European Clinical Respiratory Journal最新文献

{"title":"Utilizing a three-dimensional printed additional nebulization chamber for colistin nebulization with a large diluent volume through a vibrating mesh nebulizer: proof of concept.","authors":"Chao-Yu Chen, Wei-Lun Liu, Heng-Liang Lin, Hsia-Wei Liu, Shih-Hsing Yang, Ke-Yun Chao","doi":"10.1080/20018525.2025.2531615","DOIUrl":"https://doi.org/10.1080/20018525.2025.2531615","url":null,"abstract":"<p><strong>Introduction: </strong>The volume of colistimethate sodium (CMS) that can be administered in a single application using a vibrating mesh nebulizer (VMN) is related to the capacity of the nebulization chamber. This study designed and tested a nebulization chamber and assessed the effects of the diluent volume on colistin nebulization.</p><p><strong>Methods: </strong>A bench study was conducted to evaluate the performance of the nebulization chamber. A 7-day clinical scenario involving the nebulization of two diluent volumes of CMS (6 and 12 mL) was simulated. Each diluent volume was nebulized for seven consecutive days. Particle size and viscosity were analyzed for four diluent volumes of CMS (3 mL, 6 mL, 9 mL, and 12 mL).</p><p><strong>Results: </strong>After 7 consecutive days of nebulization, residual colistin crystals were observed in both diluent volumes, with a higher incidence in the 6-mL than in the 12-mL diluent volume. The VMN malfunctioned once on day 5 when using the 6 mL diluent volume. Nebulized colistin output was inversely correlated with diluent viscosity.</p><p><strong>Conclusion: </strong>The additional nebulization chamber facilitated the nebulization of a larger diluent volume of CMS in a single nebulization course. Larger diluent volumes resulted in fewer residual CMS crystals and lower diluent viscosity.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2531615"},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of appetite in patients with chronic obstructive pulmonary disease - a mixed methods study.","authors":"Marie Louise Bergmann, Mia Bundgaard Klausen, Lotte Holm, Jens Rikardt Andersen, Jens-Ulrik Stæhr Jensen, Howraman Meteran","doi":"10.1080/20018525.2025.2529054","DOIUrl":"https://doi.org/10.1080/20018525.2025.2529054","url":null,"abstract":"<p><strong>Background: </strong>Loss of appetite in patients with COPD can lead to malnutrition, which is associated with an increased risk of morbidity and mortality.</p><p><strong>Aims: </strong>To identify factors associated with loss of appetite among COPD patients and explore their' experiences regarding appetite and eating.</p><p><strong>Methods: </strong>A questionnaire on demographics, medical history and containing the Council on Nutrition Appetite Questionnaire (CNAQ) was posted in a COPD-specific online forum. CNAQ is validated to examine loss of appetite in older adults. The questionnaire contains 8 questions with five ordinal answer options. Ten patients who answered the questionnaire were randomly recruited for semi-structured phone interviews.</p><p><strong>Results: </strong>Eighty-seven patients responded to the questionnaire. 61% had loss of appetite. Patients with loss of appetite had a lower FEV1% predicted (31% vs. 42%, <i>p</i> = 0.03), higher CAT-score, (23 vs. 18, <i>p</i> = 0.002), and a higher proportion lived alone, (68% vs. 32%, <i>p</i> = 0.02), and got all daily meals delivered (19% vs. 0%, <i>p</i> = 0.009). Among the interviewed patients, the following factors influenced their appetite: Lack of daily routine, insufficient knowledge on nutrition, lack of social contact, bodily limitations, inadequate help and support, limited physical activity and lack of acceptance of life situation.</p><p><strong>Conclusion: </strong>Patients with loss of appetite are characterized by a low BMI, impaired lung function, more symptoms and live alone. Improvement in social contact and support, nutritional support, and acceptance of their current life situation will help address these challenges.