Pulmonary Therapy最新文献

{"title":"Interrelationship between Daytime Functional Outcomes and Psychological Distress in Patients with Obstructive Sleep Apnea: A Cross-Sectional Study.","authors":"Khue Bui-Diem, Nguyen Van Tho, Thu Nguyen-Binh, Quynh Doan-Truc, Sy Duong-Quy","doi":"10.1007/s41030-026-00365-y","DOIUrl":"https://doi.org/10.1007/s41030-026-00365-y","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) is associated with decreased daytime functional outcomes and increased psychological stress. However, the specific profile of this burden, particularly in the Vietnamese population, remains understudied. This study aimed to analyze sleep-related functional outcomes and psychological stress in a population of untreated Vietnamese patients with OSA.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 61 untreated patients with OSA (78.7% male, mean age 47.8 ± 12.9 years). Participants completed the 10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10) and the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Descriptive statistics, Spearman correlation coefficients, and a generalized linear model were used to assess the prevalence of symptoms and the relationship between functional and psychological domains.</p><p><strong>Results: </strong>The majority of the study population presented with severe OSA (mean apnea-hypopnea index [AHI], 47.5 ± 25.5 events/h). The median total score for FOSQ-10 was 16.3 (interquartile range [IQR]: 14.0-18.3). A notable finding was the high prevalence of clinically significant (moderate or higher) psychological distress, including depression, anxiety, and stress (22.9%, 54.1%, and 18.0%, respectively). Multivariate regression demonstrated that age was positively associated with FOSQ-10 general productivity but negatively associated with intimacy, whereas AHI was negatively associated with intimacy. FOSQ-10 and DASS-21 scores showed consistent negative correlations across all domains, indicating that diminished sleep-related functional quality of life correlates with elevated psychological distress.</p><p><strong>Conclusions: </strong>In untreated Vietnamese patients with OSA, the prevalence of psychological discomfort, especially anxiety, is considerable and is associated with significant functional impairment. The substantial association between low functional quality of life and high levels of psychological distress shows how important it is to do thorough baseline examinations. Routine assessment for functional impairment and psychological distress should be integral components of the clinical evaluation for patients with OSA.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 Annual Review of Pulmonary Arterial Hypertension Clinical Research.","authors":"Ilma Alves de Oliveira Nascimento, Rogério Souza, Caio Júlio Cesar Dos Santos Fernandes","doi":"10.1007/s41030-026-00359-w","DOIUrl":"https://doi.org/10.1007/s41030-026-00359-w","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary arterial hypertension (PAH) remains a progressive and life-threatening disease despite major therapeutic advances over the past three decades. Alongside evolving treatment strategies, the growing complexity of PAH management has been accompanied by an expansion of global clinical research activity, creating challenges for clinicians and researchers to synthesize emerging evidence and identify meaningful trends.</p><p><strong>Methods: </strong>This study provides a descriptive analysis of PAH-related clinical studies registered on international platforms integrated into the World Health Organization International Clinical Trials Registry Platform (ICTRP/WHO) between January and December 2025. Trials were characterized according to study design, therapeutic pathway, geographic distribution, funding source, and methodological features, including endpoint selection and incorporation of patient-reported and digital outcomes.</p><p><strong>Results: </strong>A total of 54 PAH-related studies were registered in 2025, of which 64.8% were interventional and 33.3% observational. Most trials involved pharmacological interventions and were conducted predominantly in high- and middle-income countries, with limited representation from low-income regions. Academic institutions and hospitals accounted for the majority of sponsors, while direct pharmaceutical industry sponsorship was identified in a minority of registrations. Therapeutic investigations extended beyond classical vasodilator pathways, with increased focus on transforming growth factor/bone morphogenetic protein (TGF-β/BMP) signaling modulation, metabolic and cardiorenal pathways, and selective tyrosine kinase inhibition. Methodologically, trials increasingly incorporated composite endpoints, imaging-based assessments, biomarkers, patient-reported outcome measures, and, in a subset, digital health and remote monitoring strategies.