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Pulmonary Function Testing (PFT) Project Sets New Standard In Care
September 16, 2024
Dr. Bradly Biagioni, Medical Director of Pulmonary Function (right), looks on as Chris Danby, Professional Practice Leader, Respiratory Therapy South Okanagan, demonstrates a pulmonary function test.
Pulmonary function testing (PFT) is crucial for diagnosing and managing respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD) and lung disease. Testing helps assess the severity of lung impairment, monitor the progress of diseases, and evaluate treatment effectiveness.
Quicker access to pulmonary function test results can lead to earlier diagnosis and treatment, which is crucial for respiratory conditions that require immediate attention.
Interior Health's Pulmonary Function Testing (PFT) project is an initiative two years in the making. It revolutionizes how pulmonary function tests are conducted, interpreted and reported within Interior Health. It promises to deliver test results to patients more quickly, reducing wait times for reports from two weeks to just a few days.
Causes And Symptoms Of Poor Lung Health: Expert Tips To Prevent Asthma, Cancer, COPD In Elders
Maintaining lung health becomes increasingly important to general health as we age. Lung disease affects around 1 in 7 older persons, making it a serious health risk. Among persons 60 years of age and older, chronic respiratory conditions rank as the second most common reason for hospitalisation. Elderly people are more vulnerable to diseases like lung cancer, asthma, and chronic obstructive pulmonary disease (COPD) due to physiological changes brought on by ageing.
Dr Pratibha Dogra, Senior Consultant, Pulmonology and Sleep Medicine Expert, Marengo Asia Hospital, Gurugram, says that older persons must take proactive measures to safeguard and preserve their respiratory health by being aware of these changes.
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Physiological changes in lung function with age
Dr Dogra says that the natural ageing process alters the physiology of the lungs, making breathing harder for senior citizens. Among the significant adjustments are:
Decreased lung expansion: As people age, their bones may become less flexible, leading to a stiffer rib cage and less room for the lungs to expand.
Weaker respiratory muscles: As we age, our breathing muscles, such as the diaphragm, become weaker. Breathing becomes less efficient as a result.
Diminished neurological system response: As we age, our neurological system's capacity to control breathing deteriorates, leading to a reduction in the effectiveness of respiratory function.
Reduced immune function: Lung infections and long-term respiratory illnesses are more common in older persons as their immune systems deteriorate.
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In addition to ageing naturally, prolonged exposure to cigarette smoke, air pollution, and environmental pollutants can further deteriorate lung health in the elderly. Lung cancer, pneumonia, COPD, and bronchial asthma are among the conditions that are common in older people.
Ways to protect ageing lungs
Even though ageing causes a natural decline in lung function, there are various things older generations may do to slow down this process and keep their lungs healthy.
Avoid smoking cigarette
In older persons, smoking is the primary cause of bronchitis, emphysema, and lung cancer. The effects of secondhand smoke are similar. One of the most crucial things you can do to keep your lungs healthy is to stop smoking or limit your exposure to it. Smoking raises the risk of serious respiratory disorders and accelerates the development of chronic lung diseases. If smoking has already had an impact on someone, removing exposure can help prevent more harm.
Monitor air quality and avoid pollution
Lung illness in the elderly makes them especially vulnerable to air pollution. They can learn whether it's safe to go outside by monitoring the Air Quality Index (AQI), particularly in places where there is a lot of particulate matter or smog. In winter, especially in northern India, air quality can drastically decline, making outdoor activities dangerous for people with respiratory conditions. On days with bad air quality, staying inside can lower your risk of developing respiratory issues.
Improve indoor air quality
Respiratory problems can be exacerbated by indoor contaminants such as mould, pet dander, and chemicals from cleaning supplies. Maintaining interior air quality can be accomplished with the use of air purifiers, better ventilation, and removing indoor pollution sources. This is especially crucial for senior citizens who suffer from respiratory diseases like COPD, asthma, or other ailments.
Stay physically active
It is imperative to engage in regular physical activity to preserve lung function. Simple exercises like swimming or brisk walking might support the strength of the respiratory muscles. Exercises involving deep breathing also strengthen the diaphragm, improving respiratory efficiency. Exercise increases oxygen use in the body and improves cardiorespiratory fitness, which facilitates easier breathing even though it doesn't strengthen the lungs. Moderate exercise can help people with COPD and asthma avoid their symptoms getting worse.
Adopt a healthy diet
Overall lung health is supported by a diet high in fruits, vegetables, and anti-inflammatory foods. Nutrients found in foods like apples, red bell peppers, garlic, ginger, and turmeric improve lung function. Consuming cruciferous vegetables, like broccoli and cauliflower, has been linked to a decreased risk of lung cancer, according to studies. Immune system performance and lung inflammation can both be enhanced by eating a balanced diet.