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2529054"},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of rehabilitation and palliation for people with severe lung disease or heart failure - a scoping review.","authors":"Kristoffer Marsaa, Stig Molsted, Christian Have Dall, Henrik Hansen, Lise Nottelmann, Jette Meelby, Thomas A Schmidt, Laura Hohwü Thomsen, Nina Godtfredsen","doi":"10.1080/20018525.2025.2529052","DOIUrl":"10.1080/20018525.2025.2529052","url":null,"abstract":"<p><p>Traditionally, rehabilitation and palliative care are delivered as separate services, where rehabilitation focuses on regaining physical functions and palliative care on symptom relief and existential support. There is growing recognition of the potential benefit in integrating these approaches. This scoping review explores how integration or coordination of rehabilitation and palliative care is described in the literature, with a focus on heart failure, chronic obstructive pulmonary disease, and interstitial lung disease. A systematic search was conducted in MEDLINE, EMBASE, and CINAHL, identifying 20 relevant publications. Six overarching themes emerged: overlapping treatment goals; timing of services; inclusion of advance care planning (ACP); attention to existential and spiritual dimensions; barriers to integration; and the role of informal caregivers. The majority of the included studies were re-views or expert statements, with few interventional studies. Practical implementation remains limited and poorly defined. While guidelines increasingly support integrated care models, significant challenges persist, including lack of conceptual clarity, limited evidence of effect, and unclear roles for caregivers. There is broad consensus that integration could improve quality of life for both patients and caregivers by combining the functional focus of rehabilitation with palliative symptom management and its holistic approach. While publications support this integration, its implementation in clinical practice remains unclear. A key argument for integration is the overlap in treatment goals and the potential synergy between the two approaches. Several studies highlight the opportunity to incorporate end-of-life discussions, such as ACP, into traditional rehabilitation programs. Introducing palliative care principles earlier in rehabilitation may also increase the number of patients receiving appropriate end-of-life care.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2529052"},"PeriodicalIF":1.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of CPAP treatment in a tax-funded healthcare system - a scoping review and suggestions for cost reduction of CPAP treatment.","authors":"Tiina Mattila, Hanna-Riikka Kreivi, Laura Mäkitalo, Petra Kotanen, Heidi Avellan-Hietanen, Paula Kauppi","doi":"10.1080/20018525.2025.2518663","DOIUrl":"10.1080/20018525.2025.2518663","url":null,"abstract":"<p><strong>Aims: </strong>Obstructive sleep apnoea (OSA) is an increasing global public health problem. The primary treatment option is continuous positive airway pressure (CPAP). The cost-effectiveness of CPAP in patients with OSA is incompletely characterized.</p><p><strong>Methods: </strong>For this scoping review, we conducted a PubMed search for cost-effectiveness analysis of CPAP treatment in European countries with tax-funded healthcare systems and for clinical practices to reduce costs of CPAP without reducing treatment quality. OSA severity was classified by the overnight apnoea-hypopnea index (AHI). The primary outcome was to define the cost-effectiveness of CPAP in high-income European countries with tax-funded healthcare systems. The second outcome was to describe possible clinical practices that may reduce costs of CPAP for patients with OSA without reducing CPAP treatment quality.</p><p><strong>Results: </strong>CPAP is a cost-effective treatment for those with severe or moderate OSA with symptoms, especially for middle-aged and overweight males. However, the cost-effectiveness remains unclear in mild OSA or moderate OSA without disabling sleepiness. Although CPAP adherence affects cost-effectiveness, this was not considered in all cost-effectiveness studies. The cost of CPAP treatment can be reduced, for instance, by choosing overnight polygraphy at home for diagnostics, remote contacts, nurse- and primary care-led follow-up, and by evaluating the number of necessary healthcare contacts for CPAP.</p><p><strong>Conclusion: </strong>CPAP seems to be cost-effective and should be initiated at least for those with severe OSA or moderate OSA with symptoms. CPAP adherence should be considered in cost-effectiveness studies. There are clinical practices that can reduce CPAP treatment costs without reducing treatment quality.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2518663"},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serologically assessed markers of fibroblast activity (PRO-C3 and PRO-C6) and risk assessment of pulmonary fibrosis following severe COVID-19 infection.","authors":"Anne Orholm Nielsen, Kirsten Brændholt Rasmussen, Frederikke Bay Toft, Henning Bay Nielsen, Thomas Hildebrandt, Carsten Sloth, Alejandro E Mayorca-Guiliani, Morten Karsdal, Diana Julie Leeming, Rikke Borg","doi":"10.1080/20018525.2025.2510032","DOIUrl":"10.1080/20018525.2025.2510032","url":null,"abstract":"<p><strong>Background: </strong>Impaired lung function and fibrotic scarring of the lungs following severe COVID-19 infection are well-known manifestations. However, the risk factors and predisposing factors are still unknown. This study explored whether serological biomarkers for collagen synthesis associate with impaired lung function and fibrotic scarring after COVID-19 infection.