Chronic Respiratory Disease最新文献

{"title":"Understanding exacerbation risk in BLVR: A logistic regression approach to complication prediction.","authors":"Johannes Wienker, Kaid Darwiche, Rüdiger Karpf-Wissel, Erik Büscher, Johannes Haubold, David Kersting, Hubertus Hautzel, Lukas van de Sand, Aymen Kassem, Kristin Mersmann, Christian Taube, Marcel Opitz, Marc Struß","doi":"10.1177/14799731261443319","DOIUrl":"10.1177/14799731261443319","url":null,"abstract":"<p><p>BackgroundChronic obstructive pulmonary disease (COPD) with emphysema is associated with persistent airflow limitation and frequent exacerbations. Bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) improves lung function and quality of life but carries a risk of postprocedural complications, including acute exacerbations and pneumonia. Predictors of these adverse events remain incompletely defined.PurposeTo identify clinical and inflammatory factors associated with postprocedural exacerbations in patients undergoing BLVR with EBVs, aiming to support individualized risk stratification.Patients and MethodsWe retrospectively analyzed 320 patients with advanced emphysema treated with EBVs between 2015 and 2022. Patients underwent comprehensive preprocedural evaluation, including pulmonary function testing, imaging, perfusion scintigraphy, 6-minute walk test and COPD Assessment Test. Postprocedural exacerbations within 8 weeks were documented clinically and radiographically. Binary logistic regression, including multivariable modeling, was used to identify independent predictors.ResultsThirty-five patients (10.9%) developed post-BLVR exacerbations, six of whom had pneumonia. Exacerbation risk was independently associated with diabetes mellitus type II (OR 11.0, <i>p</i> < 0.001), elevated C-reactive protein >1 mg/dL (OR 9.35, <i>p</i> < 0.001), WBC >11 cells/nL (OR 5.46, <i>p</i> = 0.002), prior exacerbation frequency (OR 2.94, <i>p</i> < 0.001) and low BMI (OR 0.78, <i>p</i> < 0.001). Residual volume showed a trend toward significance (<i>p</i> = 0.058). The final model demonstrated excellent discriminative ability (AUC = 0.923). While lung function improvement was attenuated in the exacerbation group, quality of life gains were comparable.ConclusionElevated inflammatory markers, diabetes, frequent prior exacerbations and low BMI were independently associated with early postprocedural exacerbations following BLVR with EBVs. Comprehensive preprocedural assessment and targeted management of these risk factors may enhance patient safety and improve outcomes.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261443319"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walking football for people with chronic breathlessness: A mixed-methods proof of concept study.","authors":"Callum Bradford, Kirsti J Loughran, Benjamin Harrison, Grant McGeechan, Denis Martin, Sophie Suri, Noelle Robertson, Gaynor Williams, Tim Rapley, Samantha L Harrison","doi":"10.1177/14799731261489273","DOIUrl":"10.1177/14799731261489273","url":null,"abstract":"<p><p>IntroductionPulmonary rehabilitation (PR) provides substantial benefits, but these are rarely sustained. Walking football (WF), with its slower pace and widespread availability, may offer an exercise-maintenance option. This proof-of-concept study aimed to understand the potential of WF as an exercise-maintenance intervention following PR.MethodsA mixed-methods, prospective observational design was used. Patients completing PR at two NHS trusts were invited to attend weekly 2-hour WF sessions for 6 weeks. Feasibility outcomes included recruitment, adherence, and safety. An ethnographic approach observed participant experiences and engagement. Health outcomes were assessed at baseline and post-intervention, and the intensity of a single WF session was analysed.Results160 individuals were approached; 36 expressed interest and 6 enrolled (5 male; mean age 71 years). Travel difficulties were the most common reason for declining. Five participants attended at least 4 sessions, and all continued WF after the study. One minor, unrelated adverse event occurred. Qualitative analysis of 18-hours of observations and 6 interviews generated 6 themes. The most notable finding highlighted the importance of WF sessions being exclusive to people with breathlessness. At least 3 participants achieved the minimal clinically important difference in functional exercise capacity, strength, health-related quality of life, and symptom burden. During a single session, group mean heart rate reached 66% of estimated HRmax, with a mean distance of 3.23 km covered.ConclusionsWF appears to be a promising, engaging, and potentially sustainable exercise-maintenance option following PR, though travel barriers limited uptake. Future interventions should prioritise accessible locations and consider transport support.