46z3HOcJ7TJFzxP5rgOM8JSgJ6-gtdN52rQyMcsxglNCPZQJ2PlHKN904bvnG2Eq7nGPEhKj58Ef-KKsAnW8tOVrr4Qb-zCQAegQ9b6v4PK_6wfLwfTT8BwSygsA</recordid><startdate>201705</startdate><enddate>201705</enddate><creator>Kido, Takashi</creator><creator>Muramatsu, Keiji</creator><creator>Yatera, Kazuhiro</creator><creator>Asakawa, Takeshi</creator><creator>Otsubo, Hiroki</creator><creator>Kubo, Tatsuhiko</creator><creator>Fujino, Yoshihisa</creator><creator>Matsuda, Shinya</creator><creator>Mayumi, Toshihiko</creator><creator>Mukae, Hiroshi</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><scope>7U9</scope></search><sort><creationdate>201705</creationdate><title>Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome</title><author>Kido, Takashi ; Muramatsu, Keiji ; Yatera, Kazuhiro ; Asakawa, Takeshi ; Otsubo, Hiroki ; Kubo, Tatsuhiko ; Fujino, Yoshihisa ; Matsuda, Shinya ; Mayumi, Toshihiko ; Mukae, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4569-c1fabb073ce6fbfb00c8b330773f4cf4a4ef43b86f43bcbc643fa4ed605b93b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>acute lung injury</topic><topic>Acute Lung Injury - drug therapy</topic><topic>acute respiratory distress syndrome</topic><topic>Aged</topic><topic>Cancer</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>Elastase</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glycine - administration & dosage</topic><topic>Glycine - analogs & derivatives</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>inverse probability of treatment weighting</topic><topic>Lungs</topic><topic>Male</topic><topic>Methylprednisolone</topic><topic>Mortality</topic><topic>Multiple regression analysis</topic><topic>nationwide administrative database</topic><topic>Prognosis</topic><topic>Respiratory diseases</topic><topic>Respiratory distress syndrome</topic><topic>Respiratory Distress Syndrome, Adult - drug therapy</topic><topic>Respiratory therapy</topic><topic>Retrospective Studies</topic><topic>Serine Proteinase Inhibitors - administration & dosage</topic><topic>sivelestat</topic><topic>Sulfonamides - administration & dosage</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kido, Takashi</creatorcontrib><creatorcontrib>Muramatsu, Keiji</creatorcontrib><creatorcontrib>Yatera, Kazuhiro</creatorcontrib><creatorcontrib>Asakawa, Takeshi</creatorcontrib><creatorcontrib>Otsubo, Hiroki</creatorcontrib><creatorcontrib>Kubo, Tatsuhiko</creatorcontrib><creatorcontrib>Fujino, Yoshihisa</creatorcontrib><creatorcontrib>Matsuda, Shinya</creatorcontrib><creatorcontrib>Mayumi, Toshihiko</creatorcontrib><creatorcontrib>Mukae, Hiroshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Virology and AIDS Abstracts</collection><jtitle>Respirology (Carlton, Vic.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kido, Takashi</au><au>Muramatsu, Keiji</au><au>Yatera, Kazuhiro</au><au>Asakawa, Takeshi</au><au>Otsubo, Hiroki</au><au>Kubo, Tatsuhiko</au><au>Fujino, Yoshihisa</au><au>Matsuda, Shinya</au><au>Mayumi, Toshihiko</au><au>Mukae, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome</atitle><jtitle>Respirology (Carlton, Vic.)</jtitle><addtitle>Respirology</addtitle><date>2017-05</date><risdate>2017</risdate><volume>22</volume><issue>4</issue><spage>708</spage><epage>713</epage><pages>708-713</pages><issn>1323-7799</issn><eissn>1440-1843</eissn><abstract>ABSTRACT
Background and objective
The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivelestat group and the non‐sivelestat group within 7 days of admission.
Methods
This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non‐sivelestat group.
Results
A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non‐sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75–0.93; P < 0.002). Multiple regression analysis revealed that younger age, absence of cancer, no need for haemodialysis and no use of high‐dose methylprednisolone were significantly correlated with treatment success (survive).
Conclusion
These results of this retrospective and observational study suggest that administration of sivelestat within 7 days of admission may improve the prognosis of patients with ALI/ARDS. To our knowledge, this is the largest study to evaluate the efficacy of sivelestat on ALI/ARDS.
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are critical respiratory diseases. No effective pharmacotherapies have been established and the efficacy of sivelestat for ALI/ARDS remains uncertain. Our results suggest that early sivelestat administration may improve the prognosis of patients with ALI/ARDS.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>27990710</pmid><doi>10.1111/resp.12969</doi><tpages>6</tpages></addata></record> |
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| subjects | acute lung injury Acute Lung Injury - drug therapy acute respiratory distress syndrome Aged Cancer Dose-Response Relationship, Drug Drug Administration Schedule Elastase Female Follow-Up Studies Glycine - administration & dosage Glycine - analogs & derivatives Hemodialysis Humans inverse probability of treatment weighting Lungs Male Methylprednisolone Mortality Multiple regression analysis nationwide administrative database Prognosis Respiratory diseases Respiratory distress syndrome Respiratory Distress Syndrome, Adult - drug therapy Respiratory therapy Retrospective Studies Serine Proteinase Inhibitors - administration & dosage sivelestat Sulfonamides - administration & dosage Time Factors Treatment Outcome Ventilators |
| title | Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome |
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