Matthew Miles - Academia.edu (original) (raw)

Papers by Matthew Miles

MedEdPORTAL Publications, 2016

International journal of chronic obstructive pulmonary disease, 2016

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and heal... more Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and health care expenditure worldwide. Relaxation of airway smooth muscle with inhaled bronchodilators is the cornerstone of treatment for stable COPD, with inhaled corticosteroids reserved for those with a history of exacerbations. Tiotropium has occupied center stage in COPD treatment for over 10 years and improves lung function, quality of life, exercise endurance, and reduces the risk of COPD exacerbation. Long-acting β2-agonists (LABAs) improve lung function, reduce dynamic hyperinflation, increase exercise tolerance, health-related quality of life, and reduce acute exacerbation of COPD. The combination of long-acting muscarinic antagonists (LAMAs) and LABAs is thought to leverage different pathways to induce bronchodilation using submaximal drug doses, increasing the benefits and minimizing receptor-specific side effects. Umeclidinium/vilanterol is the first combination of LAMA/LABA to be ...

Clinical Pulmonary Medicine, 2013

Clinical Pulmonary Medicine, 2014

Clinical Investigation, 2011

Therapeutic Advances in Respiratory Disease, 2012

Chronic obstructive pulmonary disease (COPD) is a serious global health burden. Comprehensive man... more Chronic obstructive pulmonary disease (COPD) is a serious global health burden. Comprehensive management of COPD includes both pharmacologic and non-pharmacologic interventions aimed at improving disease-related functional capacity, health-related quality of life, and survival. The primary medications used for treatment of COPD are inhaled bronchodilator drugs which are delivered directly to the patient's airways through a number of different mechanisms. Arformoterol, the (R,R) enantiomer of racemic formoterol, was the first long-acting beta agonist approved by the U.S. Food and Drug Administration (FDA) for nebulized delivery. We discuss the pharmacology, clinical efficacy, and safety of arformoterol, and provide recommendations for its use during longitudinal management of patients with COPD.

The mission and goals of graduate medical education continue to evolve. The Accreditation Council... more The mission and goals of graduate medical education continue to evolve. The Accreditation Council on Graduate Medical Education and the Residency Review Committee for Internal Medicine require internal medicine residency programs to advance resident knowledge of "the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care." 1 Residency programs must provide educational resources to facilitate resident involvement in scholarly activities. Time constraints introduced by the limits on resident duty hours and multiple competing demands for curricular time and clinical effort pose challenges to successfully addressing the requirement for resident scholarly activities. Efficient, well-organized, and effective strategies are needed to promote resident research.

CHEST Journal, 2014

Arformoterol tartrate (arformoterol, 15 μg bid) is a nebulized long-acting β2-agonist approved fo... more Arformoterol tartrate (arformoterol, 15 μg bid) is a nebulized long-acting β2-agonist approved for maintenance treatment of COPD. This was a multicenter, double-blind, randomized, placebo-controlled study. Patients (aged ≥ 40 years with baseline FEV1 ≤ 65% predicted, FEV1 > 0.50 L, FEV1/FVC ≤ 70%, and ≥ 15 pack-year smoking history) received arformoterol (n = 420) or placebo (n = 421) for 1 year. The primary assessment was time from randomization to respiratory death or first COPD exacerbation-related hospitalization. Among 841 patients randomized, 103 had ≥ 1 primary event (9.5% vs 15.0%, for arformoterol vs placebo, respectively). Patients who discontinued treatment for any reason (39.3% vs 49.9%, for arformoterol vs placebo, respectively) were followed for up to 1 year postrandomization to assess for primary events. Fewer patients receiving arformoterol than placebo experienced COPD exacerbation-related hospitalizations (9.0% vs 14.3%, respectively). Twelve patients (2.9%) receiving arformoterol and 10 patients (2.4%) receiving placebo died during the study. Risk for first respiratory serious adverse event was 50% lower with arformoterol than placebo (P = .003). Numerically more patients on arformoterol (13; 3.1%) than placebo (10; 2.4%) experienced cardiac serious adverse events; however, time-to-first cardiac serious adverse event was not significantly different. Improvements in trough FEV1 and FVC were greater with arformoterol (least-squares mean change from baseline vs placebo: 0.051 L, P = .030 and 0.075 L, P = .018, respectively). Significant improvements in quality of life (overall St. George's Hospital Respiratory Questionnaire and Clinical COPD Questionnaire) were observed with arformoterol vs placebo (P < .05). Arformoterol demonstrated an approximately 40% lower risk of respiratory death or COPD exacerbation-related hospitalization over 1 year vs placebo. Arformoterol was well-tolerated and improved lung function vs placebo. ClinicalTrials.gov; No.: NCT00909779; URL: www.clinicaltrials.gov.