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261489273"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiotherapy assessment of breathlessness and disordered patterns of breathing: Defining a consensus on terminology and assessment.","authors":"Lizzie Jf Grillo, Izzie Easton, Fiona M Schreuder, Adam Lewis, Chloe I Bloom, Nicholas S Hopkinson, Harriet Shannon, Anne-Marie Russell","doi":"10.1177/14799731251315483","DOIUrl":"10.1177/14799731251315483","url":null,"abstract":"<p><p><b>Introduction:</b> Abnormal breathing patterns unexplained by pathophysiology are typically referred to using terms including chronic breathlessness syndrome or complex breathlessness. Often patients with these conditions are referred to physiotherapy for an assessment of this breathlessness, where some are diagnosed with breathing pattern disorder (BrPD) or dysfunctional breathing (DB). The condition seen in physiotherapy occurs in at least 10% of the general population, increasing to 29-40% with coexisting conditions. Inconsistency in the nomenclature and physiotherapy assessment reduces recognition of the condition and hinders development in this area. <b>Aims of the study:</b> To establish expert physiotherapists' consensus on terminology to describe this condition and provide guidance for its physiotherapy assessment. <b>Participants and methods:</b> The opinions and experiences of ten respiratory physiotherapists, nine other clinicians (doctors, nurses, and speech and language therapists), and five patients diagnosed with BrPD were explored in focus groups or interviews regarding the terminology used and assessment experience. A second separate purposive sample of clinical expert physiotherapists (<i>n</i> = 11) took part in a nominal group technique (NGT) process to build consensus on the following questions: Question 1: What is your preferred term for this condition? Question 2: What are the most important assessment components to be included in all assessments? <b>Results:</b> One focus group (<i>n</i> = 10) and 14 interviews were completed. Framework analysis of the data from focus groups and interviews was undertaken and these results were shared with the participants in the nominal group. Consensus (71%) for the term breathing pattern disorder (BrPD) was achieved and an assessment guide was created. <b>Conclusion:</b> With improved consistency in its description and assessment, the adoption of breathing pattern disorder may help to further develop clinical and research priorities in this area within physiotherapy services.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251315483"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for pneumothorax in patients with interstitial lung disease undergoing transbronchial lung cryobiopsy, a research letter.","authors":"Sean Landers, Juliette Morrow, Julie McCarthy, Michael T Henry","doi":"10.1177/14799731251383492","DOIUrl":"10.1177/14799731251383492","url":null,"abstract":"<p><p>BackgroundPneumothorax is a common and important complication of transbronchial lung cryobiopsy (TBLC) in patients with interstitial lung disease (ILD), however little is known about what predisposes patients to pneumothorax during TBLC.MethodsWe reviewed the pre-TBLC ILD work-up of 76 patients who underwent TBLC in our tertiary ILD referral center from 2017 to 2023. We assessed factors including pulmonary function tests, bronchoalveolar lavage (BAL), blood tests, and imaging and to see if any of them caused an increased risk of iatrogenic pneumothorax.Results19 patients suffered a pneumothorax (25%). Neutrophilia on BAL (37.9% pneumothorax when present vs 12.8% when not present, <i>p</i> = 0.046) and the presence of ground glass opacification on high resolution CT-Thorax (38.2% vs 12.5%, <i>p</i> = 0.014) increased the risk of pneumothorax during TBLC. Other factors such as the presence of pleura in the biopsy sample (47.1% vs 17.2%, <i>p</i> = 0.021), as well as taking 3 or more biopsies (35.7% vs 11.8%, <i>p</i> = 0.019) were also significant predictors of pneumothorax.ConclusionsMarkers of acute inflammation as well as increased number of biopsies taken in a procedure lead to increased risk of pneumothorax. This may lead to changes in planning, patient selection and timing of TBLC procedures in ILD patients.