Lancet Respiratory Medicine最新文献

{"title":"Patient with cystic fibrosis not diagnosed until age 23 years now treated with the new triple therapy Trikafta","authors":"Tony Kirby","doi":"10.1016/s2213-2600(25)00017-7","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00017-7","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"63 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dupilumab on exhaled nitric oxide, mucus plugs, and functional respiratory imaging in patients with type 2 asthma (VESTIGE): a randomised, double-blind, placebo-controlled, phase 4 trial","authors":"Mario Castro, Alberto Papi, Celeste Porsbjerg, Njira L Lugogo, Christopher E Brightling, Francisco-Javier González-Barcala, Arnaud Bourdin, Mykola Ostrovskyy, Maria Staevska, Pai-Chien Chou, Liliana Duca, Ana Margarida Pereira, Charles Fogarty, Rufai Nadama, Mei Zhang, Amelie Rodrigues, Xavier Soler, Harry J Sacks, Yamo Deniz, Paul J Rowe, Juby A Jacob-Nara","doi":"10.1016/s2213-2600(24)00362-x","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00362-x","url":null,"abstract":"<h3>Background</h3>Asthma is a respiratory disease characterised by chronic airway inflammation and mucus hypersecretion. VESTIGE used functional respiratory imaging to assess changes in airway structure and function, including mucus plugging, in response to dupilumab.<h3>Methods</h3>VESTIGE was a randomised, double-blind, placebo-controlled, phase 4 trial done at 72 research sites or academic centres in 14 countries. We recruited adult patients (aged 18–70 years) with physician-diagnosed, uncontrolled, moderate-to-severe type 2 asthma (blood eosinophil count ≥300 cells/μL and fractional exhaled nitric oxide [FeNO] ≥25 parts per billion [ppb]) being treated with medium-dose to high-dose inhaled corticosteroids combined with other controller medications. Patients were randomly assigned (2:1; block size of 6) via interactive voice–web response technology to receive add-on dupilumab 300 mg subcutaneously once every 2 weeks or volume-matched placebo up to week 24. Randomisation was stratified by inhaled corticosteroids dose level and region (USA <em>vs</em> non-USA). Participants and investigators, including those assessing outcomes, were masked to group assignment. The primary endpoints were the proportion of patients with a FeNO concentration below 25 ppb at week 24, and percentage change from baseline to week 24 in airway volumes (specific regional airway volumes corrected for lung volume, [s]iV<sub><em>aw</em></sub>) at total lung capacity (TLC), both assessed in the intention-to-treat population. Safety was assessed in all patients who received at least one dose of study drug or placebo. The trial is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT04400318</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, and is completed.<h3>Findings</h3>Patient recruitment occurred from July 18, 2020, to Jan 6, 2023. Patients (mean age 50·4 years [SD 12·6]; 68 [62%] female and 41 [38%] male) were randomly assigned to receive dupilumab 300 mg (n<em>=</em>72) or placebo (n<em>=</em>37). At week 24, patients in the dupilumab group were significantly more likely than those in the placebo group to have a FeNO concentration below 25 ppb (41 [57%] of 72 patients <em>vs</em> four [11%] of 37; odds ratio: 9·8 [95% CI 3·1 to 30·8]; p<0·001). Treatment with dupilumab versus placebo led to a numerical increase in (s)iV<sub><em>aw</em></sub> at TLC from baseline to week 24, although the difference was not significant (least squares [LS] mean percentage change from baseline to week 24: 19·7% [SE 8·1] for dupilumab and −2·0% [11·5] for placebo; LS mean difference <em>vs</em> placebo: 21·8%","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"41 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and mechanisms of eosinophil action in asthma: mind the gap?","authors":"Richard E K Russell","doi":"10.1016/s2213-2600(24)00380-1","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00380-1","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"14 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding CFTR modulator access to benefit all patients who are waiting for a lung transplant","authors":"Rossa Brugha, Kavita Dave, Vicky Gerovasili, Amit Adlakha","doi":"10.1016/s2213-2600(24)00426-0","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00426-0","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"50 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pulmonary embolism in children and adolescents in the USA (2016 and 2019): a nationwide retrospective cohort study","authors":"Simon Wolf, Luca Valerio, Nils Kucher, Stavros V Konstantinides, Irene L M Klaassen, C Heleen van Ommen, Cihan Ay, Frederikus A Klok, Suzanne C Cannegieter, Stefano Barco","doi":"10.1016/s2213-2600(24)00412-0","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00412-0","url":null,"abstract":"<h3>Background</h3>Epidemiological data on acute pulmonary embolism among children and adolescents are sparse and only date back to the 2000s. We aimed to establish annual estimates and age-stratified and sex-stratified indicators of acute pulmonary embolism among children and adolescents aged 0–19 years.