</p><p><strong>Methods: </strong>In a prospective, observational cohort study involving patients hospitalized with COVID-19 requiring intensive care from June 2020 to December 2021, patients were followed up at 1, 3, 6, and 12 months after discharge. Lung function, diffusion capacity, and a panel of serological biomarkers for collagen-based fibrogenesis (PRO-C3, PRO-C6, and PRO-FIB) were measured. Additionally, a high-resolution CT scan of the lungs was performed at 3 and 12 months.</p><p><strong>Results: </strong>Thirty-four patients were included in the study. Twenty-seven (80%) were men (mean age 61 years). Most patients were former or active smokers (56%), while 44% were never smokers. Levels of both PRO-C3, PRO-C6, and PRO-FIB were higher 3 months after discharge compared to the normal range. The highest levels were measured 1 month after discharge, with PRO-C3 23.2 ng/ml, PRO-C6 15.9 ng/ml, and PRO-FIB 29.3 ng/ml. The levels of PRO-C3 declined up to 6 months after discharge and were hereafter stabilized, whereas the levels of PRO-C6 declined for the entire follow up period. Lung function improved during the first 6 months and then stabilized. Comparing lung function with PRO-C3 and PRO-C6 showed a positive correlation with lung function improving, while levels of the biomarkers declined. However, only PRO-C3 was found to be significantly associated with improvement in lung function 1 month after discharge.</p><p><strong>Conclusions: </strong>This study found that PRO-C3 and PRO-C6 are associated with changes in lung function after severe COVID-19 infection. High levels of both PRO-C6 and PRO-C3 were found up to 6 months after discharge in patients with impaired lung function, however, the values declined towards reference levels after 12 months.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2510032"},"PeriodicalIF":1.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worsening asthma at school is associated with poor psychosocial well-being.","authors":"Eerika Finell, Asko Tolvanen, Caroline Stridsman, Helena Backman, Linnéa Hedman","doi":"10.1080/20018525.2025.2509395","DOIUrl":"10.1080/20018525.2025.2509395","url":null,"abstract":"<p><strong>Objective: </strong>To study whether worsening asthma at school was related to generic health-related quality of life (HRQoL) and asthma-related impact and worry among 15-year-olds with current asthma in Sweden. In addition, we studied the association between worsening asthma at school at age 15 and the change in the degree to which asthma interfered with daily activities between ages 15 and 19 years.</p><p><strong>Methods: </strong>Within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of schoolchildren has been followed from age 8 years until 19 years of age. In the current study, the sample included 266 adolescents with physician-diagnosed asthma, and either wheeze or use of asthma medication during the last 12 months at age 15 years.</p><p><strong>Results: </strong>At age 15, HRQoL scores were lower among those who reported worsening asthma at school (standardised beta (β) =  -0.18, <i>p</i> = 0.003), they had more asthma-related worries (β =  -0.33, <i>p</i> < 0.001) and asthma impacted their life during activities more (β =  -0.46, <i>p</i> < 0.001) than those whose asthma did not worsen. Furthermore, the more adolescents reported that asthma worsened at school at age 15, the more it was associated with the increase in the degree to which asthma interfered with their activities between 15 and 19 years (β = 0.14, <i>p</i> = 0.038).</p><p><strong>Conclusions: </strong>Worsening asthma at school was associated with lower generic health-related quality of life, higher asthma-related worry and impact on daily activities among teenagers with asthma.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2509395"},"PeriodicalIF":1.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological intervention in severe asthma: from theory to practice.","authors":"Cleofé Fernández Aracil, María José Zamora Muñoz, María Del Mar García Ródenas, María Rodríguez Aguilar, Carlos J van-der Hofstadt Román, Luis Hernández Blasco","doi":"10.1080/20018525.2025.2506237","DOIUrl":"10.1080/20018525.2025.2506237","url":null,"abstract":"<p><strong>Background: </strong>Severe asthma is frequently associated with psychological comorbidities that negatively affect disease control and quality of life. Despite clinical guideline recommendations, psychological care remains limited in multidisciplinary asthma units.