Pulmonary Therapy最新文献

{"title":"Correction: Dupilumab Versus Mepolizumab for COPD: Evaluating Efficacy Outcomes Using Placebo-Adjusted Indirect Treatment Comparison.","authors":"Surya P Bhatt, Nick Freemantle, Mena Soliman, Jigna Heble, Yann Cabon, Ernesto Mayen Herrera, Joe Yang, Yingxin Xu","doi":"10.1007/s41030-025-00332-z","DOIUrl":"10.1007/s41030-025-00332-z","url":null,"abstract":"","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"219"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550314","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":"Symptomatic Sarcoidosis Treated with Acthar^® Gel: Insights from a Physician-Reported Chart Review.","authors":"Amit Patel, Priyanka P Shanbhag, Destri R Evans, Kyle Hayes, Mary P Panaccio, Johanna Purcell, George J Wan","doi":"10.1007/s41030-026-00344-3","DOIUrl":"10.1007/s41030-026-00344-3","url":null,"abstract":"<p><strong>Introduction: </strong>Real-world data on evolving treatment patterns of Acthar Gel, a Food and Drug Administration-approved therapy for patients with symptomatic sarcoidosis, have remained limited. This study described the characteristics of patients with symptomatic sarcoidosis treated with Acthar Gel, medication utilization patterns, and physicians' assessments of the effects of Acthar Gel on patients' health status.</p><p><strong>Methods: </strong>A prospectively designed medical chart review study with a predefined protocol and analysis plan was conducted in November 2024, with data abstracted from patient records between April 2022 and November 2024. Eligible patients were aged ≥ 18 years, had symptomatic sarcoidosis, and had received Acthar Gel within ≤ 24 months.</p><p><strong>Results: </strong>On average, patients with symptomatic sarcoidosis were 47 years old; most were men (56%, 22/39) and African American (46%, 18/39). Common comorbidities included chronic joint disease, hypertension, and arthritis/osteoarthritis. Before receiving Acthar Gel, physicians reported that 56% (22/39) of patients had a fair-to-poor health status (average rating 3.4/5, where 1 = excellent and 5 = poor). Frequent symptoms were fatigue, joint pain, and muscle aches or weakness. Before initiating Acthar Gel, most patients with symptomatic sarcoidosis had previously received treatment with corticosteroids (82%, 32/39), immunosuppressive drugs (51%, 20/39), and biologic disease-modifying antirheumatic drugs (51%, 20/39). Based on physician assessment, 92% (36/39) of patients experienced improved health after Acthar Gel treatment. Improvements included reduced overall symptoms (69%, 25/36), improved physical function (47%, 17/36), decreased pain (44%, 16/36), improved fatigue (36%, 13/36), reduced corticosteroid use (33%, 12/36), improved lung functioning (25%, 9/36), and improved strength (22%, 8/36).</p><p><strong>Conclusions: </strong>Based on this chart review, Acthar Gel may represent a potential treatment option for selected patients with symptomatic sarcoidosis. In this study, among patients with symptomatic sarcoidosis treated with Acthar Gel, physicians documented reduced overall symptoms, improved physical function, decreased pain, improved fatigue, reduced corticosteroid use, improved lung functioning, and improved strength using prespecified assessments.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"385-395"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143246","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":"Healthcare Resource Utilization and Medical Costs in Pulmonary Arterial Hypertension Management in Japan: A Retrospective Study Using a Claims Database.","authors":"Atsushi Tajima, Yoko Arai, Takao Nakamura, Shigeru Tokita, Anna Watzker, Takumi Sugiyama, Noriaki Emoto","doi":"10.1007/s41030-026-00343-4","DOIUrl":"10.1007/s41030-026-00343-4","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the healthcare resource utilization (HCRU), medical costs in pulmonary arterial hypertension (PAH) patients in Japan, implementation of right heart catheterization (RHC), and treatment intensity, a retrospective observational cohort study using a nationwide health insurance claims database provided by JMDC Inc. was conducted.</p><p><strong>Methods: </strong>Patients with PAH, classified based on evidence of a PAH diagnosis and PAH-targeted drug prescription within the same calendar month, were identified from the database. Demographic and clinical characteristics, as well as the implementation of RHC during the baseline period and the type of PAH-targeted drugs prescribed for the first-line therapy, were described. Outcomes included HCRU and direct medical costs between March 1, 2018 and March 31, 2023.