<h3>Methods</h3>We did a retrospective, nationwide, patient-level analysis of the Kids’ Inpatient Database, including 5733 patients with acute pulmonary embolism aged 0–19 years admitted to hospital in the USA in 2016 and 2019. The database includes data of all children admitted to hospital during the 2 years available. We also accessed the US Multiple Cause of Death database and population data from the US Census Bureau for the same 2 years. We estimated the incidence, mortality, case fatality, and proportional mortality rates, provided data on the annual pulmonary embolism burden, and provided data on clinical events recorded during hospitalisation.<h3>Findings</h3>In the years 2016 and 2019, 5733 patients (3353 [58.5%] female and 2380 [41.5%] male) were admitted to hospital with acute pulmonary embolism as the primary diagnosis or a concomitant diagnosis. The annual incidence of acute pulmonary embolism was 3·5 (95% CI 3·4–3·6) per 100 000 people. Two peaks in the incidence rate were observed—one in infants younger than 1 year and one in adolescents aged 15–19 years. The in-hospital case fatality rate was 4·5% (4·0–5·1). The crude odds ratio for in-hospital death among patients with (<em>vs</em> without) acute pulmonary embolism was 9·3 (7·9–10·9). The association between acute pulmonary embolism and death persisted across different multivariable models. Patients with acute pulmonary embolism with high-risk (<em>vs</em> no high-risk) features had the highest risk of death: 25·3% (20·6–30·5) among patients aged 0–9 years and 13·9% (11·9–16·2) among patients aged 10–19 years. In patients without high-risk features, risk of death was 4·9% (3·1–7·6) among patients aged 0–9 years and 0·7% (0·5–1·0) among patients aged 10–19 years. The risk of intracranial bleeding was also highest in the presence of pulmonary embolism with high-risk features: 8·1% (5·5–11·7) among patients aged 0–9 years and 3·6% (2·6–4·9) among patients aged 10–19 years. In patients without high-risk features, the risk of intracranial bleeding was 2·5% (1·3–4·6) among those aged 0–9 years and 0·5% (0·3–0·8) in those aged 10–19 years. Reperfusion treatments beyond systemic thrombolysis were rarely used among children and adolescents with acute pulmonary embolism.<h3>Interpretation</h3>Acute pulmonary embolism is rare during childhood and adolescence. The high pulmonary embolism-related fatality among specific subgroups of patients can be interpreted in the context of severe comorbidities and pulmonary embolism events with high-risk features.<h3>Funding</h3>None.","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"8 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PH and CKD: unravelling the cardiorenal nexus","authors":"Faeq Husain-Syed, Uta Erdbrügger, Susmita Sahoo, Thorsten Wiech, Claudio Ronco, Khodr Tello","doi":"10.1016/s2213-2600(24)00415-6","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00415-6","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"8 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you to The Lancet Respiratory Medicine's clinical and statistical peer reviewers in 2024","authors":"","doi":"10.1016/s2213-2600(25)00004-9","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00004-9","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"14 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment strategy for EGFR mutated NSCLC","authors":"Yusuke Okuma","doi":"10.1016/s2213-2600(25)00014-1","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00014-1","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"25 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time: a population-based study","authors":"Ganfeng Luo, Yanting Zhang, Harriet Rumgay, Eileen Morgan, Oliver Langselius, Jerome Vignat, Murielle Colombet, Freddie Bray","doi":"10.1016/s2213-2600(24)00428-4","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00428-4","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Lung cancer is the most common cancer worldwide, yet the current epidemiological profile of lung-cancer incidence by histological subtype is only partly understood. We aimed to assess geographical variation in incidence of lung cancer by subtype worldwide in 2022, geographical variation in adenocarcinoma incidence attributable to ambient particulate matter (PM) pollution worldwide in 2022, temporal trends in lung-cancer incidence by subtype from 1988 to 2017 in 19 countries, and generational changes.&lt;h3&gt;Methods&lt;/h3&gt;For this population-based study, we used data from the Global Cancer Observatory (GLOBOCAN) 2022, &lt;em&gt;Cancer Incidence in Five Continents Volumes VII–XII&lt;/em&gt;, and members of the African Cancer Registry Network. To obtain national estimates of lung cancer in 2022 for the four main histological subtypes (ie, adenocarcinoma, squamous cell carcinoma [SCC], small-cell carcinoma, and large-cell carcinoma) by year, sex, and age group, we combined national estimates with representative, subsite-specific incidence proportions of lung cancer on the basis of recorded incidence data compiled in &lt;em&gt;Cancer Incidence in Five Continents Volume XII&lt;/em&gt; and from members of the African Cancer Registry Network. We calculated country-specific, sex-specific, and age-specific proportions of and sex-specific and age-specific incidence rates per 100 000 people for all four histological subtypes. To account for differences in age composition between populations by country, we calculated age-standardised incidence rates (ASRs) per 100 000 people for lung cancer by subtype and sex at national and regional levels. We also quantified the burden of adenocarcinoma incidence attributable to ambient PM pollution for 179 countries in 2022. We conducted joinpoint regression and age-period-cohort analysis to assess temporal trends in ASRs in 19 countries by sex.