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251383492"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12553899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of the geriatric nutritional risk index and simplified geriatric nutritional risk index with chronic obstructive pulmonary disease.","authors":"Yiben Huang, Ruizi Xu, Xuanyang Chen, Siyao Chen, Zicong Dai, Xinran Li, Yiting Yu, Zihan Ye, Xianjing Chen, Chunyan Liu, Beibei Yu, Yage Xu, Xiaodiao Zhang","doi":"10.1177/14799731251400261","DOIUrl":"10.1177/14799731251400261","url":null,"abstract":"<p><p>PurposeThis study aimed to investigate the associations of the Geriatric Nutritional Risk Index (GNRI) and the simplified Geriatric Nutritional Risk Index (sGNRI) with Chronic Obstructive Pulmonary Disease (COPD).MethodsWe assessed 161 patients with COPD and 947 healthy controls. The sGNRI was derived using the formula: serum albumin (g/dL) + 0.1 × body mass index (BMI, kg/m²). Primary outcomes included the BODE (body mass index, airflow obstruction, dyspnea, exercise capacity) index and hospital length of stay (LOS). The secondary outcome was the prevalence of COPD.ResultsMalnourished patients (GNRI <95.40 or sGNRI <5.89) exhibited lower BMI and albumin levels, as well as worse pulmonary function (all <i>p</i> < 0.05). GNRI (Odds Ratio [OR] = 0.945, 95% Confidence Interval [CI]: 0.903-0.989, <i>p</i> = 0.015) and sGNRI (OR = 0.413, 95% CI: 0.191-0.890, <i>p</i> = 0.024) were significantly associated with the severity of COPD in a multivariable-adjusted model. Subgroup analysis revealed stronger predictive performance of GNRI and sGNRI among males, non-hypertensive patients, and smokers (for sGNRI).ConclusionsCompared with GNRI, sGNRI may serve as a more practical tool for identifying malnutrition-related risk among patients with COPD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251400261"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12635027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a clinical prediction model for falls in community-dwelling older adults with COPD: A preliminary analysis.","authors":"Khang T Nguyen, Cindy Ellerton, Joshua Wald, Natya Raghavan, Luciana G Macedo, Dina Brooks, Roger Goldstein, Marla K Beauchamp","doi":"10.1177/14799731251321494","DOIUrl":"10.1177/14799731251321494","url":null,"abstract":"<p><strong>Background: </strong>People with chronic obstructive pulmonary disease (COPD) are at a higher risk of falls. This preliminary study aims to externally validate a previously developed clinical prediction model for falls in community-dwelling older adults with COPD.</p><p><strong>Methods: </strong>This was a secondary analysis of a 12-month prospective cohort study. Older adults (≥60 years) with COPD, who reported a fall in the past year and/or had balance concerns, were tracked for 12-month future falls. Baseline predictors included 12-month history of ≥2 falls, total chronic conditions, and Timed Up and Go Dual-Task (TUG-DT) test scores. Model performance was assessed for discrimination (c-statistic), calibration (E:O, CITL, and calibration slope), and clinical value (decision curve analysis).</p><p><strong>Results: </strong>The study included 89 participants (average age 73 ± 9 years; 83 females; FEV₁%predicted = 47%). Of these, 35 (39%) reported ≥1 future fall, totaling 89 falls. The model demonstrated acceptable discrimination (c-statistic = 0.62, CI [0.51,0.72]), and calibration (E:O = 1, CITL = 0, and a calibration slope = 1). Decision curve analysis showed greater clinical value when using the prediction model compared to screening for fall history alone.</p><p><strong>Conclusions: </strong>A 12-month history of ≥2 falls, higher total chronic conditions, and worse TUG-DT test scores, predicts falls in community-dwelling older adults with COPD. Larger studies are needed before clinical application.