Respiratory investigation最新文献

{"title":"Long-term safety and effectiveness of mepolizumab for patients with bronchial asthma in routine clinical practice in Japan — final report of special drug use investigation","authors":"Eriko Tsuboi ,&nbsp;Hironobu Aoki ,&nbsp;Kiyomi Aizawa ,&nbsp;Masaki Komatsubara ,&nbsp;Peter Howarth","doi":"10.1016/j.resinv.2025.05.003","DOIUrl":"10.1016/j.resinv.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>Mepolizumab is an anti-interleukin-5 (IL-5) monoclonal antibody that blocks IL-5-driven airway inflammation, including eosinophilia. Mepolizumab is well tolerated and effective in reducing exacerbations in patients with bronchial asthma. However, limited real-world data are available for treatment outcomes of mepolizumab in patients with bronchial asthma in Japan. Therefore, this large-scale study aimed to assess the long-term safety and effectiveness of mepolizumab in patients with bronchial asthma in Japan.</div></div><div><h3>Methods</h3><div>In this real-world observational study conducted between January 2017 and September 2023, patients with bronchial asthma who had available data in an electronic data capture system for at least 52 weeks prior to subcutaneous mepolizumab treatment were monitored for 52 weeks from their first dose of mepolizumab. Safety was evaluated based on patient-reported adverse drug reactions (ADRs), and effectiveness was evaluated by frequency of asthma exacerbations, changes in Asthma Control Test (ACT) scores, and peak expiratory flow (PEF).</div></div><div><h3>Results</h3><div>Overall, 1061 patients were enrolled. ADRs were reported by 4.1 % of patients in the safety population (n = 1027). No new safety concerns were identified. The overall effectiveness was evaluated in 959 patients in the effectiveness population. Post-mepolizumab initiation, asthma exacerbations were reduced from 3.8 to 1.0 per person-year; mean (standard deviation [SD]) ACT scores improved from 15.9 (4.6) to 21.4 (3.9); mean (SD) PEF improved from 304.4 L/min (146.8) to 349.5 L/min (134.7) compared with pre-mepolizumab initiation.</div></div><div><h3>Conclusions</h3><div>This analysis of real-world data demonstrates that mepolizumab was well tolerated and effective in patients with bronchial asthma in Japan.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 651-659"},"PeriodicalIF":2.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090231","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":"Eosinophilic granulomatosis with polyangiitis: current status and future perspectives","authors":"Yosuke Kamide,&nbsp;Masami Taniguchi","doi":"10.1016/j.resinv.2025.04.018","DOIUrl":"10.1016/j.resinv.2025.04.018","url":null,"abstract":"<div><div>Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis with hypereosinophilia that is preceded by asthma and chronic rhinosinusitis with nasal polyps. Since multiple organs may be involved in this disease, early treatment is required. In this regard, glucocorticoid (GC) therapy is often initiated before a definitive diagnosis is made. A biopsy of an injured organ is useful for a diagnosis but is not performed in all cases due to its invasiveness and, at times, diagnostic accuracy. Therefore, a comprehensive diagnosis is often made based on symptoms and clinical course of disease. However, it is sometimes difficult to distinguish EGPA from other hypereosinophilic diseases or vasculitides.</div><div>In recent years, in addition to GC and immunosuppressive agents, anti–interleukin (IL)-5/IL-5 receptor alpha (IL-5Rα) antibodies targeting eosinophils have become increasingly important in the treatment of EGPA. However, accumulating data suggest that such anti–IL-5/IL-5Rα antibody therapy may have effects beyond those observed in eosinophils. This paper outlines the clinical features, diagnosis, pathogenesis, and current treatment of EGPA, a hypereosinophilic disease.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 639-650"},"PeriodicalIF":2.