All of the studies were placebo controlled. There were 1281 participants in total stratified by smoking status; however, each trial used a different definition of smoking status. All trials recorded change in FEV1 from baseline to six months after ICS treatment. In the never-smokers, ex-smokers and light smokers the improvement in FEV1 ranged from 120 to 300 ml after six months ICS use. However, the current and heavy smokers showed less improvement; the range reported was -300 ml to 197 ml. These results suggest that in COPD, current and heavy smokers are not gaining the same benefit from ICS use on lung function as never- and ex-smokers do. This could be due to ‘steroid resistance’ caused by inactivation

of HDAC2 by smoking. However, the effect reported here could also be due to other factors, such as difference in; severity of disease, co-prescribed medications (such as bronchodilators) and methodology between trials. In practice this Selleckchem Panobinostat means that practitioners should selleck compound consider smoking status before prescribing ICS due to potentially reduced efficacy; however, further work is needed with larger patient numbers to determine if the effect reported here is statistically significant and due to ‘steroid resistance’ or other mechanisms. 1. National Guideline Clearinghouse. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary

disease. Released 2001 (revised 2013); http://www.guideline.gov/content.aspx?id=43794. 2. Barnes PJ, Ito K, Adcock IM. Corticosteroid resistance in chronic obstructive pulmonary disease: inactivation of histone deacetylase. Lancet 2004; 363: 731–733. C. Bond, E. Fluess, G. Macfarlane, G. Jones University of Aberdeen, Aberdeen, Scotland, UK Current epidemiological studies do not take into account the effect of pain management

on self reported pain prevalence and severity. A pain management questionnaire to Succinyl-CoA be used in pain surveys was developed and validated. Pain prevalence increases by 6% when pain management is taken into account. Pain management information should be collected and used in future epidemiological studies. Pain is very common with a UK prevalence of 60%; it is largely managed by medication, and other treatments (eg alterative and complementary therapies). However population-based studies do not take medication and other treatments into account when determining pain prevalence and severity. The aim of this cross-sectional study was to (1) develop and validate an instrument to collect information on pain management ie medication and other alternative and complementary treatments; (2) assess whether population estimates of pain change when pain management information is taken into account. A sample of 4600 residents in the Grampian region of Scotland aged =>25 years, randomly selected from the NHS register, were mailed a questionnaire.