ERJ Open Research最新文献

{"title":"Utility of <i>Veillonella parvula</i> polymerase chain reaction in diagnosing aspiration pneumonia: a prospective observational study.","authors":"Yao-Kuang Wu, Mei-Chen Yang, Hsueh-Wen Chung, Chou-Chin Lan, Lun-Yu Jao, Chia-Hui Chang, I-Shiang Tzeng, Chih-Yu Chan, Hui-Ching Huang, You-Chen Chao, Wen-Lin Su","doi":"10.1183/23120541.01286-2024","DOIUrl":"10.1183/23120541.01286-2024","url":null,"abstract":"<p><strong>Background: </strong>Aspiration pneumonia is a critical concern, particularly in older adults with comorbidities. Micro-aspiration is often underdiagnosed due to the lack of precise diagnostic tools. This study evaluated the utility of anaerobic PCR for <i>Veillonella parvula</i> compared with traditional diagnostic methods for predicting aspiration pneumonia.</p><p><strong>Methods: </strong>This prospective observational case-control study included patients with new-onset acute respiratory failure requiring mechanical ventilation in intensive care units (ICUs) at a Taiwan medical centre (2022-2024). Demographic data, laboratory results and tracheal aspirates were collected within 48 h of ICU admission. PCR results for <i>Veillonella</i> spp. and <i>V. parvula</i>, along with pepsin and α-amylase levels, were analysed. Pneumonia diagnosis was confirmed by two pulmonologists.</p><p><strong>Results: </strong>Among 87 patients (53 with aspiration pneumonia, 34 without), aspiration pneumonia primarily affected the right side and had atypical phenotypes. Demographics, traditional risk factors, comorbidities and disease severity were similar between groups. <i>Veillonella</i> spp<i>.</i> PCR showed higher sensitivity (92.5%) and specificity (97.1%) than <i>V. parvula</i> PCR (79.2% and 97.1%), chest radiographs with symptoms (73.6% and 88.2%), α-amylase (28.3% and 64.7%) and pepsin (73.6% and 38.2%). Logistic regression revealed that <i>Veillonella</i> spp<i>.</i> PCR had an adjusted odds ratio of 467.2 (95% CI 30.96-7049.4, p<0.001) for predicting aspiration pneumonia. Patients with aspiration pneumonia had longer ICU stays (18.28 days <i>versus</i> 13.03 days, p=0.001) and ventilator days (17.30 days <i>versus</i> 12.09 days, p=0.002).</p><p><strong>Conclusions: </strong><i>Veillonella</i> spp. PCR offers better diagnostic sensitivity and specificity than traditional methods for aspiration pneumonia, potentially guiding antibiotic stewardship.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12336991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820951","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":"Automated computed tomographic analysis of bronchial thickness and mucus plugs in bronchiectasis with asthma.","authors":"Tjeerd van der Veer, Eleni-Rosalina Andrinopoulou, Punitkumar Makani, Gert-Jan Braunstahl, Harm A W M Tiddens","doi":"10.1183/23120541.00736-2024","DOIUrl":"10.1183/23120541.00736-2024","url":null,"abstract":"<p><strong>Background: </strong>Bronchiectasis disease is characterised by cough, sputum and exacerbations, with chest computed tomography (CT) typically showing bronchial wall thickening and mucus plugging in addition to bronchial dilation. Asthma is a common comorbidity and associated with increased, eosinophilic, airway inflammation. Automated measurements of bronchial wall thickening and mucus plugs may serve as biomarkers for inflammation and are associated with clinical characteristics such as spirometry, blood eosinophil counts and disease severity in patients with bronchiectasis and asthma co-diagnosis.</p><p><strong>Methods: </strong>In a cross-sectional retrospective cohort of 64 patients with bronchiectasis disease and asthma, we applied automated image analysis to assess bronchial dimensions and mucus plug metrics on chest CT scans. These metrics were correlated with spirometry, blood eosinophil counts as well as FACED and Bronchiectasis Severity Index (BSI) scores using correlations and multiple regression analyses.</p><p><strong>Results: </strong>In 63 patients, bronchial wall thickness and mucus plugs were quantified. Negative correlations were observed between bronchial wall thickness markers and spirometry (bronchial wall thickness/accompanying artery diameter and forced expiratory volume in 1 s (FEV₁), r= -0.37; FEV₁/forced vital capacity, r= -0.30). Mucus plugs correlated negatively with spirometry and positively with FACED and BSI scores (number of mucus plugs and BSI, r=0.45). Correlations with blood eosinophil counts were very weak. In multiple regression analyses, independent associations were observed for FEV₁, <i>Pseudomonas aeruginosa</i> and frequent exacerbations.</p><p><strong>Conclusion: </strong>This study identified key relationships between automated measurements of bronchial wall thickness and mucus plugs and clinical characteristics, highlighting their potential as imaging biomarkers to enhance phenotyping, improve risk assessment and facilitate tailored treatment strategies in bronchiectasis.