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070944","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":"Olaparib-induced interstitial lung disease: A case series analysis","authors":"Mototaka Hattori ,&nbsp;Yu Mikami ,&nbsp;Midori Sato ,&nbsp;Hiroyuki Nagai ,&nbsp;Koki Fujii ,&nbsp;Yuki Horiguchi ,&nbsp;Masahiro Shuzui ,&nbsp;Kensuke Fukuda ,&nbsp;Yuichiro Miyamoto ,&nbsp;Mayuyo Mori ,&nbsp;Munetoshi Hinata ,&nbsp;Masanori Kawakami ,&nbsp;Akihisa Mitani ,&nbsp;Goh Tanaka ,&nbsp;Hidenori Kage","doi":"10.1016/j.resinv.2025.05.002","DOIUrl":"10.1016/j.resinv.2025.05.002","url":null,"abstract":"<div><div>Olaparib-induced interstitial lung disease (OILD) is a rare but potentially serious adverse event, and its imaging characteristics and clinical course remain unclear. Ishimoto et al. previously reported three cases of OILD, but further characterisation is needed. We present three additional cases, all presenting with fever and bilateral ground-glass opacities (GGO) and fine reticulonodular opacities on computed tomography (CT). Bronchoalveolar lavage fluid (BALF) analysis showed marked lymphocytosis (&gt;75 %). Prednisolone (0.5–1 mg/kg/day) was effective without fibrosis. BALF lymphocytosis may aid in the diagnosis of OILD. OILD should be considered in febrile patients receiving olaparib.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 629-632"},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069112","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":"Exploring factors associated with clinical remission in patients with severe asthma receiving anti-IL-4Rα, anti-IL-5/5R, or anti-IgE treatment","authors":"Shota Takahashi ,&nbsp;Naoya Tanabe ,&nbsp;Satoshi Marumo ,&nbsp;Yu Hara ,&nbsp;Yusuke Hayashi ,&nbsp;Shinya Tsukamoto ,&nbsp;Kyohei Morita ,&nbsp;Chie Yoshimura ,&nbsp;Moon Hee Hwang ,&nbsp;Hironobu Sunadome ,&nbsp;Atsuyasu Sato ,&nbsp;Kota Murohashi ,&nbsp;Takeshi Kaneko ,&nbsp;Hisako Matsumoto ,&nbsp;Toyohiro Hirai","doi":"10.1016/j.resinv.2025.05.005","DOIUrl":"10.1016/j.resinv.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>The optimal selection of biologics is critical for achieving clinical remission (CR) in patients with severe asthma. This real-world study examined baseline prebiologic factors associated with CR in patients with severe asthma receiving anti-IL-4Rα, anti-IL-5/5R, or anti-IgE treatment.</div></div><div><h3>Methods</h3><div>This Japanese multicenter retrospective observational study included consecutive patients with severe asthma whose spirometry and asthma control test (ACT) data were available after at least 1 year of anti-IL-4Rα, anti-IL-5/5R, or anti-IgE treatment. The 3-domain CR was defined based on no maintenance oral corticosteroid (OCS) use, no exacerbation in the previous year, and ACT ≥23. The 4-domain CR was defined based on no OCS, no exacerbation, ACT ≥20, and percentage-predicted forced expiratory volume in 1 s ≥ 80 %.</div></div><div><h3>Results</h3><div>A total of 236 patients with severe asthma were included (n = 81, 104, and 51 for the anti-IL-4Rα, anti-IL-5/5R, and anti-IgE treatment groups, respectively). The rates of 3- and 4-domain CR were 28–47 % and 22–36 %, respectively. In the multivariate models, the presence of chronic rhinosinusitis and higher FeNO levels were associated with 3-domain CR in patients receiving anti-IL-4Rα treatment but not in those receiving anti-IL-5/5R or anti-IgE treatment after adjusting for baseline OCS use, past-year exacerbation history, body mass index, sex, and disease duration. Moreover, higher FeNO levels were associated with 4-domain CR in patients receiving anti-IL-4Rα treatment after adjustment for the same variables.</div></div><div><h3>Conclusion</h3><div>Anti-IL-4Rα treatment may be effective for patients with severe asthma who have chronic rhinosinusitis or high FeNO levels at baseline.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 633-638"},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069111","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":"Gastroesophageal reflux disease is not associated with disease severity in patients with Mycobacterium avium complex lung infection","authors":"Mayank N. Nihalani ,&nbsp;Manar Al Jawish ,&nbsp;Wendelyn Bosch ,&nbsp;Margaret M. Johnson ,&nbsp;Maoyin Pang ,&nbsp;Ken Devault ,&nbsp;Lesley A. Houghton ,&nbsp;Andree H. Koop","doi":"10.1016/j.resinv.2025.05.006","DOIUrl":"10.1016/j.resinv.