</p><p><strong>Conclusion: </strong>Clinical trials registered in 2025 reflect a PAH research landscape characterized by stable trial volume, diversification of therapeutic targets, and progressive methodological refinement. The growing use of multidimensional endpoints and patient-centered and digital tools suggests a increasing integration of therapeutic response. Persistent gaps in geographic representation and endpoint standardization, however, remain key challenges for the future of PAH clinical research.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Considerations for Managing Transitions from Parenteral Prostacyclins to Oral Selexipag in Pulmonary Arterial Hypertension.","authors":"Jean M Elwing, Christina Benninger, Paul Strachan, Korawin Triyasakorn, Marla Choren, B Kody Timms, Lori Reed","doi":"10.1007/s41030-026-00357-y","DOIUrl":"https://doi.org/10.1007/s41030-026-00357-y","url":null,"abstract":"<p><p>The prostacyclin pathway represents a foundational pathway in the treatment of patients with pulmonary arterial hypertension (PAH). Parenteral prostacyclin pathway agents (PPAs) are often used for treatment of severe PAH but their broader use is limited by administration difficulties, including a need for continuous infusion, administration side effects, and complexities of a chronic indwelling catheter. Administration of the prostacyclin receptor agonist selexipag, an oral therapy with more than 10 years' clinical experience, may be more favorable for some patients. However, treatment protocols for transitioning from parenteral PPAs to oral selexipag are lacking. Here, we describe practical considerations for managing such transitions. The transition process requires an individualized and shared decision-making approach between the patient and multidisciplinary team to optimize treatment outcomes. Key considerations include patient selection criteria, setting expectations, transition setting (inpatient vs outpatient), transition speed, dose adjustment, and clinical follow-up. Appropriate patient candidates for transition to oral selexipag should be clinically stable and selected based on a comprehensive evaluation using validated risk scores and hemodynamic parameters. Expectations and realistic treatment goals should be discussed collaboratively and must include the possibility of returning to parenteral PPAs if clinically indicated. Transition protocols should be flexible and tailored to each patient. Outpatient transition may be considered depending on transition speed, the patient's ability to follow dosing instructions, and access to emergency care if needed. Speed of the transition to oral selexipag varies based on individual patient needs. Close monitoring and long-term follow-up are essential following transitions to maximize success and patient safety. In summary, transitioning from parenteral PPAs to oral selexipag can be challenging and complex. However, success is achievable for suitable patients through careful planning, setting transparent expectations, and an individualized approach with close monitoring and long-term follow-up.Graphical abstract available for this article.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oscillating Positive Expiratory Pressure (OPEP) Therapy in Bronchiectasis and Chronic Obstructive Pulmonary Disease (COPD): A Narrative Review of Clinical Studies.","authors":"Judy L Schloss, Dominic P Coppolo, Jason A Suggett, Breeanna R Long, Mark W Nagel, Jolyon P Mitchell","doi":"10.1007/s41030-026-00354-1","DOIUrl":"https://doi.org/10.1007/s41030-026-00354-1","url":null,"abstract":"<p><p>Exacerbations associated with bronchiectasis with or without chronic obstructive pulmonary disease (COPD) are often associated with generation and accumulation of excessive mucus in the airways of the lungs. Not only can mucus plugs reduce the perfusion of oxygen to the alveolar gas exchange region but they also serve as a location for opportunistic bacterial/viral infection. Delivery of inhaled medications to treat receptors associated with the underlying COPD distal to the obstructed airways can be restricted or prevented altogether. This narrative review examines clinical evidence published mainly since 2004 for the use of oscillating positive expiratory pressure (OPEP) as a drug-free airway clearance therapy (ACT) for patients experiencing COPD with or without bronchiectasis. OPEP therapy is considered as a preventative measure in between exacerbations and to clear the airways during severe exacerbations. The review is intended to assist clinicians involved with COPD-bronchiectasis management, given the increased awareness of the advantages of OPEP therapy in clinical practice guidelines.