Expert review of respiratory medicine最新文献_第10页

Safety and efficacy of mepolizumab in eosinophilic chronic obstructive pulmonary disease: a systematic review and meta-analysis. mepolizumab治疗嗜酸性慢性阻塞性肺疾病的安全性和有效性：一项系统综述和荟萃分析

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-30 DOI: 10.1080/17476348.2025.2581347

Jorge Sinclair De Frías, Agostina Velo, Lorenzo Olivero, Abdul Rehman, Avinash Singh, David J Steiger

{"title":"Safety and efficacy of mepolizumab in eosinophilic chronic obstructive pulmonary disease: a systematic review and meta-analysis.","authors":"Jorge Sinclair De Frías, Agostina Velo, Lorenzo Olivero, Abdul Rehman, Avinash Singh, David J Steiger","doi":"10.1080/17476348.2025.2581347","DOIUrl":"10.1080/17476348.2025.2581347","url":null,"abstract":"Introduction: Up to 40% of patients with COPD have an eosinophilic phenotype, which increases the risk of acute exacerbations. Mepolizumab, an anti - IL-5 monoclonal antibody, has shown mixed results. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of mepolizumab 100 mg in eosinophilic COPD.Methods: Following PRISMA and Cochrane guidelines, we searched PubMed, Embase, and Cochrane Central through 18 May 2025. Randomized controlled trials comparing mepolizumab 100 mg versus placebo in eosinophilic COPD were included. The primary outcome was the annualized rate of moderate or severe exacerbations. Data were pooled using random-effects models.Results: Four RCTs (1,953 patients) were included. Mepolizumab reduced annualized rate of moderate or severe exacerbations (Rate Ratio 0.80; 95% CI: 0.73-0.89; p < 0.00001) and prolonged time to first exacerbation (HR 0.78; 95% CI: 0.69-0.88; p < 0.0001). Sensitivity analysis excluding METREX showed fewer exacerbations requiring ED visits or hospitalization (Rate Ratio 0.63; 95% CI: 0.46-0.86; p = 0.004). Patient-reported outcomes did not improve. Safety was favorable, with reduced serious adverse events, including deaths (RR 0.84; 95% CI: 0.73-0.98; p = 0.03).Conclusions: Mepolizumab reduces exacerbations with good safety in eosinophilic COPD, though without improvement in quality-of-life outcomes.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"437-445"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380396","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}

引用次数: 0

Isolated lung perfusion for targeted therapies: applications in acute respiratory distress syndrome, acute lung injury, and transplantation. 分离肺灌注靶向治疗：急性呼吸窘迫综合征、急性肺损伤和移植的应用

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-11-07 DOI: 10.1080/17476348.2025.2583356

Daniella H Wong, Gabriel A Ramos, Sean W W Noona, Steven D Young, Matthew P Weber, Victor E Laubach, Irving L Kron

{"title":"Isolated lung perfusion for targeted therapies: applications in acute respiratory distress syndrome, acute lung injury, and transplantation.","authors":"Daniella H Wong, Gabriel A Ramos, Sean W W Noona, Steven D Young, Matthew P Weber, Victor E Laubach, Irving L Kron","doi":"10.1080/17476348.2025.2583356","DOIUrl":"10.1080/17476348.2025.2583356","url":null,"abstract":"Introduction: Isolated lung perfusion (ILP) is a platform equipped for localized delivery, assessment, and optimization of lung-targeted therapies to manage acute respiratory distress syndrome (ARDS), acute lung injury, and transplantation. Here we review platform capabilities, therapeutic potential, and translational pathways with particular focus on ARDS.Areas covered: A systematic search was performed in the PubMed database to identify relevant works. From this comprehensive review, we discuss the historical application of ILP in lung transplantation and thoracic oncology, and its progression to treating acute lung injury. Recent preclinical studies have demonstrated the efficacy of pharmacological interventions, gene therapy, and cell-based approaches delivered via ILP. Molecular investigations have revealed mechanisms underlying ILP effects, including modulation of inflammatory pathways, enhancement of cellular repair processes, and activation of tissue protection mechanisms. Significant technical refinements have extended perfusion durations, improved monitoring capabilities, and enhanced delivery systems.Expert opinion: ILP has surfaced as the ideal platform for precision medicine approaches to ARDS management. Despite significant advances, challenges to clinical translation persist. Issues of standardization, cost analysis, and minimally invasive techniques need to be addressed to continue expanding in diagnostic utility and therapeutic benefit with a focus on personalized approaches based on ARDS etiology and patient-specific biomarkers.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"345-357"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461051","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}