&lt;h3&gt;Findings&lt;/h3&gt;In 2022, we estimated that there were 1 572 045 new cases of lung cancer worldwide among male individuals, of which 717 211 (45·6%) were adenocarcinoma, 461 171 (29·4%) were SCC, 180 063 (11·5%) were small-cell carcinoma, and 101 861 (6·5%) were large-cell carcinoma. In 2022, we estimated that there were 908 630 new cases of lung cancer worldwide among female individuals, of which 541 971 (59·7%) were adenocarcinoma, 155 598 (17·1%) were SCC, 87 902 (9·7%) were small-cell carcinoma, and 59 271 (6·5%) were large-cell carcinoma. Among male individuals, the highest ASRs were in east Asia for adenocarcinoma (27·12 [95% CI 27·04–27·21] per 100 000 people), east Europe for SCC (21·70 [21·51–21·89] per 100 000 people) and small-cell carcinoma (9·85 [9·72–9·98] per 100 000 people), and north Africa for large-cell carcinoma (4·33 [4·20–4·45] per 100 000 people). Among female individuals, the highest ASRs were in east Asia for adenocarcinoma (19·04 [18·97–19·11] per 100 000 people), north America for SCC (5·28 [5·21–5·35] per 100 000 people) and small-cell carcinoma (4·28 [4·21–4·35] pe","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"20 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rezivertinib versus gefitinib as first-line therapy for patients with EGFR-mutated locally advanced or metastatic non-small-cell lung cancer (REZOR): a multicentre, double-blind, randomised, phase 3 study","authors":"Yuankai Shi, Yanzhen Guo, Xingya Li, Lin Wu, Zhaohong Chen, Sheng Yang, Minghong Bi, Yanqiu Zhao, Wenxiu Yao, Huiqing Yu, Ke Wang, Wenhua Zhao, Meili Sun, Liangming Zhang, Zhiyong He, Yingcheng Lin, Jianhua Shi, Bo Zhu, Lijun Wang, Yueyin Pan, Anqi Zhou","doi":"10.1016/s2213-2600(24)00417-x","DOIUrl":"https://doi.org/10.1016/s2213-2600(24)00417-x","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;This study aimed to compare the efficacy and safety of rezivertinib (BPI-7711) and gefitinib as first-line therapies in patients with &lt;em&gt;EGFR&lt;/em&gt;-mutated locally advanced or metastatic non-small-cell lung cancer (NSCLC).&lt;h3&gt;Methods&lt;/h3&gt;This multicentre, double-blind, randomised, phase 3 study (REZOR) included eligible patients from 50 hospitals across China. Those who had been histologically or cytologically confirmed as having NSCLC with &lt;em&gt;EGFR&lt;/em&gt; exon 19 deletion or exon 21 Leu858Arg mutation by central laboratory were randomly assigned (1:1) to receive once daily either rezivertinib 180 mg or gefitinib 250 mg, until unacceptable toxicity occurred, disease progression, or other treatment discontinuation criteria were met. Each cycle lasted for 21 days. The primary endpoint was progression-free survival evaluated by masked independent central review (MICR) in the intention-to-treat set. This trial is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT03866499&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; and follow-up is ongoing.&lt;h3&gt;Findings&lt;/h3&gt;Between July 15, 2019, and Feb 14, 2022, 695 patients were screened. Among them, 369 eligible patients were randomly assigned to receive either rezivertinib 180 mg/day plus placebo (n=184) or gefitinib 250 mg/day plus placebo (n=185) in a 1:1 ratio; all of eligible participants were included in the intention-to-treat set. Median MICR-assessed progression-free survival was 19·3 months (95% CI 13·8–22·1) in the rezivertinib group and 9·6 months (8·4–11·3) in the gefitinib group (hazard ratio [HR] 0·48, 95% CI 0·36–0·63; p&lt;0·0001) and the prespecified subgroup efficacy analysis showed consistent results. Median duration of exposure was 16·0 months (95% CI 0·0–29·7) in the rezivertinib group and 11·0 months (0·0–28·9) in the gefitinib group. Grade 3 or higher treatment-emergent adverse events (82 [45%] of 184 in the rezivertinib group; 80 [43%] of 185 in the gefitinib group) and treatment-related adverse events (TRAEs; 43 [23%] of 184 in the rezivertinib group; 43 [23%] of 185 in the gefitinib group) were similar in both groups. One patient died from a TRAE in the rezivertinib group, due to pneumonia and interstitial lung disease.&lt;h3&gt;Interpretation&lt;/h3&gt;Our findings suggested that rezivertinib is a potential choice for patients with &lt;em&gt;EGFR&lt;/em&gt;-mutated locally advanced or metastatic NSCLC as first-line therapy, owing to the superior overall efficacy and subgroup progression-free survival compared with gefitinib in targeted patients. No new safety signals were identified.&lt;h3&gt;Funding&lt;/h3&gt;Beta Pharma","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"61 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}