Drugs, 2012

Chronic obstructive pulmonary disease (COPD) is a respiratory syndrome affecting more than 80 mil... more Chronic obstructive pulmonary disease (COPD) is a respiratory syndrome affecting more than 80 million people worldwide and is estimated to become the third-leading cause of death worldwide by 2030. A standard-of-care approach to COPD treatment is multifaceted, including pharmacological and non-pharmacological therapies, yet the optimum combination among many bronchodilator possibilities remains unclear. We discuss the evidence for effectiveness of combination bronchodilator and inhaled corticosteroid therapy in affecting the minimal clinically important difference for these agents in COPD. We propose an approach to the rational use of these combinations that favours the combination of long-acting b-adrenergic agents with longacting anticholinergic agents in lieu of any other bronchodilators whenever possible. We suggest that, to better detect effects of disease modification in COPD, future studies of combination bronchodilator effectiveness should emphasize endpoints other than short-term change in post-bronchodilator forced expiratory volume in 1 second (FEV 1 ).

The American Journal of Medicine, 2011

The mission and goals of graduate medical education continue to evolve. The Accreditation Council... more The mission and goals of graduate medical education continue to evolve. The Accreditation Council on Graduate Medical Education and the Residency Review Committee for Internal Medicine require internal medicine residency programs to advance resident knowledge of "the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care." 1 Residency programs must provide educational resources to facilitate resident involvement in scholarly activities. Time constraints introduced by the limits on resident duty hours and multiple competing demands for curricular time and clinical effort pose challenges to successfully addressing the requirement for resident scholarly activities. Efficient, well-organized, and effective strategies are needed to promote resident research.

Annals of the American Thoracic Society, Jan 5, 2015

This paper outlines specific tips for those applying to pulmonary and/or critical care medicine f... more This paper outlines specific tips for those applying to pulmonary and/or critical care medicine fellowship training in the United States utilizing the PAIR-Match steps: Preparation, Application, Interview, Ranking, and Match. Preparation for fellowship begins long before the application process with an assessment of one's long-term goals (to the extent that these are known). The cornerstone of the application is the Curriculum Vitae, which should highlight applicants' pulmonary and critical care-related experiences and scholarly work. Applicants should obtain letters of recommendation from faculty members who know them well and can write a letter that speaks to their strengths in clinical, scholarly, or leadership areas. The personal statement is an opportunity to share experiences not otherwise shared in the application, and is an opportunity to explain any breaks in training or performance lapses. When selecting programs to which they will apply, applicants should pay clos...

MedEdPORTAL Publications, 2016

International journal of chronic obstructive pulmonary disease, 2016

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and heal... more Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and health care expenditure worldwide. Relaxation of airway smooth muscle with inhaled bronchodilators is the cornerstone of treatment for stable COPD, with inhaled corticosteroids reserved for those with a history of exacerbations. Tiotropium has occupied center stage in COPD treatment for over 10 years and improves lung function, quality of life, exercise endurance, and reduces the risk of COPD exacerbation. Long-acting β2-agonists (LABAs) improve lung function, reduce dynamic hyperinflation, increase exercise tolerance, health-related quality of life, and reduce acute exacerbation of COPD. The combination of long-acting muscarinic antagonists (LAMAs) and LABAs is thought to leverage different pathways to induce bronchodilation using submaximal drug doses, increasing the benefits and minimizing receptor-specific side effects. Umeclidinium/vilanterol is the first combination of LAMA/LABA to be ...

Clinical Pulmonary Medicine, 2013

Clinical Pulmonary Medicine, 2014

Clinical Investigation, 2011

Therapeutic Advances in Respiratory Disease, 2012

Chronic obstructive pulmonary disease (COPD) is a serious global health burden. Comprehensive man... more Chronic obstructive pulmonary disease (COPD) is a serious global health burden. Comprehensive management of COPD includes both pharmacologic and non-pharmacologic interventions aimed at improving disease-related functional capacity, health-related quality of life, and survival. The primary medications used for treatment of COPD are inhaled bronchodilator drugs which are delivered directly to the patient's airways through a number of different mechanisms. Arformoterol, the (R,R) enantiomer of racemic formoterol, was the first long-acting beta agonist approved by the U.S. Food and Drug Administration (FDA) for nebulized delivery. We discuss the pharmacology, clinical efficacy, and safety of arformoterol, and provide recommendations for its use during longitudinal management of patients with COPD.

The mission and goals of graduate medical education continue to evolve. The Accreditation Council... more The mission and goals of graduate medical education continue to evolve. The Accreditation Council on Graduate Medical Education and the Residency Review Committee for Internal Medicine require internal medicine residency programs to advance resident knowledge of "the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care." 1 Residency programs must provide educational resources to facilitate resident involvement in scholarly activities. Time constraints introduced by the limits on resident duty hours and multiple competing demands for curricular time and clinical effort pose challenges to successfully addressing the requirement for resident scholarly activities. Efficient, well-organized, and effective strategies are needed to promote resident research.