</p><p><strong>Objective: </strong>To evaluate the effectiveness of an online group psychological intervention in improving emotional well-being and disease control in patients with severe asthma.</p><p><strong>Methods: </strong>A longitudinal study was conducted between 2021 and 2024 in a specialized severe asthma unit. The intervention consisted of eight weekly online sessions combining cognitive-behavioral techniques and emotional regulation strategies. Psychological and quality-of-life variables were assessed at baseline, post-intervention, and at 6 and 12 months of follow-up.</p><p><strong>Results: </strong>A total of 41 patients completed the program. Significant and sustained improvements were observed in anxiety, depression, hyperventilation, and asthma-related quality of life up to 12 months after the intervention. No changes were found in alexithymia, perceived social support, or family functioning.</p><p><strong>Conclusion: </strong>An online group psychological intervention is a feasible and effective approach to improving emotional health and quality of life in patients with severe asthma. Its integration into asthma care units may contribute to a more comprehensive and patient-centered management strategy.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2506237"},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conducting a registry-based randomised trial (REDOX) in chronic respiratory failure: experiences and advice.","authors":"Josefin Sundh, Magnus Ekström","doi":"10.1080/20018525.2025.2502237","DOIUrl":"10.1080/20018525.2025.2502237","url":null,"abstract":"<p><p>Registry-based randomised controlled trials (R-RCTs) represent a paradigm shift in research, with the potential to accomplish pragmatic but large trials with high external validity. In this paper, we review our experiences from planning and performing the <i>REgistry-based randomised controlled trial of treatment Duration and mortality in long-term OXygen therapy (REDOX) trial</i>, the first R-RCT within respiratory medicine. The REDOX study compared the two established treatment options of home oxygen 15 and 24 h per day. Previous recommendations to use oxygen for at least 15 h but preferably 24 h per day were based on a non-randomised comparison of two different studies. We hypothesised that oxygen 24 h/day was non-superior to 15 h/day and used the Swedish National Registry for Respiratory Failure (Swedevox) to perform an R-RCT showing that home oxygen 24 h/day does not improve survival, hospitalisation or patient-reported outcomes within 1 year. We describe the entire procedure of REDOX from planning to publication and use it to discuss challenges and potential solutions for future R-RCTs. In summary, common features of R-RCTs are the use of a registry for identification and randomisation of participants and for reporting and collecting baseline and outcome data, and the design is typically used to compare two treatment options. Important strengths are high generalisability, low cost, feasibility for consecutive recruitment in clinical practice, and high completeness of follow-up. Limitations include that coverage, completeness and accuracy of baseline data may differ between registries. Specific challenges (and solutions) in REDOX were addressing an important question (pragmatic clinical trials), management (clinical research support teams), costs (using registry-based infrastructure), different electronic data capture systems (posttrial linkage), slow recruitment (amendment of protocol) and resistance to challenge treatment traditions.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2502237"},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric disorders as predictor of adherence to non-invasive ventilation treatment in patients with acute exacerbation in chronic obstructive pulmonary disease - a real life study.","authors":"Johanne Hermann Karlsen, Peter Ascanius Jacobsen, Mia Solholt Godthaab Brath, Ulla Møller Weinreich","doi":"10.1080/20018525.2025.2484080","DOIUrl":"10.1080/20018525.2025.2484080","url":null,"abstract":"<p><strong>Introduction: </strong>Non-invasive ventilation (NIV) treatment is effective and potentially lifesaving in patients with respiratory acidosis and acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, feelings of anxiety during NIV treatment are common, potentially leading to premature patient-initiated termination of treatment.The primary aim of this study is to examine whether psychiatric disorders are a risk factor of premature patient-initiated termination of NIV treatment. The secondary aim is to examine the patterns in use of sedative drugs during NIV treatment.