引用次数: 0

Inhaled nitric oxide in therapy of pediatric and neonatal acute respiratory distress syndrome: the good, the bad and the ugly. 吸入一氧化氮治疗小儿和新生儿急性呼吸窘迫综合征：好，坏，丑。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-11-06 DOI: 10.1080/17476348.2025.2583353

Qi He, Shuyue Liu, Wenwen Tang, Xiaoyan Gao, Bingbing Li, Chenlu Liang, George H Lorimer, Hasan Bayram, Jun Wang

{"title":"Inhaled nitric oxide in therapy of pediatric and neonatal acute respiratory distress syndrome: the good, the bad and the ugly.","authors":"Qi He, Shuyue Liu, Wenwen Tang, Xiaoyan Gao, Bingbing Li, Chenlu Liang, George H Lorimer, Hasan Bayram, Jun Wang","doi":"10.1080/17476348.2025.2583353","DOIUrl":"10.1080/17476348.2025.2583353","url":null,"abstract":"Introduction: Pediatric and neonatal acute respiratory distress syndrome (PARDS/NARDS) cause significant mortality or long-term morbidity in childhood. The optimal management remains elusive, making a review of therapies like inhaled nitric oxide (iNO) timely and crucial.Areas covered: This review elucidates the mechanisms of iNO and critically appraises its application in PARDS/NARDS. A literature search covering the period up to December 2024 was conducted in PubMed, Embase, and Web of Science. We evaluated its effects on oxygenation, inflammation, and outcomes, highlighting the inconclusive impact on survival and neurodevelopment, and the limitations posed by variable response and safety concerns.Expert opinion: While iNO can improve oxygenation, its routine use is not recommended due to uncertain long-term benefits. Future, rigorous trials must identify predictive biomarkers and patient subgroups most likely to benefit, paving the way for personalized iNO therapy in neonatal and pediatric critical care.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"379-392"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395861","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}

引用次数: 0

Humidification insights in mechanical ventilation and respiratory support. A narrative review. 加湿在机械通气和呼吸支持中的应用。叙述性评论

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-11-03 DOI: 10.1080/17476348.2025.2581342

Kunal Deokar, Gustavo A Plotnikow, Sanjay Singhal, Bushra Mina, Mostafa ElShazly, Megan Wooldridge, Jessica Whittle, Antonio Esquinas

{"title":"Humidification insights in mechanical ventilation and respiratory support. A narrative review.","authors":"Kunal Deokar, Gustavo A Plotnikow, Sanjay Singhal, Bushra Mina, Mostafa ElShazly, Megan Wooldridge, Jessica Whittle, Antonio Esquinas","doi":"10.1080/17476348.2025.2581342","DOIUrl":"10.1080/17476348.2025.2581342","url":null,"abstract":"Introduction: Adequate airway humidification is important in respiratory care, significantly affecting patient comfort, airway function, and clinical outcomes. Adequate humidification helps prevent airway dryness, mucosal damage, and respiratory complications, making its understanding crucial for effective patient management.Areas covered: The bibliographic database PubMed and search engine Google Scholar was searched for systematic reviews and metanalyses, clinical trials and observational studies on humidification practices in adult spontaneously breathing tracheostomized patients and those receiving invasive mechanical ventilation, noninvasive ventilation (acute and long term), and oxygen therapy (low and high flow). The physiological principles of airway humidification, the characteristics and applications of various active and passive humidification devices, impact of ventilator settings, interfaces, and patient-specific factors on humidification efficacy were reviewed.Expert opinion: There is no doubt that humidification plays a crucial role in maintaining airway mucosal integrity. A comprehensive knowledge of humidification strategies is must for their proper implementation in clinical practice. Even when upper airways are intact, as in NIV or oxygen therapy, humidification may still be necessary to prevent discomfort and maintain mucosal integrity. Future research should focus on refining humidification strategies to maximize efficacy, minimize complications and developing improved methods for monitoring airway humidity at the patient interface.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"393-406"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403280","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}