Get vaccinated
For older persons, especially those with pre-existing lung issues, respiratory infections can be deadly. Pneumococcal and flu shots should be administered annually to avoid infections that exacerbate respiratory conditions. In addition to vaccines, infection prevention measures include proper hygiene, getting adequate sleep, and managing stress.
Also see: Ditch these 8 habits for healthy lungs, lower risk of asthma, lung cancer, tuberculosis, and more
Recognising early warning signs of lung problems
Senior citizens must identify the early indicators of lung issues. A doctor should be consulted if you experience symptoms like a cough that doesn't go away after more than a month, wheezing, coughing up blood, or chest pain that gets worse when you breathe. Severe consequences can be avoided with early identification and treatment.
One essential component of ageing successfully is lung health. Proper diet, exercise, avoidance of pollutants, and early detection of respiratory problems are among the proactive ways older individuals can maintain lung function and enhance their quality of life. Ensuring that lung health receives regular care and attention can help the lungs age as elegantly as the rest of the body.
Disclaimer: This article, including health and fitness advice, only provides generic information. Don't treat it as a substitute for a qualified medical opinion. Always consult a specialist or your health specialist for more information.
Nivedita is a Delhi-based journalist who writes on health, fashion, lifestyle and entertainment. Views expressed are personal.
FIBRONEER-IPF Trial Of Nerandomilast Meets Primary End Point
The positive phase 3 results showed improved lung function with nerandomilast vs placebo at 52 weeks in idiopathic pulmonary fibrosis (IPF).
In a significant breakthrough for the treatment of idiopathic pulmonary fibrosis (IPF), Boehringer Ingelheim announced its investigational drug, nerandomilast (BI 1015550), has successfully met the primary end point in the pivotal phase 3 FIBRONEER-IPF trial.1
The main end point in the study was lung function based on absolute change from baseline in forced vital capacity (FVC) at week 52 vs a placebo. The achievement marks the first such success in a decade, signaling a potential new treatment option for a condition that currently has limited pharmaceutical interventions.
Boehringer Ingelheim plans to submit a new drug application for nerandomilast based on the positive trial resultsImage credit: MichaelVi – stock.Adobe.Com
"This announcement is not just a milestone for us at Boehringer Ingelheim but a beacon of hope for the 3 million people worldwide living with idiopathic pulmonary fibrosis," Ioannis Sapountzis, PhD, head of global therapeutic areas at Boehringer Ingelheim, posted to LinkedIn.2 "IPF is considered a rare disease, yet the burden on the individual and those around them is far from small. Through our growing understanding of the condition, we are able to streamline our research with the aim of fulfilling the unmet needs of those living with IPF."
Boehringer Ingelheim plans to submit a new drug application for nerandomilast to the FDA and other global regulators based on the positive trial results.1 The company is also conducting a second phase 3 study on progressive pulmonary fibrosis, FIBRONEER-ILD.
Currently, IPF treatment options are limited to nintedanib (Ofev) and pirfenidone (Esbriet), both of which can slow disease progression. Nerandomilast, which inhibits the enzyme phosphodiesterase 4B (PDE4B), is poised to offer a novel mechanism of action that could outperform existing therapies. Boehringer Ingelheim's decision to advance this drug into a phase 3 trial, launched in 2022, is a key step toward addressing the unmet needs of patients with IPF, many of whom experience significant declines in lung function over time.
The FIBRONEER-IPF trial included 1177 participants with IPF across more than 30 countries. They were divided into 3 groups, taking a dose of nerandomilast 9 mg, nerandomilast 18 mg, or placebo twice daily. The primary end point was absolute change in FVC—a key measure of lung function—from baseline to week 52.
After 52 weeks, patients taking either dose of nerandomilast exhibited better performance on the FVC test compared with those taking placebo. This positive result led the trial to meet its primary end point, although specific data on lung function improvement, including FVC scores, has yet to be released. Boehringer Ingelheim said it is holding back full data on both efficacy and safety until the first half of 2025. Despite the limited release of data, nerandomilast's potential to improve lung function and slow disease progression more effectively than current therapies is generating excitement.
"This is the first IPF phase 3 trial in a decade to meet its primary end point," Sapountzis said in the news release. "Today's announcement represents the next step in our long history in the research of this disease. IPF has a high unmet need for patients, and we are continuously fostering our research activities to develop more options for one of the most common interstitial lung diseases."
Although nerandomilast has not yet been approved for use, it received an FDA breakthrough therapy designation for IPF in February 2022.3 Its efficacy, safety, and tolerability were initially assessed in a phase 2 trial involving 147 patients with IPF, where lung function was measured over 12 weeks.
The FIBRONEER-IPF study's scope goes beyond lung function improvement.1 Secondary end points included time to hospitalization or death, but Boehringer Ingelheim has yet to disclose these findings. The trial also included patients both on and off stable therapy with nintedanib or pirfenidone, raising questions about how nerandomilast performs as a monotherapy vs in combination with existing drugs.
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