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div><em>Mycobacterium avium</em> complex (MAC) pulmonary infection was previously associated with gastroesophageal reflux disease (GERD), although the effects of GERD on MAC outcomes remains unclear. The goal of this study was to assess the prevalence of GERD in patients with MAC pulmonary infection and its association with clinical outcomes.</div></div><div><h3>Methods</h3><div>This was a retrospective study of adult patients with confirmed MAC pulmonary infection who underwent ambulatory pH monitoring. Pathologic acid reflux was defined as a total distal acid exposure time ≥6 %. Adjunctive esophageal tests including esophagogastroduodenoscopy, barium esophagram, and high-resolution manometry were assessed. The primary outcomes were pulmonary function testing and treatment of MAC pulmonary infection.</div></div><div><h3>Results</h3><div>Of 132 included patients, 35 (26.5 %) had an acid exposure time ≥6 %. There were no differences between patients with and without pathologic acid reflux by AET and pulmonary function tests including FEV1 absolute (1.79 vs. 1.83 L, p = 0.68), FEV1 % predicted (78.6 vs. 78.0 %, p = 0.94), FEV1/FVC % predicted (71.1 vs. 68.0 %, p = 0.38), or DLCO % predicted (66.0 vs. 79.0 %, p = 0.097). Additionally, there were no differences in MAC pulmonary infection outcomes including antimicrobial treatment, duration, or lobectomy. Findings on adjunctive esophageal testing did not associate with outcomes by pulmonary function tests or treatment of MAC pulmonary infection.</div></div><div><h3>Conclusions</h3><div>The prevalence of GERD in patients with MAC pulmonary infection based on ambulatory pH monitoring was 26.5 %. MAC pulmonary infection with GERD was not associated with worse outcomes and further study is needed to assess the impacts of GERD on MAC pulmonary infection.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 623-628"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069113","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":"Post-COVID-19 condition in patients receiving invasive positive pressure ventilation or high flow nasal cannula therapy","authors":"Soko Numata ,&nbsp;Yu Nakatani ,&nbsp;Kazufumi Takamatsu ,&nbsp;Akihito Yokoyama","doi":"10.1016/j.resinv.2025.05.004","DOIUrl":"10.1016/j.resinv.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Invasive positive pressure ventilation (IPPV) and high-flow nasal cannula (HFNC) are often employed for severe COVID-19 patients. Such advanced respiratory support might influence the post-COVID-19 condition (PCC). Here, we investigated the potential association between advanced respiratory support and PCC.</div></div><div><h3>Methods</h3><div>This study is ancillary to the separately reported multicenter observational study that included moderate to severe COVID-19 patients who required hospitalization between September 2020 and September 2021 in Japan. PCC symptoms, chest CT images, and lung function tests were evaluated 3 months after discharge. Frequency of PCC was compared between patients with and without advanced respiratory support using propensity score matching including severity on admission.</div></div><div><h3>Results</h3><div>Among 714 participants, 100 received advanced respiratory support (IPPV: 56, HFNC: 44). Patients who received advanced respiratory support significantly more frequently had PCC symptoms, CT abnormalities, and lung dysfunction. However, comparison of propensity score-matched controls indicated no significant differences in the frequency of symptoms, although CT and lung function abnormalities remained significantly higher. Furthermore, these differences were only observed in elderly patients. There were no differences in the frequency of PCC between patients with IPPV versus HFNC therapy.</div></div><div><h3>Conclusions</h3><div>Patients treated with IPPV or HFNC showed more PCC symptoms that were largely related to the initial disease severity. CT and pulmonary function abnormalities were also more frequent in such patients, especially the elderly, although this showed no correlation with disease severity. These findings underscore the correlation between age and PCC in COVID-19 patients who received advanced respiratory support.</div><div>This study was registered in the UMIN Clinical Trials Registry (UMIN-CTR) under the identifier UMIN000041168.