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Public Health Impact of Updated COVID-19 Vaccination Strategies in Thailand: Epidemiological Data Update.","authors":"Karan Thakkar, Ruangwit Thamaree, Moe H Kyaw, Iustina Chirila, Carlos Fernando Mendoza, Josie Dodd, Ben Yarnoff, Sasisopin Kiertiburanakul","doi":"10.1007/s41030-026-00358-x","DOIUrl":"https://doi.org/10.1007/s41030-026-00358-x","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates the anticipated health and economic effects of multiple COVID-19 vaccination strategies using an updated vaccine in Thailand.</p><p><strong>Methods: </strong>A previously published hybrid decision tree and Markov model, originally developed for the USA, was calibrated using Thailand-specific epidemiological, demographic, and economic data from 2024. The model assessed several age- and risk-based vaccination strategies assuming vaccine uptake ranging from 20% to 50%. Health outcomes (cases, hospitalizations, deaths, and long COVID cases) and economic outcomes (long COVID costs, direct medical costs, and productivity losses) were projected from payer and societal perspectives. Vaccine effectiveness was assumed to be 50% against infection, 60% against symptoms, and 70% against severe disease, with a 6-month duration of protection.</p><p><strong>Results: </strong>Vaccinating individuals aged 60 years and above and high-risk individuals aged 6 months to 59 years was projected to prevent 318,700 infections, 9147 hospitalizations, and 1061 deaths in 1 year. This strategy was estimated to yield THB 3300 million in direct medical cost savings and THB 2695 million in productivity loss savings. Increasing coverage in this population to 50% could amplify these reductions by up to 150%.</p><p><strong>Conclusions: </strong>With updated Thai data, analyses suggest that use of an adapted COVID-19 vaccine could continue to generate considerable public-health and economic gains, particularly when coverage among older adults and high-risk groups is expanded. These findings carry implications for sustaining preparedness and guiding national vaccination policy.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Clinical Questionnaires for Predicting Obstructive Sleep Apnea in Patients with Non-Valvular Atrial Fibrillation.","authors":"Thu Nguyen Ngoc Phuong, Thanh V Kim, Duong Hiep Ho, Thuong Thanh Phuong, Nguyen Thi Le Trang, Tran Thanh Tuyen, Bui Dan Que, Doan Thi Hoa, Ngo Thi Thanh Thao, Sy Duong-Quy","doi":"10.1007/s41030-026-00356-z","DOIUrl":"https://doi.org/10.1007/s41030-026-00356-z","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) is common but frequently underdiagnosed in patients with atrial fibrillation (AF), particularly in low- and middle-income countries, where access to polysomnography is limited. This study evaluated the diagnostic accuracy of the STOP-BANG, Berlin, and Epworth Sleepiness Scale (ESS) questionnaires for OSA screening in Vietnamese patients with non-valvular AF.</p><p><strong>Methods: </strong>This cross-sectional diagnostic accuracy study was conducted in a tertiary inpatient cardiology department in Ho Chi Minh City, Vietnam. Consecutive adults with chronic non-valvular AF completed the STOP-BANG, Berlin, and ESS questionnaires, followed by overnight unattended type III polysomnography (ApneaLink™, ResMed). OSA was defined as an apnea-hypopnea index ≥ 5 events/hour according to International Classification of Sleep Disorders (ICSD)-3 criteria. Diagnostic performance was assessed using sensitivity, specificity, area under the receiver operating characteristic curve (AUC), predictive values, and likelihood ratios.</p><p><strong>Results: </strong>Among 126 participants (median age 61 years; 45.2% male vs. 54.8% female), OSA prevalence was 74.6%. STOP-BANG showed the highest diagnostic accuracy (AUC 0.903, 95% confidence interval [95% CI] 0.852-0.954), with sensitivity of 81.9% and specificity of 96.9%. The Berlin questionnaire demonstrated moderate performance (AUC 0.824, 95% CI 0.735-0.914; sensitivity 89.4%; specificity 59.4%). ESS performed poorly in this population (AUC 0.499, 95% CI 0.386-0.613; sensitivity 6.4%).