</p><p><strong>Results: </strong>A total of 405 patients with PAH were included in the analyses; 298 patients (73.6%) did not undergo RHC [RHC(-) cohort], and 107 patients (26.4%) underwent RHC [RHC(+) cohort] during the baseline period. Among the overall population, 59.3% received oral/inhaled monotherapy and 5.4% received parenteral prostacyclin analogue (PPA) combination therapy; 70.1% of the RHC(-) cohort received oral/inhaled monotherapy versus 29.0% in the RHC(+) cohort, 1.7% of the RHC(-) cohort received PPA combination therapy versus 15.9% in the RHC(+) cohort. Overall, the HCRU and the total medical costs tended to increase with treatment intensity in both RHC(-) and RHC(+) cohorts. The increase of the medical costs was mainly due to increase in costs related to hospitalization and prescription of PAH-targeted drugs.</p><p><strong>Conclusion: </strong>The results revealed that HCRU and medical costs were especially high in those who were treated intensively with PPA combination therapy at first-line. In terms of extensive HCRU and associated medical costs, the limitations of existing treatment strategies for PAH were noted. In addition, these results highlight the need for innovative treatments to reduce the considerable disease burden described in this study.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"365-384"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202335","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":"Asthma Awareness Questionnaire: Development, Psychometric Validation, and Extent.","authors":"Irene Prediletto, Benedetta Bondi, Matteo Bonini, Giovanna Elisiana Carpagnano, Manuela Latorre, Eleonora Nucera, Francesca Puggioni, Giulia Scioscia, Pierachille Santus, Giovanni Sotgiu, Francesco Blasi, Giorgio Walter Canonica, Pierluigi Paggiaro, Arianna Aruanno, Diego Bagnasco, Francesca Cefaloni, Federico Di Marco, Gabriele Fontanili, Marcello Mincarini, Giovanni Paoletti, Dejan Radovanovic, Valentina Pinelli, Francesca Ricchiuto, Pasquale Tondo, Vitaliano Nicola Quaranta, Rachele Vallara, Fulvio Braido, Ilaria Baiardini","doi":"10.1007/s41030-026-00342-5","DOIUrl":"10.1007/s41030-026-00342-5","url":null,"abstract":"<p><strong>Introduction: </strong>Patient awareness extends beyond factual knowledge, encompassing emotional and cognitive engagement with the disease. As in other chronic diseases, it plays a critical role in asthma management. A comprehensive, validated tool for assessing this multifaceted construct in patients with asthma has been lacking. This study aimed to develop and validate the Asthma Awareness Questionnaire (AAQ) within the framework of the Mild/Moderate Asthma Network of Italy (MANI) study, a real-world, prospective, longitudinal cohort study involving adults diagnosed with mild-to-moderate asthma according to Global Initiative for Asthma (GINA) 2020 criteria.</p><p><strong>Methods: </strong>The questionnaire was developed through a Delphi process involving clinicians and patients. Psychometric properties (scale dimensions, internal validity, construct validity, and reliability) were explored, as well as the total and domain level of awareness.</p><p><strong>Results: </strong>Starting from an initial list of 39 items, the Delphi process led to a provisional 22-item version. A total of 149 participants completed the AAQ at baseline and 6-month follow-up visit. Exploratory and confirmatory factor analyses supported a three-factor structure-agency, knowledge, and acceptance-with the exclusion of four items. Internal consistency (Cronbach's α = 0.78), construct validity (assessed through correlations with established patient-reported outcome measures), and test-retest reliability (ICC = 0.723) were assessed. Awareness levels were suboptimal overall (mean total score ≈ 60/100), with knowledge scores nearing the 80/100 threshold, while agency and acceptance lagged.</p><p><strong>Conclusion: </strong>The AAQ is a psychometrically sound instrument that captures the multidimensional nature of asthma awareness. Its use may guide future interventions aimed at improving patient self-management. Further validation in broader clinical settings is warranted.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT12345678.