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 617-622"},"PeriodicalIF":2.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943418","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":"Impact of long COVID on the health-related quality of life of Japanese patients: A prospective nationwide cohort study","authors":"Kazuma Yagi ,&nbsp;Masahiro Kondo ,&nbsp;Hideki Terai ,&nbsp;Takanori Asakura ,&nbsp;Ryusei Kimura ,&nbsp;Ryo Takemura ,&nbsp;Hiromu Tanaka ,&nbsp;Keiko Ohgino ,&nbsp;Katsunori Masaki ,&nbsp;Ho Namkoong ,&nbsp;Shotaro Chubachi ,&nbsp;Jun Miyata ,&nbsp;Ichiro Kawada ,&nbsp;Tatsuya Kaido ,&nbsp;Shuko Mashimo ,&nbsp;Keigo Kobayashi ,&nbsp;Toshiyuki Hirano ,&nbsp;Ho Lee ,&nbsp;Kai Sugihara ,&nbsp;Nao Omori ,&nbsp;Koichi Fukunaga","doi":"10.1016/j.resinv.2025.05.001","DOIUrl":"10.1016/j.resinv.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Various prolonged systemic symptoms, forming the long coronavirus disease (COVID), have been observed in patients who have recovered from the acute phase of COVID-19. Although previous studies have reported that COVID-19 impacts health-related quality of life (HRQoL), the associations of long COVID symptoms and clinical characteristics with HRQoL remain unclear. This study aimed to clarify these associations using nationwide Japanese epidemiological data.</div></div><div><h3>Methods</h3><div>A prospective nationwide cohort study was conducted on patients with COVID-19 between January 2020 and February 2021 at 26 participating medical institutions in Japan. Various long COVID symptoms and HRQoL scores at 3, 6, and 12 months following diagnosis were collected from 986 participants. Generalized estimating equations (GEE) were used to explore the association between HRQoL scores evaluated using the short form-8 (SF-8), long COVID symptoms, and baseline clinical characteristics.</div></div><div><h3>Results</h3><div>Patients who had one long COVID symptom showed a significantly lower physical component summary score (PCS) and mental component summary score (MCS) compared with those without any symptoms at all time points after diagnosis. GEE revealed that long COVID symptoms, including dyspnea, fatigue, headache, and muscle weakness, were significantly associated with worse PCS, whereas poor concentration, sleep disorders, fatigue, and headache were significantly associated with worse MCS. Severity-related baseline parameters for patients with COVID-19 were significantly associated with worse PCS scores, although these factors were not significantly associated with worse MCS scores.</div></div><div><h3>Conclusions</h3><div>Long COVID symptoms were associated with lower physical and mental HRQoL. Severe outcomes of COVID-19 impacted PCS but not MCS.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 610-616"},"PeriodicalIF":2.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928422","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":"Inhaled treprostinil for pulmonary hypertension due to interstitial lung disease","authors":"Tetsutaro Nagaoka","doi":"10.1016/j.resinv.2025.04.020","DOIUrl":"10.1016/j.resinv.2025.04.020","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 608-609"},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923474","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":"Reduced hemoglobin-corrected diffusing capacity in pulmonary arterial hypertension with preserved pulmonary function and morphology","authors":"Ayako Igarashi-Sugimoto ,&nbsp;Ichizo Tsujino ,&nbsp;Hideki Shima ,&nbsp;Junichi Nakamura ,&nbsp;Toshitaka Nakaya ,&nbsp;Takahiro Sato ,&nbsp;Taku Watanabe ,&nbsp;Hiroshi Ohira ,&nbsp;Kaoruko Shimizu ,&nbsp;Takashi Yokota ,&nbsp;Sari Iwasaki ,&nbsp;Satonori Tsuneta ,&nbsp;Isao Yokota ,&nbsp;Satoshi Konno","doi":"10.1016/j.resinv.2025.04.002","DOIUrl":"10.1016/j.resinv.2025.04.002","url":null,"abstract":"<div><h3>Background</h3><div>The diffusing capacity and the transfer coefficient of the lung for carbon monoxide (D_LCO and K_CO, respectively) are reduced in pulmonary arterial hypertension; however, the effect of pulmonary arterial hypertension alone on these parameters and their clinical impact remain unclear. We aimed to elucidate the exclusive impact of pulmonary arterial hypertension on these two parameters and examine their association with other parameters.