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783801","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":"Top 10 priorities for chronic cough: Canadian James Lind Alliance Priority-Setting Partnership (CAN-COUGH).","authors":"Saif Samari, Ana Oliveira, Danica Brister, Elena Kum, Shawn D Aaron, Darryl Adamko, Anurag Bhalla, Christopher Carlsten, Maxime Cormier, Anne K Ellis, Stephen K Field, Krystelle Godbout, Paul Hernandez, Jeremy A Hirota, Alan Kaplan, Tom Kovesi, Renata Mancopes, Maria Sedeno, Maeve Smith, Robert Newman, Philip King, Tiffany Gallagher, Sarah Butson, Dina Brooks, Imran Satia","doi":"10.1183/23120541.01370-2024","DOIUrl":"10.1183/23120541.01370-2024","url":null,"abstract":"<p><strong>Background: </strong>Chronic cough significantly impacts individuals' quality of life and poses challenges for healthcare providers due to limited licensed treatments, side effects of available medications and difficulty accessing nonpharmacological interventions. Understanding priorities for research, education and knowledge dissemination from the perspectives of individuals with chronic cough and healthcare providers can guide future efforts. This study aimed to identify these key priorities in Canada.</p><p><strong>Study design and methods: </strong>We conducted a cross-sectional study using the James Lind Alliance (JLA) method to set priorities. Chronic cough was identified as the healthcare problem. Participants rated items related to research, education and knowledge dissemination in an online survey using a seven-point Likert scale. Results of the survey were reviewed by the Canadian Thoracic Society's (CTS) multidisciplinary working group and patient partners who engaged in a face-to-face Priority-Setting Partnership, to establish a \"Top 10\" priorities list for chronic cough.</p><p><strong>Results: </strong>74 individuals with chronic cough and 62 healthcare providers completed the scoping survey. The top-rated priorities included enhancing knowledge of existing treatments, developing new treatments and improving diagnostic testing. The final \"Top 10\" priorities list emphasised the need for developing infrastructure for evaluating new treatments, improving understanding of biological mechanisms and raising awareness among the public and policymakers.</p><p><strong>Conclusion: </strong>This is the first priority-setting project for chronic cough, highlighting key areas to address in research, education and dissemination. The identified priorities will serve as a foundation for future efforts to improve the management and care of individuals with chronic cough.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783764","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":"Infant respiratory outcomes following asthma management and exacerbations in pregnancy.","authors":"Bronwyn K Brew, Peter G Gibson, Adam M Collison, Joerg Mattes, Gabriela Martins Costa Gomes, Annelies Robijn, Megan E Jensen, Wilfried Karmaus, Paul Robinson, Michael J Peek, Sean Seeho, Peter D Sly, Vanessa E Murphy","doi":"10.1183/23120541.01139-2024","DOIUrl":"10.1183/23120541.01139-2024","url":null,"abstract":"<p><strong>Background: </strong>Improved maternal asthma management in pregnancy may reduce recurrent bronchiolitis and wheeze outcomes in infancy. We assessed whether infant bronchiolitis and wheeze outcomes are influenced by inflammation-guided management intervention, inhaled corticosteroid (ICS) use or exacerbations in pregnancy.</p><p><strong>Methods: </strong>A randomised controlled trial (RCT) secondary analysis and observational cohort analysis using the same study population was carried out. Pregnant women (12-23 weeks' gestation) from six centres in Australia were recruited and randomised to inflammation-guided asthma management or usual care between 2013 and 2023. ICS use and asthma exacerbations were reported during pregnancy and postnatally. When infants were 6 (n=691) and 12 (n=606) months of age, respiratory information was collected from parents and medical records. Associations for the RCT and observational analyses were assessed with logistic regression.</p><p><strong>Results: </strong>Guided asthma management in pregnancy was not associated with bronchiolitis or wheeze-related outcomes, for example for recurrent bronchiolitis at 12 months, the intervention OR was 1.04 (95% CI 0.62-1.73). In the observational analyses, ICS use in pregnancy was not associated with respiratory outcomes; however, asthma exacerbations in pregnancy were associated with at least one bronchiolitis episode (adjusted odds ratio (adjOR) 2.20, 95% CI 1.28-3.76) or croup episode (adjOR 4.34, 95% CI 1.89-9.96) at 6 months, and wheeze (adjOR 1.80, 95% CI 1.14-2.84) and increasing wheeze episodes at 12 months (adjOR 1.81, 95% CI 1.17-2.79).