</p><p><strong>Conclusions: </strong>STOP-BANG demonstrated superior diagnostic accuracy and practicality for OSA screening in patients with non-valvular AF, supporting its use to guide referrals for confirmatory sleep testing in resource-limited settings.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate Change and the Switch from Pressurised Metered-Dose Inhalers to Dry Powder Inhalers: A Proportionate Balancing of Risk and Reward?","authors":"Sanjeeva Dissanayake, Jason Suggett, Alan Kaplan","doi":"10.1007/s41030-026-00355-0","DOIUrl":"https://doi.org/10.1007/s41030-026-00355-0","url":null,"abstract":"<p><p>Urgent action is required to limit the increase in global temperatures. While mitigation efforts are primarily directed at transitioning away from fossil fuels, given their overwhelming contribution to greenhouse gas emissions, infrastructural change is slow to effect. Thus, behavioural changes, which can be effected rapidly, are also critical. To limit healthcare-related emissions, a widespread transition away from pressurised metered-dose inhalers (pMDIs), containing hydrofluorocarbons with high global warming potential (GWP), to dry powder inhalers (DPIs) with minimal GWP, has been proposed. This paper discusses whether the stated grounds for this transition are robust and are proportionate to the potential environmental gain and, while not to be ignored, whether a greater emphasis should be placed upon other measures that may have a greater impact.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Adherence to Elexacaftor/Tezacaftor/Ivacaftor in People with Cystic Fibrosis.","authors":"Carina M E Hansen, Badr Zendaky, Annelies M Zwitserloot, Patricia M L A van den Bemt, Job F M van Boven","doi":"10.1007/s41030-026-00351-4","DOIUrl":"https://doi.org/10.1007/s41030-026-00351-4","url":null,"abstract":"<p><strong>Introduction: </strong>Cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulators are the cornerstone treatment for CF, but nonadherence can reduce their effect. Long-term adherence data on elexacaftor/tezacaftor/ivacaftor (ETI) combined with the evening dose ivacaftor (IVA) are lacking. The aim of this study was to determine 3-year adherence to ETI and IVA based on pharmacy refill data.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted using pharmacy refill data. Medication adherence was calculated using the proportion of days covered (PDC). The primary outcome was the PDC for ETI and IVA, which were calculated at 1, 2, and 3 years after initiating ETI and IVA. The secondary outcome was the proportion of non-adherent people with CF (pwCF), defined as having a PDC < 0.8.</p><p><strong>Results: </strong>A total of 128 pwCF were included (75 male [59%], mean age 28.8 ± 15.5 years). At year 1, the PDCs for ETI and IVA (N = 128 and 112) were (median, range) 0.98 (0.69-1.0) and 0.98 (0.68-1.0); at 2 years (N = 105 and 95), 0.99 (0.54-1.0) and 1.0 (0.69-1.0), and at 3 years (N = 56 and 51), 0.98 (0.49-1.0) and 0.99 (0.54-1.0). Over time, a statistically significant decrease in PDC was observed [p = 0.01 (ETI, years 1 vs. 3) and p = < 0.01 (IVA)]. The percentage of non-adherent pwCF increased over time, from 3.6% (IVA) and 3.3% (ETI) at year 1 to 15.7% (IVA) and 12.5% (ETI) at year 3.</p><p><strong>Conclusions: </strong>Three-year adherence to ETI and IVA based on pharmacy refill data was high, yet declined over time.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of BMI on the Effect of Biologic Agents for Severe Asthma.","authors":"Styliani Papadopoulou, Christodoulos Komiotis, Fotios Drakopanagiotakis, Stelios Loukides, Paschalis Steiropoulos","doi":"10.1007/s41030-026-00352-3","DOIUrl":"https://doi.org/10.1007/s41030-026-00352-3","url":null,"abstract":"<p><strong>Introduction: </strong>The association between severe asthma and obesity is well established, as higher body mass index (BMI) is associated with higher prevalence and incidence of severe asthma. Biologic agents have been recently developed for severe asthma treatment. However, the efficacy of biologic agents in patients with higher BMI is not well studied. The aim of this systematic review was to determine whether there is an association between BMI and the response to five novel biologic agents.