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

Comparison of effectiveness and safety between baricitinib and tocilizumab in severe COVID-19: a retrospective study. 巴西替尼与托珠单抗治疗重症COVID-19的有效性和安全性比较。回顾性研究。

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-04 DOI: 10.1080/17476348.2025.2473486

Ioannis Tomos, Ioannis Grigoropoulos, Chrysavgi Kosti, Serafeim Chrysikos, Antonia Digalaki, Konstantinos Thomas, Georgios Hillas, Pinelopi Kazakou, Anastasia Antoniadou, Dimitra Kavatha, Katerina Dimakou

{"title":"Comparison of effectiveness and safety between baricitinib and tocilizumab in severe COVID-19: a retrospective study.","authors":"Ioannis Tomos, Ioannis Grigoropoulos, Chrysavgi Kosti, Serafeim Chrysikos, Antonia Digalaki, Konstantinos Thomas, Georgios Hillas, Pinelopi Kazakou, Anastasia Antoniadou, Dimitra Kavatha, Katerina Dimakou","doi":"10.1080/17476348.2025.2473486","DOIUrl":"10.1080/17476348.2025.2473486","url":null,"abstract":"Background: Immunomodulators tocilizumab and baricitinib have been used for the treatment of severe COVID-19, however, there are only few published studies comparing their efficacy.Research design and methods: All consecutive non-ICU hospitalized severe COVID-19 patients who received baricitinib or tocilizumab, were included retrospectively. Primary outcomes were mortality or intubation on day 14, time to oxygen therapy weaning and duration of hospitalization. Safety was measured as treatment-related adverse events.Results: 321 hospitalized patients with severe COVID-19 were included (mean age 62.4 years ± 14.7); 241 (75.1%) received baricitinib (mean age 64.2 years ± 15.2) and 80 (24.9%) tocilizumab (mean age 57.3 ± 11.7). Patients who received baricitinib presented significantly lower risk of mortality or intubation on day 14, compared to the tocilizumab group after adjusting for age, sex, vaccination, Charlson comorbidity index, body mass index, remdesivir administration and WHO ordinal scale at enrollment (OR: 0.42, 95% CI: 0.20-0.86). In the augmented inverse-probability weighting regression, the protective role of baricitinib remained statistically significant (OR: 0.76, 95% CI: 0.66-0.88). No difference in secondary bacterial infections was detected, but tocilizumab was associated with significant higher rate of liver injury (Odds Ratio, 95%CI, p < 0.001).Conclusions: Our study suggests survival and safety are significantly better for baricitinib compared to tocilizumab in severe COVID-19. Clinical randomized trials are needed for confirmation.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"389-397"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525573","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

Management options for excessive daytime sleepiness in patients with obstructive sleep apnea. 阻塞性睡眠呼吸暂停患者日间过度嗜睡的管理选择。

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/17476348.2025.2479614

Maria R Bonsignore, Francesco Fanfulla, Pietro Ingrao, Simone Lombardo, Pasquale Tondo, Vanessa Lo Nano, Carolina Lombardi

{"title":"Management options for excessive daytime sleepiness in patients with obstructive sleep apnea.","authors":"Maria R Bonsignore, Francesco Fanfulla, Pietro Ingrao, Simone Lombardo, Pasquale Tondo, Vanessa Lo Nano, Carolina Lombardi","doi":"10.1080/17476348.2025.2479614","DOIUrl":"10.1080/17476348.2025.2479614","url":null,"abstract":"Introduction: Excessive daytime sleepiness (EDS) is a symptom of obstructive sleep apnea (OSA) associated with the risk of accidents at work or while driving. OSA treatment decreases EDS, but some patients remain sleepy despite optimal control of OSA. Patients who do not tolerate or refuse OSA treatment may be symptomatically treated for EDS. Solriamfetol and pitolisant are wake-promoting agents (WPA) recently approved for use in sleepy OSA patients accepting or refusing OSA treatment.Areas covered: This narrative review provides updated information on: how to assess EDS in OSA patients, epidemiology, and management of residual EDS in treated OSA patients and the results of recent studies using new WPAs in patients accepting or refusing CPAP treatment. Literature was accessed from PubMed between 1 December 2024 and 6 January 2025.Expert opinion: The new WPAs are useful drugs with a favorable safety profile to be included as a possible therapeutic option for sleepy OSA patients. However, it is still uncertain which subgroups of patients should be treated for the symptom of EDS while maintaining a low-risk profile in terms of the consequences of OSA on health. Until such data is available, use of WPA in OSA patients should be managed by Sleep Specialists.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"325-345"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660069","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

Effects of household cleaning products on the lungs: an update. 家用清洁产品对肺部的影响：最新进展。