</p><p><strong>Conclusion: </strong>Although there was no evidence that guided asthma management or ICS use in pregnancy reduces infant bronchiolitis or wheeze, maternal asthma exacerbations are an important risk factor for these outcomes. Further research is needed to reduce exacerbations in pregnancy.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783805","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":"SARS-CoV-2 spike treatment and transfection impairs airway epithelial repair.","authors":"Tony Guo, Gurpreet Singhera, Jasmine Memar Vaghri, Wan Yi Liang, Janice M Leung, Del Dorscheid","doi":"10.1183/23120541.00940-2024","DOIUrl":"10.1183/23120541.00940-2024","url":null,"abstract":"<p><strong>Background: </strong>The airway epithelium serves as a physical and immune barrier against inhaled insults. This tissue is susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and, following injury, the airway epithelium undergoes repair to restore barrier function. Although components of SARS-CoV-2, such as the spike glycoprotein essential in viral entry, have been shown to alter biological functions in various tissues, it is unclear how SARS-CoV-2 can impact airway epithelial functions, such as wound repair.</p><p><strong>Methods: </strong>In this study, 16HBE14o- epithelial monolayer cultures were either treated with recombinant SARS-CoV-2 spike glycoprotein S1 subunit at 4 μg·mL^-1 or transfected with a plasmid expressing full-length spike glycoprotein. Secreted inflammatory mediators, markers of proliferation and cell cycle arrest, culture proliferation, and wound closure measurements following mechanical injury were assessed.</p><p><strong>Results: </strong>Spike treatment and transfection altered measures of culture proliferation and markers of proliferation and cell cycle arrest. Secreted interleukin-6 but not interleukin-8 were significantly higher with spike S1 treatment, while both were significantly elevated with spike transfection. Wound closure was inhibited by both spike treatment and transfection, with significant reductions compared to control.</p><p><strong>Conclusions: </strong>SARS-CoV-2 spike S1 treatment and transfection can alter measures of proliferation and inflammation as well as impair wound closure of 16HBE14o- airway epithelial cells. These results highlight how components of SARS-CoV-2 can impair functions of the airway epithelium independent of viral replication.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783762","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":"Development and external validation of a model for lung transplantation-free survival prediction of primary Sjögren syndrome-associated interstitial lung disease: a prospective cohort study.","authors":"Wenyan Meng, Xinran Zhang, Shu Zhang, Bingbing Xie, Yanhong Ren, Shiyao Wang, Jing Geng, Xiaojuan Guo, Min Liu, Sheng Xie, Ling Zhao, Chen Wang, Huaping Dai","doi":"10.1183/23120541.01049-2024","DOIUrl":"10.1183/23120541.01049-2024","url":null,"abstract":"<p><strong>Background: </strong>Primary Sjögren syndrome-associated interstitial lung disease (pSS-ILD) patients have a worse prognosis than pSS patients without pulmonary involvement. This study aims to establish a prediction nomogram for early prediction of lung transplantation (LTx)-free survival in pSS-ILD patients.</p><p><strong>Methods: </strong>The training cohort comprised 260 patients from China-Japan Friendship Hospital between 1 January 2016 and 30 June 2022, while the external validation cohort consisted of 135 patients from Beijing Chaoyang Hospital between 1 January 2007 and 31 December 2012. Univariable Cox regression analysis and least absolute shrinkage and selection operator were employed for variable selection, and a nomogram model was developed to predict the 1-, 3- and 5-year LTx-free survival. Discrimination and calibration of the nomogram were assessed using the concordance index (C-index), area under the curve, calibration curve and decision curve analysis.</p><p><strong>Results: </strong>Multivariable Cox regression demonstrated that elevated age, oxygenation index, carbohydrate antigen 125 and fibrosis score were independent risk factors for LTx-free survival in pSS-ILD patients. The C-index values for the training and validation cohorts were 0.812 and 0.809, respectively. The 1-, 3- and 5-year AUC values for the training cohort were 0.781, 0.874 and 0.909, respectively, while those for the validation cohort were 0.793, 0.826 and 0.863. The bias-corrected curve was close to the ideal curve and revealed a strong consistency between predicted and observed outcomes.</p><p><strong>Conclusions: </strong>We developed a nomogram capable of predicting the LTx-free survival probability at 1, 3 and 5 years in pSS-ILD patients. This model has the potential to be a useful tool for prediction of death or LTx in pSS-ILD.