</div></div><div><h3>Methods</h3><div>We retrospectively selected patients with pulmonary arterial hypertension with normal pulmonary function upon pulmonary function testing and with normal lung parenchyma upon chest computed tomography. We calculated the hemoglobin-corrected D_LCO (D_LCO-Hbc) and K_CO (K_CO-Hbc) and examined their association with established pulmonary hypertension-related parameters. An exploratory analysis of pulmonary vasculopathy was performed in an autopsy case.</div></div><div><h3>Results</h3><div>We included 50 patients with pulmonary arterial hypertension for analysis. Their median %D_LCO-Hbc and %K_CO-Hbc were 62 % and 70 %, respectively. The D_LCO-Hbc was associated with functional class, 6-min walk distance, alveolar-arterial oxygen tension difference, cardiac output, and pulmonary arterial hypertension-related death. The D_LCO-Hbc and K_CO-Hbc were also correlated with the lowest minute ventilation/carbon dioxide production ratio (ρ = −0.84 and −0.49, respectively), an index that represents ventilation–perfusion mismatch. The autopsy revealed pulmonary arterial hypertension-specific arteriopathy that was heterogeneously distributed in the lungs.</div></div><div><h3>Conclusions</h3><div>The D_LCO-Hbc and K_CO-Hbc were reduced to 60 %–70 % in patients with pulmonary arterial hypertension even when their pulmonary function and morphology were preserved. The decreases were associated with pulmonary hypertension-related clinical parameters and survival and may be caused by heterogeneous vasculopathy and subsequent ventilation–perfusion mismatch.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 600-607"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916726","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":"Switching to tezepelumab from other biologics in patients with severe asthma: a retrospective study","authors":"Toshiyuki Sumi ,&nbsp;Taiki Ishigooka ,&nbsp;Keigo Matsuura ,&nbsp;Takumi Ikeda ,&nbsp;Yuta Koshino ,&nbsp;Keito Suzuki ,&nbsp;Yuichi Yamada ,&nbsp;Hirofumi Chiba","doi":"10.1016/j.resinv.2025.04.022","DOIUrl":"10.1016/j.resinv.2025.04.022","url":null,"abstract":"<div><h3>Background</h3><div>Tezepelumab, an anti-thymic stromal lymphopoietin antibody, has shown efficacy in reducing exacerbations and improving control in patients with severe asthma (SA), including those with low type 2 (T2) inflammation. We aimed to evaluate the efficacy and safety of switching to tezepelumab in patients with SA that was inadequately controlled by previous biologics.</div></div><div><h3>Methods</h3><div>In this retrospective study, we included patients with SA previously treated with at least one biologic and subsequently switched to tezepelumab (210 mg every 4 weeks) for ≥24 weeks between December 2022 and December 2023. Clinical outcomes were evaluated using changes in Asthma Control Test (ACT) scores, oral corticosteroid (OCS) dose, pulmonary function, exacerbation frequency, and Biologics Asthma Response Score (BARS). Positive T2 biomarkers were defined as peripheral blood eosinophil count ≥150/μL, immunoglobulin (Ig) E &gt; 167 IU/mL, or exhaled nitric oxide &gt;25 ppb.</div></div><div><h3>Results</h3><div>Among 22 patients, 77 % were exacerbation-free after 12 weeks, and 64 % were classified as responders (ACT score increase ≥3). Remission (ACT ≥23, no exacerbations, steroid-free) was achieved in 18 %. ACT scores, forced expiratory volume in 1 s (FEV1; median +40 mL, p = 0.0413), and OCS doses significantly improved. According to BARS, 41 and 41 % had “Good response” and “Response,” respectively. Improvements were observed in patients switching from anti–IL-5 agents and dupilumab; however, benefits varied by prior biologic.</div></div><div><h3>Conclusions</h3><div>Tezepelumab may be effective for patients with SA who could not respond to other biologics. Further studies are warranted to evaluate long-term outcomes and optimal patient selection.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 4","pages":"Pages 592-599"},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916725","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}