引用次数: 0

High burden of severe and very severe undernutrition among adults with tuberculosis: findings from a state wide operational research in Chhattisgarh, India. 成人结核病患者严重和极严重营养不良的高负担：来自印度恰蒂斯加尔邦一项全国性业务研究的结果。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-05 DOI: 10.1080/17476348.2025.2569845

Vishnu Gupta, Chetanya Malik, Kalpita Shringarpure, Himanshu A Gupte, Hemant D Shewade, Khemraj Sonwani, Vikash Ranjan Keshri

{"title":"High burden of severe and very severe undernutrition among adults with tuberculosis: findings from a state wide operational research in Chhattisgarh, India.","authors":"Vishnu Gupta, Chetanya Malik, Kalpita Shringarpure, Himanshu A Gupte, Hemant D Shewade, Khemraj Sonwani, Vikash Ranjan Keshri","doi":"10.1080/17476348.2025.2569845","DOIUrl":"10.1080/17476348.2025.2569845","url":null,"abstract":"Background: Undernutrition drives the TB epidemic in India with 4-5 times higher mortality among adults with severe/very severe undernutrition. We assessed proportion of severe/very severe undernutrition among adults with TB and timeliness in receiving monetary support for nutrition (Direct benefit transfer-DBT) and food baskets.Research design and methods: This analytical cross-sectional study conducted in Chhattisgarh, tribal Indian state, utilized program data of adults with TB notified in public facilities under the National TB Elimination Program from April-June 2024. Body Mass Index (BMI) was categorized for nutritional status and equity in distribution of DBT and foodbaskets was evaluated using frequency, proportions, and Chi-square for trend.Results: Of 6568 adults with TB, BMI was calculated for 6397 (97%). Proportion of severe and very severe undernutrition was 22% and 13% respectively. First DBT instalment was received by 81%, with 29% receiving it within two months; 21% received foodbaskets, with similar coverage across all undernutrition categories (p > 0.05), reflecting inequity.Conclusions: There is a high burden of severe/very severe undernutrition among TB patients. Similar DBT and food basket coverage among those with severe/very severe undernutrition and other TB patients indicates inequity in distribution. Undernutrition-basedindicators and linkage of DBT and food baskets should be prioritized.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"467-473"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214754","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}

引用次数: 0

Multimorbidity in the modulator era: challenges of managing an ageing cystic fibrosis population. 调节剂时代的多病：管理老龄化囊性纤维化人群的挑战。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-03-01 Epub Date: 2025-10-05 DOI: 10.1080/17476348.2025.2568244

Alex Chan, Freddy Frost, Dilip Nazareth

{"title":"Multimorbidity in the modulator era: challenges of managing an ageing cystic fibrosis population.","authors":"Alex Chan, Freddy Frost, Dilip Nazareth","doi":"10.1080/17476348.2025.2568244","DOIUrl":"10.1080/17476348.2025.2568244","url":null,"abstract":"Introduction: Cystic Fibrosis (CF) is an autosomal recessive disorder caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene, leading to defective chloride ion transport and multisystem disease. The introduction of CFTR modulators, particularly elexacaftor/tezacaftor/ivacaftor (ETI), has significantly improved life expectancy and quality of life for people with CF (pwCF). As survival increases, an aging CF population faces different new challenges.Areas covered: This review aims to highlight emerging challenges and comorbidities in an aging CF population to ensure sustained benefits from recent therapeutic advancements. The review includes the discussion of the changes in lung function, nutrition, cardiometabolic diseases, malignancy risk and psychosocial health. A structured literature search was conducted using PubMed, focusing on articles published between 2000 and 2025, including recent clinical trials and international guidelines. National registry data has also been reviewed.Expert opinion: With CFTR modulators progress rapidly, the future focus should shift to refining and optimizing CF care. Standard practice should involve a multidisciplinary, proactive and preventative strategy to manage co-morbidities, ensuring the ultimate goal moving from simply extending pwCF's life to ensuring a high quality of life throughout their lifespan.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"267-277"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188204","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}