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783803","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":"Association of positive airway pressure adherence with use of antihypertensive drugs in patients with sleep apnoea.","authors":"Dany Jaffuel, Erika Nogue, François Roubille, Jean-Pierre Mallet, Sébastien Bailly, François Goupil, Audrey Thomas, Carole Hervé, Philippe Masson, Acya Bizieux-Thaminy, Margaux Blanchard, Sandrine Kerbrat, Abdelkebir Sabil, Wojciech Trzepizur, Camille Roubille, Sarah Skinner, Arnaud Bourdin, Nicolas Molinari, Frédéric Gagnadoux","doi":"10.1183/23120541.00081-2025","DOIUrl":"10.1183/23120541.00081-2025","url":null,"abstract":"<p><strong>Background: </strong>The impact of positive airway pressure (PAP) therapy on the use of oral antihypertensive drugs (OAHDs) in patients with obstructive sleep apnoea (OSA) remains unclear. This study aimed to evaluate the association between PAP use and the delivery of OAHDs.</p><p><strong>Methods: </strong>Data from the Pays de la Loire Sleep Cohort were linked with the French health insurance database to quantify OAHD delivery in patients with hypertension at the initiation of PAP therapy. The primary end-point was the change in OAHD score, reflecting the number of OAHD classes delivered. PAP use groups were defined as: termination, 0-<4 h·day^-1, 4-<6 h·day^-1 and ≥6 h·day^-1.</p><p><strong>Results: </strong>The study included 2205 OSA patients (median (Q1-Q3) apnoea-hypopnea index of 39 (30-55) events·h^-1), of whom 68% were male. The median age was 61 (54-68) years, the body mass index (BMI) was 32.42 (28.95-36.43) kg·m^-2 and the Epworth score was 10 (6-13). After 1 year of PAP, the mean±sd OAHD score decreased from 2.16±1.11 to 2.13±1.18 with no significant difference between PAP use groups. Respectively, 11.93% and 11.07% of patients experienced a decrease or increase in OAHD score, with no significant difference between PAP use groups. Multivariate analysis revealed that an increase in OAHD score was significantly positively associated with age, usage of calcium channel blockers and number of consultations. A decrease in OAHD score was significantly associated with baseline OAHD score, number of consultations, use of loop diuretics and a decrease in medication possession ratio.</p><p><strong>Conclusion: </strong>PAP use is not associated with a change in OAHD score after 1 year.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783800","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":"Increased loop gain and upper airway collapsibility among smoking patients with obstructive sleep apnoea.","authors":"Liang-Wen Hang, Eysteinn Finnsson, Jón S Ágústsson, Scott A Sands, Wan-Ju Cheng","doi":"10.1183/23120541.01283-2024","DOIUrl":"10.1183/23120541.01283-2024","url":null,"abstract":"<p><strong>Background: </strong>Smoking is a known risk factor for obstructive sleep apnoea (OSA). However, the specific pathological mechanism linking smoking to OSA remains unclear. This study aims to explore the endotypic traits of OSA among current and former smokers.</p><p><strong>Methods: </strong>We prospectively collected polysomnographic data from 980 patients with an apnoea-hypopnoea index (AHI) ≥15 h^-1 from a single clinical sleep centre. Smoking status was determined through self-reported questionnaires completed prior to polysomnography. Endotypic traits (including arousal threshold, collapsibility, loop gain, circulatory delay, ventilatory response to arousal and upper airway compensation) were estimated using polysomnographic signals. Adjusted multivariate linear regression analysis was conducted to investigate the association between smoking and endotypic traits.</p><p><strong>Results: </strong>Compared with nonsmokers, current smokers were associated with a 7.6 h^-1 higher AHI, an 8.8% eupnoea higher arousal threshold, a 4.0% eupnoea lower ventilation at the eupnoeic drive (V_passive), a 6.7% eupnoea lower ventilation at arousal threshold (V_active), a 0.03 higher loop gain, and a 0.64 lower delay during non-rapid eye movement sleep. During rapid eye movement sleep, current smokers showed an 11.1% eupnoea higher arousal threshold, a 6.5% eupnoea lower V_active, a 4.6% eupnoea lower median ventilation observed at minimal ventilatory drive (V_min), a 0.05 higher loop gain, and a 0.57 lower delay. Former smokers exhibited a 5.7% eupnoea lower upper airway compensation and a 6.7% eupnoea lower V_active during rapid eye movement sleep compared with nonsmokers. Smoking amount and duration since quitting were not linearly associated with AHI or endotypic traits.</p><p><strong>Conclusions: </strong>Smoking is associated with increased upper airway collapsibility and loop gain among patients with OSA. These effects may be reversible following smoking cessation.