</p><p><strong>Methods: </strong>This retrospective cohort study includes 195 patients with AECOPD receiving NIV between 1 January and 31 December 2018, in hospitals in the Northern Region of Denmark. Information was obtained from medical records. Psychiatric disorders were defined by the use of psycholeptics at home, right before admission.Primary outcome was premature patient-initiated termination of NIV treatment. Secondary outcome was the use of any sedative drug during NIV treatment.</p><p><strong>Results: </strong>Patient-initiated premature termination was seen in 41 (21%) of cases. This group had a significantly higher mortality (43.9% vs. 19.5% in the total population, <i>p</i> < 0.01). A higher risk of patient-initiated premature termination was seen in patients with psychiatric disorders (Odds ratio 2.18, <i>p</i> < 0.05) and older age (Odds ratio 1.06, <i>p</i> < 0.05). No significant difference in the use of sedative drugs was seen (34.1% vs. 38.1% in the total population, p 0.12).</p><p><strong>Conclusion: </strong>A significantly higher risk of premature patient-initiated termination of NIV treatment was seen in patients with psychiatric disorders and older patients, but not in patients with active smoking or excessive use of alcohol. No significant difference in the pattern of sedative drug use during treatment was seen.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2484080"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of glucagon-like peptide-1 receptor agonists in patients with obstructive sleep apnea: a systematic review and meta-analysis of randomized controlled trials.","authors":"Obieda Altobaishat, Ahmed Farid Gadelmawla, Elsayed Balbaa, Mustafa Turkmani, Mohamed Abouzid","doi":"10.1080/20018525.2025.2484048","DOIUrl":"10.1080/20018525.2025.2484048","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a common condition affecting around one billion people worldwide. Emerging evidence from recent studies suggests that Glucagon-like peptide 1 receptor (GLP-1) agonists may reduce OSA severity. Hence, this meta-analysis aims to evaluate the efficacy and safety of GLP-1 agonists in patients with OSA.</p><p><strong>Methods: </strong>Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched four electronic databases (PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science) to identify eligible studies reported up to 24 June 2024. Using Review Manager software, we reported outcomes as risk ratios (RRs) or mean difference (MD) and confidence intervals (CIs). The protocol for this review has been registered and published in PROSPERO with the ID (CRD42024562853).</p><p><strong>Results: </strong>The meta-analysis included three randomized controlled trials with 828 patients. Pooled analysis of patients administered GLP-1 agonists or tirzepatide showed improvement in Apnea/Hypopnea Index (MD -16.57 events per hour, 95% CI [-27.41, -5.73], <i>p</i> = 0.003), weight reduction (MD -12.71%, 95% CI [-21.38, -4.03], <i>p</i> = 0.004), and systolic blood pressure (MD -4.93 mmHg,95% CI [-7.67, -2.19], <i>p</i> = 0.0004). Tirzepatide showed a reduction in high-sensitivity C-reactive protein (MD -0.89 mg/dl, 95% CI [-1.25, -0.54], <i>p</i> < 0.0001) and sleep apnea-specific hypoxic burden (MD -66.21%/min, 95% CI [-81.75, -50.67], <i>p</i> < 0.0001). Despite the heterogeneity observed in the AHI and weight, it was resolved, and the results were consistent. GLP-1 agonists/tirzepatide showed comparable outcomes concerning diastolic blood pressure (MD -1.34 mmHg, 95% CI [-2.80, 0.12], <i>p</i> = 0.07). No significant serious adverse events were observed for GLP-1 agonists/tirzepatide, but it was associated with a higher incidence of gastrointestinal adverse events.</p><p><strong>Conclusion: </strong>GLP-1 agonists, including tirzepatide, improved Apnea/Hypopnea Index, weight, and systolic blood pressure in adults with moderate-to-severe OSA. However, the evidence remains limited to two published studies comprising three randomized controlled trials using different pharmacological agents. Consequently, further research is needed before firm conclusions can be drawn.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":"12 1","pages":"2484048"},"PeriodicalIF":1.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}