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"351-364"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158115","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":"Bronchiectasis Treatment Goals, Unmet Needs, and Emerging Therapies: A Podcast.","authors":"Patrick A Flume, Diego J Maselli","doi":"10.1007/s41030-025-00330-1","DOIUrl":"10.1007/s41030-025-00330-1","url":null,"abstract":"<p><p>Bronchiectasis is a chronic and progressive inflammatory lung disease characterized by dilated airways, impaired mucociliary clearance, recurrent infections, and inflammation. In this podcast, we discuss the heterogeneous causes and complex pathophysiology of bronchiectasis, reviewing the therapeutic tools we currently have available to target aspects of the vicious vortex that drives disease progression. Patient evaluation involves identifying underlying causes such as autoimmune diseases or immune deficiencies, conducting sputum cultures for bacteria, fungi, and mycobacteria, and performing pulmonary function tests. The primary objectives of treatment are to alleviate symptoms, reduce burdensome exacerbations, enhance quality of life, and slow disease progression, requiring shared decision-making to align clinical and patient priorities. Effective management necessitates a multimodal approach to address all aspects of pathophysiology including airway obstruction, infection, and inflammation. An unmet need remains to fully address the inflammation, which is predominantly neutrophilic, driving bronchiectasis. Emerging therapies that directly target dysregulated neutrophilic inflammation via inhibition of the enzyme dipeptidyl peptidase 1 (DPP1) reduce neutrophil serine protease (NSP) activity. Brensocatib, an oral, once-daily DPP1 inhibitor, was recently approved by the FDA and is indicated in the USA for the treatment of noncystic fibrosis bronchiectasis in adult and pediatric patients 12 years of age and older. In the phase 3, 52-week ASPEN trial, brensocatib significantly reduced exacerbation burden, and the 25-mg dose reduced lung function decline and nominally significantly improved patient-reported symptoms compared with placebo. Additional therapies in development include other DPP1 inhibitors (verducatib and HSK31858) and drugs targeting phosphodiesterase 3/4 inhibition (ensifentrine) and anti-interleukin-33 (itepekimab). Overall, the future is promising for patients with the historically neglected and underdiagnosed disease bronchiectasis, with growing awareness and new therapeutic tools becoming available. Podcast (MP4 81554 KB).</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564138","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":"Double-Blind Randomized Placebo-Controlled Trial of a Lactobacillus Probiotic Blend in Chronic Obstructive Pulmonary Disease.","authors":"Teodora Nicola, Nancy M Wenger, Kara Seidman, Michael Evans, Youfeng Yang, Dongquan Chen, William J Van Der Pol, Amar Walia, Elliot J Lefkowitz, Jun Wang, Ashley LeMoire, Lois Lin, Casey Morrow, Namasivayam Ambalavanan, Amit Gaggar, Charitharth Vivek Lal","doi":"10.1007/s41030-025-00333-y","DOIUrl":"10.1007/s41030-025-00333-y","url":null,"abstract":"<p><strong>Introduction: </strong>Gut microbiota modulate systemic anti-inflammatory and immune responses in the lungs, suggesting a potential to support lung health through probiotic supplementation. We hypothesized that a probiotic blend (Lactobacilli) combined with herbal extracts (resB^®) could improve quality of life in patients with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>We conducted a randomized, double-blinded, placebo-controlled study (NCT05523180) evaluating the safety and impact of resB^® on quality of life in volunteers with COPD. Participants took resB^® or placebo (two capsules daily) for 12 weeks. The primary endpoint was change in quality of life by Saint George's Respiratory Questionnaire (SGRQ). Secondary outcomes included safety, serum and sputum biomarkers, and microbiome analysis. resB^® was well tolerated with no related adverse events.</p><p><strong>Results: </strong>Participants receiving resB^® showed significant improvement in SGRQ symptom scores (P < 0.05), while placebo recipients did not. In the resB^® group, serum and sputum levels of matrix metalloproteinase 9, C-reactive protein, and interleukin 6 decreased (P < 0.05), correlating with increased stool Lactobacilli. Additionally, Veillonella abundance increased in both stool and sputum.</p><p><strong>Conclusion: </strong>These findings suggest that resB^® improves respiratory symptoms and reduces inflammation in patients with COPD, potentially by modulating gut and lung microbiota.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT05523180.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"251-263"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550247","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":"Modeling the Potential Public Health Impact of Updated COVID-19 Vaccination Strategies in Singapore: Epidemiological Data Update.","authors":"Karan Thakkar, Moe H Kyaw, Iustina Chirila, Carlos Fernando Mendoza, Josie Dodd, Ben Yarnoff","doi":"10.1007/s41030-025-00340-z","DOIUrl":"10.1007/s41030-025-00340-z","url":null,"abstract":"<p><strong>Introduction: </strong>This study estimated the potential public health impact of alternative COVID-19 vaccination strategies in Singapore.