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783804","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-world comparative effectiveness of biologic therapies in severe asthma: EU-ADVANTAGE.","authors":"Giorgio Walter Canonica, Johann Christian Virchow, Arnaud Bourdin, Juby Jacob-Nara, Kinga Borsos, Richard H Stanford, Zhixiao Wang, Mena Soliman, Lynn Huynh, Fariha Haque, Mei Sheng Duh, Wei-Han Cheng","doi":"10.1183/23120541.01217-2024","DOIUrl":"10.1183/23120541.01217-2024","url":null,"abstract":"<p><strong>Background: </strong>In Europe, although multiple biologics have been approved for the treatment of severe asthma (SA), comparative data from real-world settings remain limited. This study compared the real-world effectiveness of dupilumab with that of omalizumab, benralizumab and mepolizumab in European patients with SA.</p><p><strong>Methods: </strong>In the EU-ADVANTAGE study, physicians from France, Italy, Germany, Spain and the Netherlands were recruited to review medical charts of patients (aged ≥12 years) who had physician-confirmed SA and initiated dupilumab, omalizumab, benralizumab or mepolizumab (index) between May 2019 and February 2022. Patients with ≥12 months of pre- and post-index records were included. Differences in baseline covariates were balanced with inverse probability of treatment weighting (IPTW) between dupilumab and other biologics. Reductions in SA exacerbations and oral corticosteroid (OCS) prescriptions during the 12-month post-index period were estimated using a doubly robust regression.</p><p><strong>Results: </strong>A total of 2739 patients met all study criteria; 1281, 638, 406 and 414 received dupilumab, omalizumab, benralizumab and mepolizumab, respectively. After IPTW, the majority of baseline covariates were balanced (standardised difference <10%) between dupilumab and other biologics in a pairwise manner. After regression, dupilumab was associated with a lower risk of SA exacerbations during the 12-month post-index period, as follows: 22% <i>versus</i> omalizumab, 35% <i>versus</i> benralizumab and 23% <i>versus</i> mepolizumab. Additionally, dupilumab significantly reduced OCS prescriptions by 25% <i>versus</i> omalizumab, 27% <i>versus</i> benralizumab and 21% <i>versus</i> mepolizumab.</p><p><strong>Conclusions: </strong>The findings suggest that dupilumab may reduce severe exacerbations and OCS use in patients with SA better than omalizumab, benralizumab and mepolizumab in European real-world settings.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783808","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":"Spirometry at different Latin American altitudes: a Global Lung Function Initiative project.","authors":"Laura Gochicoa-Rangel, David Martínez-Briseño, Cole Bowerman, Sanja Stanojevic, Luciano Enrique Busi, Santiago C Arce, Mónica Gutiérrez-Clavería, Carlos E Rodríguez-Martínez, Carlos Aguirre-Franco, Ana Moya-Olivares, Vanessa Vernaza-Alcedo, Nilda Luz Palma Chambilla, Nelson Villca-Alá, Rosario Fernández-Plata, Rogelio Pérez-Padilla, Carlos Guzmán-Valderrábano, Marie Solange-Caussade, Luis Torre-Bouscoulet","doi":"10.1183/23120541.00060-2024","DOIUrl":"10.1183/23120541.00060-2024","url":null,"abstract":"<p><strong>Aim: </strong>Approximately 20% of people in Latin America live more than 2500 m above sea level. In this ethnically and socioeconomically diverse population, it is challenging to differentiate the effects of altitude from population differences in lung function. The aim of the present study was to quantify the contribution of altitude on the variability in lung function measured by spirometry in Latin America.</p><p><strong>Methods: </strong>Data from healthy individuals living in nine cities across Latin America (from sea level to >2500 m above sea level) were collated. <i>Z</i>-scores for forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) and FEV₁/FVC were calculated using available reference equations. Mixed-effects linear regression models were used to quantify the variance in spirometry explained by altitude. The percentage of individuals that were below the lower limit of normal (fifth percentile) were summarised.</p><p><strong>Results: </strong>A total 4480 subjects (3-94 years) were included. Average FEV₁ and FVC <i>z</i>-scores differed between the altitude groups, whereas FEV₁/FVC did not. After adjusting for sex, height and age, altitude explained up to ∼18% of the variability in lung function measured by spirometry.</p><p><strong>Conclusion: </strong>For people living at altitude, existing approaches to interpreting spirometry measures may misclassify individuals.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 4","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783763","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}