</p><p><strong>Methods: </strong>Our study design followed the PRISMA guidelines. A literature search was performed using the PubMed/Medline and the Scopus databases up to May 2025 for the following agents: mepolizumab, benralizumab, dupilumab, reslizumab, and tezepelumab. After meticulous screening, 21 articles were selected.</p><p><strong>Results: </strong>Studies on mepolizumab showed that higher BMI was associated with failure to achieve clinical remission, while BMI < 30 kg/m² was associated with better clinical outcomes. Regarding benralizumab, significant improvements were observed in respiratory symptoms and reductions in annual asthma exacerbation rate for patients with BMI ≤ 35 kg/m² but not for patients with BMI > 35 kg/m². One study about dupilumab describes it as equally effective across all BMI levels. Reslizumab appears to be effective across different BMI levels; however, effectiveness seems to decrease in patients with high BMI. Regarding tezepelumab, no study was found.</p><p><strong>Conclusions: </strong>Biologic agents are effective treatments for severe asthma, although mepolizumab, benralizumab, and reslizumab appear to have better results in patients with lower BMI. Dupilumab appears to be equally effective across all BMI categories, while no data are available for tezepelumab. More studies in patient populations with severe asthma and comorbid obesity are needed to evaluate the effectiveness of biologic therapies in this specific category of patients.</p><p><strong>Trial registration: </strong>Registration and protocol: PROSPERO CRD42024609708.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Resource Utilization in Refractory MACLD: Comparison of an Amikacin Liposome Inhalation Suspension (ALIS) Cohort with a Non-ALIS Cohort.","authors":"Timothy R Aksamit, Catherine Waweru, Emily Welch, Elsie Divinagracia, Ping Wang, Leona Markson","doi":"10.1007/s41030-025-00324-z","DOIUrl":"10.1007/s41030-025-00324-z","url":null,"abstract":"<p><strong>Introduction: </strong>Add-on treatment with amikacin liposome inhalation suspension (ALIS) to a multidrug antibiotic regimen is the only US Food and Drug Administration-approved treatment for adults with refractory Mycobacterium avium complex lung disease (MACLD). In real-world settings, other antibiotics may be added on to treat refractory MACLD. We analyzed healthcare resource utilization in a US patient population who received add-on treatment for refractory MACLD.</p><p><strong>Methods: </strong>This was a retrospective claims analysis using Merative™ MarketScan® databases (January 2016 to December 2022). Two patient cohorts were defined: an ALIS and non-ALIS cohort. Index date was date of first prescription with ALIS or non-ALIS antibiotic for refractory MACLD. Hospitalizations (all-cause, respiratory-related, nontuberculous mycobacteria (NTM)-related) and emergency room (ER) visits at 0-6-month and 7-12-month post-index periods were compared with baseline (6-month pre-index period) per cohort. Multivariate logistic regression models compared the odds of hospitalizations or ER visits between cohorts.</p><p><strong>Results: </strong>The ALIS and non-ALIS cohorts comprised 116 and 63 patients, respectively. The most common add-on treatments for refractory MACLD in the non-ALIS cohort were parenteral amikacin (41.3%) and moxifloxacin (27.0%). In the ALIS cohort, significant reductions from baseline, as compared with the 7-12-month post-index period, were observed in all-cause (12.1% vs 22.4%), respiratory-related (8.6% vs 20.7%), and NTM-related hospitalizations (9.5% vs 19.8%) (P < 0.05 for all comparisons). There were no significant changes from baseline in hospitalizations at follow-up in the non-ALIS cohort. No significant changes from baseline in ER visits or hospital length of stay were observed in either cohort. Adjusted odds ratios (ORs) of all-cause (OR [95% confidence interval, CI] 0.45 [0.21-0.96]) and respiratory-related hospitalizations (OR 0.44 [0.21-0.96]) were statistically significantly lower in the ALIS cohort compared with the non-ALIS cohort.</p><p><strong>Conclusions: </strong>Add-on treatment with ALIS in refractory MACLD may lead to reductions in hospitalizations over time and lower odds of hospitalizations compared with add-on treatment with non-ALIS antibiotics.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"221-235"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524252","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}