</p><p><strong>Methods: </strong>The outcomes of alternative vaccination strategies using a Pfizer-BioNTech COVID-19 vaccine updated to the latest circulating strain were estimated using a combined decision tree-Markov cohort model. The model was previously used to estimate the impact of vaccination based on epidemiological data from 2021/22 and vaccine coverage data from 2022/23. It has now been updated with epidemiology data from 2023/24 and an assumed vaccine coverage of 20%. Age-specific inputs were derived from local epidemiological data and published sources. The model projected health outcomes (cases, hospitalizations, and deaths) and economic outcomes (direct medical costs and productivity losses) across different age and risk subgroups.</p><p><strong>Results: </strong>Vaccinating individuals aged 60 and above, as well as individuals aged 6 months to 59 years with comorbidities, making them at high risk for severe COVID-19 outcomes, with a vaccine coverage of 20%, is projected to result in 14,099 fewer infections, 2668 fewer hospitalizations, and 21 fewer deaths in 1 year. This leads to a total estimated savings of SGD 21.3 million in direct medical costs and SGD 24.8 million in indirect costs. Increasing coverage to 50% has the potential to further increase deaths, hospitalizations, infections, and costs averted by 150%.</p><p><strong>Conclusions: </strong>Although vaccination has a smaller impact on public health compared to the previous evaluation because of the updated epidemiology and lower estimated coverage, an updated vaccine can still have a public health and economic impact in Singapore.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"317-327"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934849","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":"A Pragmatic RCT of FF/UMEC/VI in Patients with Uncontrolled Asthma: PERFORM Protocol.","authors":"Stephen G Noorduyn, Nicola Brown, Jodie Crawford, Lydia Demetriou, Afisi S Ismaila, Lawrence Mbuagbaw, Sameer Parpia, Behnam Sadeghirad, David Slade, Alison C Moore","doi":"10.1007/s41030-026-00346-1","DOIUrl":"10.1007/s41030-026-00346-1","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma imposes a high disease burden, with approximately half of patients experiencing uncontrolled disease despite inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) therapy. A previous randomised controlled trial demonstrated clinical benefits of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) single-inhaler triple therapy (SITT) versus FF/VI dual therapy in patients with moderate-severe asthma without a requirement for exacerbation history. Here, we present the protocol for the PERFORM pragmatic trial, comparing the effectiveness of initiating FF/UMEC/VI SITT via the ELLIPTA® inhaler (GSK) versus continuing or initiating non-ELLIPTA ICS/LABA usual care for a broad patient population with uncontrolled asthma.</p><p><strong>Methods: </strong>PERFORM is a 52-week, stratified, randomised, open-label, active-controlled, parallel-group, global pragmatic trial enrolling adult patients with uncontrolled asthma, currently untreated or treated with ICS or ICS/LABA therapy. Patients will be randomised 1:1 to either initiate once-daily FF/UMEC/VI (intervention) or continue or initiate non-ELLIPTA ICS/LABA (control), receiving treatment in a usual care setting. The primary endpoint is the change from baseline in trough forced expiratory volume in 1 s at week 24. The key secondary endpoint is whether patients achieve improvement (≥ 0.5-point decrease from baseline) in the Asthma Control Questionnaire-7 score at week 24. Other secondary endpoints include clinical remission, health-related quality of life, and work and activity impairment. The trial aims to randomise 1136 patients (568 per arm).</p><p><strong>Planned outcomes: </strong>PERFORM is a pragmatic randomised controlled trial generating data relevant to a broad population of patients with uncontrolled asthma representative of routine clinical practice. This trial will also include the first prospective data on clinical remission for patients treated with inhaled therapy.