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251321494"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time experience of an acute exacerbation of COPD: A qualitative exploration.","authors":"Bedor S Alkhathlan, Amy C Barradell, Neil J Greening, Theresa Harvey-Dunstan, Sally J Singh","doi":"10.1177/14799731251340407","DOIUrl":"10.1177/14799731251340407","url":null,"abstract":"<p><p><b>Introduction:</b> Many qualitative studies have explored patients' experiences of an Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) retrospectively. To our knowledge, no study has conducted a real-time investigation of COPD exacerbation experience during hospitalisation.<b>Objective:</b> To establish an in-depth and comprehensive understanding of the whole COPD exacerbation experience and uncover any unrecognised burdens that might serve as barriers to engagement in discharge services post-AECOPD.<b>Methods:</b> Semi-structured interviews were conducted, and data were analysed using thematic analysis. The study included participants who were admitted to the hospital with a primary diagnosis of AECOPD.<b>Results:</b> Twelve participants were included in the study (Male, <i>n</i> = 9; Female, <i>n</i> = 3), with a mean ± SD age of 66 ± 8 years. Findings generated three overarching themes, and sub-themes: (I) Health deterioration phase (II) Implications of AECOPD and the associated hospitalisation, and (III) Recovery journey.<b>Conclusion:</b> The impact of breathlessness appears to extend across the COPD exacerbation journey and, for some, well beyond. Breathlessness both within and extending beyond the acute phase was associated with comorbid psychological distress. Interventions should consider appropriate phasing within the management process, focus on breathlessness and involve a behavioural therapy component.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251340407"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12075960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship among depressive symptoms, dyspnea-related fear and sarcopenia in patients with chronic obstructive pulmonary disease: The mediating effect of physical activity.","authors":"Wenxiu Wang, Lili Wang, Rongrong Fan, Li Xie, Jing Zhu","doi":"10.1177/14799731251335028","DOIUrl":"10.1177/14799731251335028","url":null,"abstract":"<p><p><b>Objectives:</b> Sarcopenia is influenced by multiple factors, including psychological aspects. This study aimed to explore the relationships among depressive symptoms, dyspnea-related fear, and sarcopenia, with a focus on the mediating role of physical activity. <b>Methods:</b> A cross-sectional study was conducted among 348 COPD patients at a tertiary hospital in Western China from July 2023 to July 2024. Sarcopenia was assessed according to the 2019 AWGS criteria, including hand bioelectrical impedance analysis (BIA), and grip strength testing. Depressive symptoms, dyspnea-related fear, and physical activity were evaluated through self-reported measures using the depression subscale of the Hospital Anxiety and Depression Scale (HADS), the Breathlessness Beliefs Questionnaire (BBQ), and the International Physical Activity Questionnaire Short Form (IPAQ-SF), respectively. Logistic regressions analyses explored associations among depressive symptoms, dyspnea-related fear, and sarcopenia. Maximum Likelihood (ML) estimation was employed using Mplus software to evaluate the mediating effect of physical activity on the relationships. <b>Results:</b> The prevalence of sarcopenia among COPD patients was 60.3%. In the logistic regression analysis with sarcopenia as the dependent variable, physical activity levels (OR = 0.508, <i>p</i> = 0.019) and depressive symptoms (OR = 1.079, <i>p</i> = 0.029) were statistically significant, while BBQ scores were not (OR = 1.031, <i>p</i> = 0.070). Mediating analyses revealed that depressive symptoms directly increased the risk of sarcopenia (β = 0.076, <i>p</i> = 0.042) but did not do so indirectly via physical activity (β = 0.056, <i>p</i> = 0.146). Conversely, dyspnea-related fear had an indirect effect on sarcopenia through physical activity, with a borderline statistical significance (β = 0.053, <i>p</i> = 0.049). <b>Conclusions:</b> This study highlights the critical role of psychological factors in sarcopenia development among COPD patients, with physical activity serving as a significant mediator. These findings underscore the need for integrated rehabilitation strategies addressing both psychological and physical activity barriers to improve outcomes for COPD patients.