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-14 DOI: 10.1080/17476348.2025.2478968

Emilie Pacheco Da Silva, Orianne Dumas, Nicole Le Moual

{"title":"Effects of household cleaning products on the lungs: an update.","authors":"Emilie Pacheco Da Silva, Orianne Dumas, Nicole Le Moual","doi":"10.1080/17476348.2025.2478968","DOIUrl":"10.1080/17476348.2025.2478968","url":null,"abstract":"Introduction: Household disinfectants and cleaning products (HDCPs), which involve a complex mixture of chemical ingredients, are commonly used in homes. HDCPs significantly contribute to chemical exposure in the indoor environment by releasing particles and volatile organic compounds while being used, potentially harming the respiratory health of those exposed.Areas covered: We provide an overview of scientific literature, especially from the last five years, regarding the (i) effects of using of HDCPs on adults' respiratory health; (ii) associations between prenatal or childhood exposure to HDCPs and children respiratory health. Finally, we discuss on standard and innovative methods of HDCP exposure assessment.Expert opinion: Recent literature provides further evidence on the harmful role of HDCPs on respiratory health in both adults and children. Exposure to HDCPs is a modifiable asthma risk factor that requires more consideration, in order to reduce asthma-related morbidity, and to improve and maintain an optimal control of the disease. Further research is essential to deepen the current knowledge, particularly by using innovative methods of exposure assessment to HDCPs, which could enhance the exposure characterization in both adults and children, and contribute to identify HDCP's chemical compounds leading to a risk for respiratory health.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"313-324"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627245","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

Elevated serum tumor-associated antigens in patients with interstitial lung disease: a retrospective study on clinical features and prognosis. 间质性肺疾病患者血清肿瘤相关抗原升高：临床特征和预后的回顾性研究

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1080/17476348.2025.2473480

Yanling Ding, Yahong Chen, Ming Chen, Yi Liu, Nan Li, Yongchang Sun

{"title":"Elevated serum tumor-associated antigens in patients with interstitial lung disease: a retrospective study on clinical features and prognosis.","authors":"Yanling Ding, Yahong Chen, Ming Chen, Yi Liu, Nan Li, Yongchang Sun","doi":"10.1080/17476348.2025.2473480","DOIUrl":"10.1080/17476348.2025.2473480","url":null,"abstract":"Background: Elevated serum tumor-associated antigens (TAAs) were reported to be common in patients with interstitial lung disease (ILD) and correlated with pulmonary involvement or malignancy development. However, there were no adequate longitudinal studies on the association between elevated TAAs and various types of ILDs in Chinese patients.Research design and methods: The treatment-naïve ILD patients were retrospectively enrolled. The clinical, laboratory, imaging characteristics, and prognosis were analyzed and compared among those with normal and different number of elevated TAAs.Results: An increase of at least one TAA was present in 169/308 (54.87%) of our patients. Both baseline alveolar and interstitial scores were much higher, and lung involvement tended to be worse during follow-up in patients with two and three or more elevated TAAs than in normal TAAs. Patients with three or more elevated TAAs had the highest interstitial scores and a higher all-cause mortality during follow-up than those with one elevated TAA or normal TAAs. The occurrence of malignancy was similar in all patients.Conclusion: Elevated TAAs were present in 54.87% of ILD patients and associated with lung interstitial lesions, which might be a marker for lung involvement progression, while not for malignancy development in ILD.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"379-387"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517611","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

Genetic underpinning of idiopathic pulmonary fibrosis: the role of mucin. 特发性肺纤维化的遗传基础：粘蛋白的作用。

Expert review of respiratory medicine Pub Date : 2025-02-25 DOI: 10.1080/17476348.2025.2464035

Seyedeh Zahra Fotook Kiaei, David A Schwartz

{"title":"Genetic underpinning of idiopathic pulmonary fibrosis: the role of mucin.","authors":"Seyedeh Zahra Fotook Kiaei, David A Schwartz","doi":"10.1080/17476348.2025.2464035","DOIUrl":"10.1080/17476348.2025.2464035","url":null,"abstract":"Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterized by progressive scarring and reduced survival. The development of IPF is influenced by rare and common genetic variants, cigarette smoking, aging, and environmental exposures. Among the two dozen genetic contributors, the MUC5B promoter variant (rs35705950) is the dominant risk factor, increasing the risk of both familial and sporadic IPF and accounting for nearly 50% of the genetic predisposition to the disease.Areas covered: This review provides an expert perspective on the genetic underpinnings of IPF rather than a systematic analysis, emphasizing key insights into its genetic basis. The articles referenced in this review were identified through targeted searches in PubMed, Scopus, and Web of Science for studies published between 2000 and 2023, prioritizing influential research on the genetic factors contributing to IPF. Search terms included 'idiopathic pulmonary fibrosis,' 'genetics,' 'MUC5B,' 'telomere dysfunction,' and 'surfactant proteins.' The selection of studies was guided by the authors' expertise, focusing on the most relevant publications.Expert opinion: The identification of genetic variants not only highlights the complexity of IPF but also offers potential for earlier diagnosis and personalized treatment strategies targeting specific genetic pathways, ultimately aiming to improve patient outcomes.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257365","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