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"397-412"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166539","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":"Drug-Induced Pulmonary Toxicity in the Era of Immunotherapy and Biologics: A Narrative Review of Mechanism, Diagnosis, and Management.","authors":"Josmar J Ríos Poveda, Manuela Herrera Tamayo, Juan J Zapata Huizi, Jacobo Sellares, Fernanda Hernández-González","doi":"10.1007/s41030-025-00338-7","DOIUrl":"10.1007/s41030-025-00338-7","url":null,"abstract":"<p><p>Drug-induced interstitial lung disease (DI-ILD) has emerged as a clinically significant complication associated with a broadening spectrum of therapeutic agents. DI-ILD can result in significant morbidity and mortality if not promptly diagnosed and treated. In this review, we synthesize current evidence concerning the epidemiology, risk factors, pathophysiological mechanisms, clinical manifestations, diagnostic approaches, and management strategies of DI-ILD, with focused emphasis on three major therapeutic groups: immune checkpoint inhibitors (ICIs), chimeric antigen receptor T-cell (CAR-T) therapies, and biological agents; adding other commonly used drugs known for causing DI-ILD as well, such as: amiodarone, methotrexate, and nitrofurantoin. Early recognition, drug discontinuation, tailored immunosuppression, and supportive care are pivotal to improving outcomes. Enhanced medical awareness and a multidisciplinary care approach are essential to mitigate morbidity and mortality. By synthesizing current knowledge, this review aims to enhance awareness and understanding of DI-ILD, thereby facilitating earlier diagnosis and more effective management strategies for this potentially severe adverse drug event.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"99-116"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896866","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":"Management of Patients with Asthma, COPD, and OSA in Outpatient Unit: ACOSOU-Global Perspectives and Challenges.","authors":"Sy Duong-Quy, Tuan Huynh-Anh, Thu Vo-Pham-Minh, Linh Tran-Thanh-Duy, Duyen Le-Thi-Hong, Trung Bui-Viet, Tien Nguyen-Quang, Tram Tang-Thi-Thao, Anh Nguyen-Tuan, Toi Nguyen-Van, Tran V Hoc, Thu Nguyen-Ngoc-Phuong, Quan Vu-Tran-Thien, Khue Bui-Diem, Bang Nguyen-Trong, Thai Nguyen-Duy, Dung Nguyen-Thi-Thu, Thuy Tran-Phan-Chung, Huong Le-Thi-Minh, Linh Pham-Van, Giap Vu-Van, Vinh Nguyen-Nhu, Bao Le-Khac, Nhung Nguyen-Viet, Francis Martin, Thomas Penzel, Clete Kushida, Timothy Craig","doi":"10.1007/s41030-026-00345-2","DOIUrl":"10.1007/s41030-026-00345-2","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is increasingly recognized as a major comorbidity in chronic respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD). The coexistence of OSA with asthma or COPD significantly complicates the clinical course, leading to poorer disease control, more frequent exacerbations, reduced lung function, impaired sleep quality, and increased cardiovascular and overall mortality. In asthma, OSA exacerbates airway inflammation, enhances bronchial hyperresponsiveness, and decreases responsiveness to standard therapies. In COPD, the \"overlap syndrome\" is associated with profound nocturnal hypoxemia, chronic hypercapnia, pulmonary hypertension, and a markedly elevated risk of hospitalization and death. Underlying mechanisms include chronic airway inflammation, oxidative stress induced by intermittent hypoxia, instability of ventilatory control (high loop gain), structural upper-airway alterations, and the burden of obesity and metabolic dysfunction. These interactions highlight the urgent need for integrated and proactive management strategies. Thus, we propose an Asthma-COPD-OSA Outpatient Unit (ACOSOU)-a care-delivery model, not a disease entity-designed to integrate systematic screening, diagnosis, treatment initiation, and long-term follow-up of OSA in patients with asthma and COPD. Optimal care requires systematic screening in respiratory outpatient settings, appropriate diagnostic pathways using polysomnography or home sleep apnea testing, and individualized treatment approaches. Continuous positive airway pressure (CPAP) remains the cornerstone therapy for OSA-asthma and OSA-COPD overlap, improving gas exchange, reducing exacerbations, and enhancing disease control. Comprehensive management also includes optimization of inhaled therapies, pulmonary rehabilitation, weight reduction, sleep hygiene, and multidisciplinary collaboration. This review proposes an integrated ACOSOU model to streamline screening, diagnosis, CPAP titration, and long-term follow-up. However, implementation in low- and middle-income countries faces challenges including limited trained sleep-medicine personnel, unequal access to diagnostic tools, and high CPAP costs without insurance coverage. Strengthening infrastructure, training, and policy support will be essential to improve outcomes for patients with chronic respiratory diseases and OSA comorbidity.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"117-144"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012142","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}