引用次数: 0

Insights into sinonasal disease in patients with primary ciliary dyskinesia. 原发性纤毛运动障碍患者鼻窦疾病的认识。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-03-01 Epub Date: 2025-10-20 DOI: 10.1080/17476348.2025.2577483

Ela Erdem Eralp, Bulent Karadag

{"title":"Insights into sinonasal disease in patients with primary ciliary dyskinesia.","authors":"Ela Erdem Eralp, Bulent Karadag","doi":"10.1080/17476348.2025.2577483","DOIUrl":"10.1080/17476348.2025.2577483","url":null,"abstract":"Introduction: Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterized by impaired motile ciliary function, resulting in defective mucociliary clearance and chronic sinopulmonary disease. Although lower airway manifestations are well known, sinonasal disease is often underrecognized or undertreated outside specialist centers, particularly in adults and in settings without routine Ear-Nose-Throat evaluation.Areas covered: Despite its clinical burden, standardized diagnostic and therapeutic protocols for sinonasal disease in PCD are limited. This review synthesizes current knowledge on the pathophysiology, clinical presentation, diagnostic approaches, and management strategies for sinonasal involvement in PCD based on recent publications. Additionally, the review highlights the burden of disease and its impact on quality of life, role of genotype-phenotype correlations, and the emerging need for disease-specific outcome measures.Expert opinion: Despite growing evidence, diagnosis and management remain inconsistent due to a lack of standardized tools and guidelines. Multidisciplinary care and implementation of validated outcome measures are essential to optimize clinical follow-up and improve quality of life in this population. Future advances in imaging, microbiome profiling, and personalized interventions are needed. Furthermore, defining a standardized criteria for sinonasal exacerbations and integrating upper airway outcomes into clinical studies will be critical for advancing both research and patient care.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"287-294"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310387","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}

引用次数: 0

COPD and the burden of multimorbidity: navigating the complexity. 慢性阻塞性肺病和多重疾病的负担：在复杂性中导航。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-03-01 Epub Date: 2025-10-07 DOI: 10.1080/17476348.2025.2569126

Maria Kallieri, Georgios Hillas, Konstantinos Bartziokas, Stelios Loukides, Dimitrios Toumpanakis

{"title":"COPD and the burden of multimorbidity: navigating the complexity.","authors":"Maria Kallieri, Georgios Hillas, Konstantinos Bartziokas, Stelios Loukides, Dimitrios Toumpanakis","doi":"10.1080/17476348.2025.2569126","DOIUrl":"10.1080/17476348.2025.2569126","url":null,"abstract":"Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic condition that affects millions of people worldwide. The majority of patients with COPD have multiple coexisting chronic diseases, such as cardiovascular diseases, osteoporosis, lung cancer, and metabolic syndrome, a phenomenon that is known as multimorbidity. The coexistence of these diseases with COPD complicates diagnosis, treatment, and prognosis.Areas covered: This review explores the underlining mechanisms that connect COPD and multimorbidity, such as shared risk factors and pathophysiological pathways. It also highlights the challenges in managing multimorbid patients and emphasizes the fact that the complexity of comorbidities may require a multidisciplinary approach in COPD management.Expert opinion: Managing COPD in the context of multimorbidity requires a multidisciplinary approach. This approach should combine pharmacological and non-pharmacological treatments for COPD, adhere to evidence-based guidelines for managing comorbidities, and target modifiable shared risk factors to improve overall patient outcomes.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"251-266"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240622","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}

引用次数: 0

Rituximab treatment for connective tissue diseases associated-pulmonary hypertension: a systematic literature review. 利妥昔单抗治疗结缔组织病相关肺动脉高压：系统文献综述