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251335028"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving landscape of digital inhaler platforms and adherence support in chronic airways disease.","authors":"Hnin Wint Wint Aung, Anna Murphy, Neil J Greening","doi":"10.1177/14799731251366969","DOIUrl":"10.1177/14799731251366969","url":null,"abstract":"<p><p>Inhaled therapies remain the cornerstone in managing chronic airway diseases, offering direct treatment delivery to the lungs with minimal systemic adverse effects. With advancements in respiratory care, digital inhalers have emerged as a transformative innovation. Their functions extend beyond delivering inhaled medication, providing deeper insights into patients' medication use behaviour and intervening through complementary platform features and integrated data analytics. However, despite being available for over two decades, the widespread adoption of digital inhaler platforms remains limited due to uncertainties regarding their cost-effectiveness, feasibility in real-world settings, and concerns regarding sustainability. Identifying patient groups that could benefit most from these technologies and designing strategies for effective deployment across diverse healthcare contexts is important. To achieve this, bridging the gap between innovation and accessibility is required so that digital inhaler platforms evolve into inclusive, patient-centred tools rather than niche technologies. This narrative review provides a summary of the evolution and current landscape of digital inhaler technology, its impact on clinical outcomes in chronic airway disease, and key challenges that stakeholders should address for the successful integration of these tools into respiratory care. We also propose key components of a patient-centred digital inhaler adherence support model that prioritises accessibility and efficacy.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251366969"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensifentrine in COPD patients taking long-acting bronchodilators: A pooled post-hoc analysis of the ENHANCE-1/2 studies.","authors":"Mark Dransfield, Nathaniel Marchetti, Ravi Kalhan, Daniel Reyner, Amy L Dixon, Tara Rheault, Kathleen Ann Rickard, Antonio Anzueto","doi":"10.1177/14799731251314874","DOIUrl":"10.1177/14799731251314874","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of ensifentrine, a novel PDE3/PDE4 inhibitor, were previously evaluated in the ENHANCE-1 (NCT04535986) and ENHANCE-2 (NCT04542057) trials. Here, we present a pooled post-hoc subgroup analysis of patients according to background chronic obstructive pulmonary disease (COPD) maintenance medication regimens.</p><p><strong>Objective: </strong>This analysis aimed to explore the efficacy and safety of ensifentrine in patients receiving long-acting muscarinic antagonists (LAMA) or long-acting beta-agonists with inhaled corticosteroids (LABA + ICS).</p><p><strong>Methods: </strong>Eligible patients had moderate to severe COPD, were aged 40-80 years, and were symptomatic at randomization. Patients were randomized 5:3, receiving twice-daily ensifentrine 3 mg or placebo via standard jet nebulizer over 24 weeks.</p><p><strong>Results: </strong>The pooled post-hoc analysis included 485 LAMA patients and 272 LABA + ICS patients. Ensifentrine showed lung function improvement over placebo at week 12, including average FEV₁ AUC_0-12 h in the LAMA (placebo-corrected least squares mean change from baseline [LSMC], 92 mL; 95% CI, 54, 131; <i>p</i> < 0.001) and LABA + ICS subgroups (LSMC, 74 mL; 95% CI, 27, 121; <i>p</i> = 0.002). Ensifentrine reduced the rate and risk of exacerbations in both LAMA (48% and 50%, respectively) and LABA + ICS (51% and 56%, respectively) subgroups. Ensifentrine-treated patients reported improvement in symptoms and quality of life over 24 weeks. The safety profile of ensifentrine in each subgroup was similar to the profile in the pooled modified intention-to-treat population.</p><p><strong>Conclusions: </strong>Nebulized ensifentrine offers a novel non-steroidal anti-inflammatory and bronchodilator treatment added to existing LAMA or LABA + ICS treatment options in patients with moderate to severe, symptomatic COPD.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"22 ","pages":"14799731251314874"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}