CHEST Journal, 2014

Arformoterol tartrate (arformoterol, 15 μg bid) is a nebulized long-acting β2-agonist approved fo... more Arformoterol tartrate (arformoterol, 15 μg bid) is a nebulized long-acting β2-agonist approved for maintenance treatment of COPD. This was a multicenter, double-blind, randomized, placebo-controlled study. Patients (aged ≥ 40 years with baseline FEV1 ≤ 65% predicted, FEV1 > 0.50 L, FEV1/FVC ≤ 70%, and ≥ 15 pack-year smoking history) received arformoterol (n = 420) or placebo (n = 421) for 1 year. The primary assessment was time from randomization to respiratory death or first COPD exacerbation-related hospitalization. Among 841 patients randomized, 103 had ≥ 1 primary event (9.5% vs 15.0%, for arformoterol vs placebo, respectively). Patients who discontinued treatment for any reason (39.3% vs 49.9%, for arformoterol vs placebo, respectively) were followed for up to 1 year postrandomization to assess for primary events. Fewer patients receiving arformoterol than placebo experienced COPD exacerbation-related hospitalizations (9.0% vs 14.3%, respectively). Twelve patients (2.9%) receiving arformoterol and 10 patients (2.4%) receiving placebo died during the study. Risk for first respiratory serious adverse event was 50% lower with arformoterol than placebo (P = .003). Numerically more patients on arformoterol (13; 3.1%) than placebo (10; 2.4%) experienced cardiac serious adverse events; however, time-to-first cardiac serious adverse event was not significantly different. Improvements in trough FEV1 and FVC were greater with arformoterol (least-squares mean change from baseline vs placebo: 0.051 L, P = .030 and 0.075 L, P = .018, respectively). Significant improvements in quality of life (overall St. George's Hospital Respiratory Questionnaire and Clinical COPD Questionnaire) were observed with arformoterol vs placebo (P < .05). Arformoterol demonstrated an approximately 40% lower risk of respiratory death or COPD exacerbation-related hospitalization over 1 year vs placebo. Arformoterol was well-tolerated and improved lung function vs placebo. ClinicalTrials.gov; No.: NCT00909779; URL: www.clinicaltrials.gov.

Drugs, 2012

Chronic obstructive pulmonary disease (COPD) is a respiratory syndrome affecting more than 80 mil... more Chronic obstructive pulmonary disease (COPD) is a respiratory syndrome affecting more than 80 million people worldwide and is estimated to become the third-leading cause of death worldwide by 2030. A standard-of-care approach to COPD treatment is multifaceted, including pharmacological and non-pharmacological therapies, yet the optimum combination among many bronchodilator possibilities remains unclear. We discuss the evidence for effectiveness of combination bronchodilator and inhaled corticosteroid therapy in affecting the minimal clinically important difference for these agents in COPD. We propose an approach to the rational use of these combinations that favours the combination of long-acting b-adrenergic agents with longacting anticholinergic agents in lieu of any other bronchodilators whenever possible. We suggest that, to better detect effects of disease modification in COPD, future studies of combination bronchodilator effectiveness should emphasize endpoints other than short-term change in post-bronchodilator forced expiratory volume in 1 second (FEV 1 ).

The American Journal of Medicine, 2011

The mission and goals of graduate medical education continue to evolve. The Accreditation Council... more The mission and goals of graduate medical education continue to evolve. The Accreditation Council on Graduate Medical Education and the Residency Review Committee for Internal Medicine require internal medicine residency programs to advance resident knowledge of "the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care." 1 Residency programs must provide educational resources to facilitate resident involvement in scholarly activities. Time constraints introduced by the limits on resident duty hours and multiple competing demands for curricular time and clinical effort pose challenges to successfully addressing the requirement for resident scholarly activities. Efficient, well-organized, and effective strategies are needed to promote resident research.

Annals of the American Thoracic Society, Jan 5, 2015

This paper outlines specific tips for those applying to pulmonary and/or critical care medicine f... more This paper outlines specific tips for those applying to pulmonary and/or critical care medicine fellowship training in the United States utilizing the PAIR-Match steps: Preparation, Application, Interview, Ranking, and Match. Preparation for fellowship begins long before the application process with an assessment of one's long-term goals (to the extent that these are known). The cornerstone of the application is the Curriculum Vitae, which should highlight applicants' pulmonary and critical care-related experiences and scholarly work. Applicants should obtain letters of recommendation from faculty members who know them well and can write a letter that speaks to their strengths in clinical, scholarly, or leadership areas. The personal statement is an opportunity to share experiences not otherwise shared in the application, and is an opportunity to explain any breaks in training or performance lapses. When selecting programs to which they will apply, applicants should pay clos...