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-03-01 Epub Date: 2025-09-17 DOI: 10.1080/17476348.2025.2557634

Amany Touil, Selma Bouden, Sarra Maazaoui, Leila Rouached, Aicha Ben Tekaya, Siwar Ben Dhia, Ines Mahmoud, Rawdha Tekaya, Olfa Saidane, Leila Abdemloula

{"title":"Rituximab treatment for connective tissue diseases associated-pulmonary hypertension: a systematic literature review.","authors":"Amany Touil, Selma Bouden, Sarra Maazaoui, Leila Rouached, Aicha Ben Tekaya, Siwar Ben Dhia, Ines Mahmoud, Rawdha Tekaya, Olfa Saidane, Leila Abdemloula","doi":"10.1080/17476348.2025.2557634","DOIUrl":"10.1080/17476348.2025.2557634","url":null,"abstract":"Introduction: To evaluate the efficacy and safety of Rituximab (RTX) in the treatment of pulmonary hypertension (PH) in patients with connective tissue diseases (CTDs).Methods: A systematic review of the published literature was performed according to the PRISMA guidelines. Eligible articles were clinical trials, cohort studies, case series, and case reports of adult patients with CTD-PH treated with RTX. The selected languages were English and French.Results: Six studies fulfilled the selection criteria and two of them were prospective. Most patients were from the U.S.A. and Russia. The predominant sex was female (85.9%), and the age of the included patients ranged from 29 years to 67 years. PH was confirmed by right heart catheterization in 3 studies. The CTDs associated with PH were systemic sclerosis (3 cases), adult-onset Still's disease (one case), systemic lupus erythematosus (one case) and mixed connective tissue disease (one case). The mean number of infusions was 4.2. The mean follow-up period across all studies was 18.3 months. Clinical and paraclinical parameters before and after RTX infusions were evaluated and showed improvement. RTX for the treatment of CTD-PH appeared to be well tolerated.Conclusions: RTX seemed to be effective and safe in the treatment of CTD-PH.Systematic review registration: PROSPERO, ID: CRD420251037839.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"321-328"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994826","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}

引用次数: 0

Clinical perspective on non-sleepy obstructive sleep apnea; to treat or not to treat? 非困倦性阻塞性睡眠呼吸暂停的临床观察治疗还是不治疗？

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-03-01 Epub Date: 2025-07-25 DOI: 10.1080/17476348.2025.2539542

Steven Luu, Budhima Nanayakkara, Brendon J Yee

{"title":"Clinical perspective on non-sleepy obstructive sleep apnea; to treat or not to treat?","authors":"Steven Luu, Budhima Nanayakkara, Brendon J Yee","doi":"10.1080/17476348.2025.2539542","DOIUrl":"10.1080/17476348.2025.2539542","url":null,"abstract":"Introduction: Excessive daytime sleepiness has traditionally been regarded as the hallmark symptom of obstructive sleep apnea (OSA), yet nearly half of individuals with OSA do not report significant sleepiness. While treatments are well established for sleepy patients, their role in non-sleepy individuals remains relatively underexplored.Areas covered: This review discusses the limitations of current tools used to measure sleepiness, evaluates the evidence for various treatment options for OSA in non-sleepy populations, and outlines key considerations for shared decision-making. We examine noninvasive therapies including positive airway pressure (PAP), oral appliance therapy, and weight loss interventions only.Expert opinion: Randomized controlled trials have not demonstrated cardiometabolic benefits of PAP therapy in non-sleepy individuals with OSA, though these studies are limited by poor PAP adherence and imprecise tools for identifying high-risk patients. As such, a pragmatic trial of PAP may be a reasonable strategy in non-sleepy people with moderate-to-severe OSA, cardiovascular comorbidities, or other OSA-related complications; provided patients are counseled about the challenges of adherence and the uncertain benefits in this population. Looking ahead, management of non-sleepy OSA will likely be guided by individualized, risk-based approaches incorporating physiological endotyping, objective biomarkers of cardiovascular risk, and patient preferences.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"227-239"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700744","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}

引用次数: 0