The emerging role of anticoagulants targeting Factor XI in thromboembolism management. 抗凝剂靶向因子XI在血栓栓塞治疗中的新作用。

Expert review of respiratory medicine Pub Date : 2025-02-20 DOI: 10.1080/17476348.2025.2467463

Laurent Bertoletti, Jean Escal, Lutfi Ozturk, Margaux Geier, Géraldine Poenou

引用次数: 0

Amivantamab plus lazertinib vs. osimertinib in first-line EGFR-mutant advanced non-small cell lung cancer. 阿米万他单抗+拉泽替尼vs奥西替尼治疗一线egfr突变晚期非小细胞肺癌。

Expert review of respiratory medicine Pub Date : 2025-02-20 DOI: 10.1080/17476348.2025.2467338

Nazmul Hasan, Misako Nagasaka

引用次数: 0

The prognostic value of NT-proBNP in 28-day mortality and post-discharge survival in pneumonia: a retrospective cohort study from Taiwan. nt-proBNP对肺炎患者28天死亡率和出院后生存率的预测价值：台湾回顾性队列研究。

Expert review of respiratory medicine Pub Date : 2025-02-18 DOI: 10.1080/17476348.2025.2467339

Van-Dong Nguyen, Hsien-Chun Lin, Wen-Chen Lee, Ke-Shiuan Ju, Jing-En Dai, Pei-Ni Hsieh, Chun-You Chen, Chih-Hsin Lee

{"title":"The prognostic value of NT-proBNP in 28-day mortality and post-discharge survival in pneumonia: a retrospective cohort study from Taiwan.","authors":"Van-Dong Nguyen, Hsien-Chun Lin, Wen-Chen Lee, Ke-Shiuan Ju, Jing-En Dai, Pei-Ni Hsieh, Chun-You Chen, Chih-Hsin Lee","doi":"10.1080/17476348.2025.2467339","DOIUrl":"10.1080/17476348.2025.2467339","url":null,"abstract":"Background: NT-proBNP, traditionally used to assess heart failure, is increasingly recognized for its prognostic value in other diseases. This study evaluates its value in pneumonia.Research design and methods: We conducted a retrospective cohort study of adult patients hospitalized for pneumonia at Wan Fang Hospital (2017-2021) to investigate whether elevated NT-proBNP levels predicted poorer outcomes. Logistic regression identified risk factors for 28-day mortality, while the Cox regression model identified predictors of post-discharge survival.Results: Among 2,805 patients (79.6 ± 13.4 years, female 45%), the 28-day mortality rate was 18.2%, and the median post-discharge follow-up time was 359 days. Moderately (increased but < 10000 pg/mL) and severely (>10000 pg/mL) elevated NT-proBNP levels had higher 28-day mortality compared to normal NT-proBNP; adjusted odds ratios: 2.24 (1.34-3.75, p = 0.002) and 3.57 (2.03-6.27, p < 0.001). Moderately and severely elevated NT-proBNP levels related to shorter survival time than normal NT-proBNP levels; adjusted hazard ratios 1.60 (1.28-2.00, p < 0.001) and 2.03 (1.56-2.63, p < 0.001). All ratios were adjusted with comorbidities, sex, age, and clinical and laboratory tests.Conclusions: Elevated NT-proBNP levels predict higher 28-day mortality and shorter survival time in patients with pneumonia across most subpopulations. This marker holds potential as a prognostic biomarker for pneumonia, especially in high-risk patients.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411988","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

Pathophysiology of small airways in idiopathic pulmonary fibrosis (IPF): the silent zone. 特发性肺纤维化（IPF）小气道的病理生理学：沉默区。

Expert review of respiratory medicine Pub Date : 2025-02-17 DOI: 10.1080/17476348.2025.2467341

Wenying Lu, Affan Mahmood Shahzad, Athul Antony Simon, Greg Haug, Maddison Waters, Sukhwinder Singh Sohal

{"title":"Pathophysiology of small airways in idiopathic pulmonary fibrosis (IPF): the silent zone.","authors":"Wenying Lu, Affan Mahmood Shahzad, Athul Antony Simon, Greg Haug, Maddison Waters, Sukhwinder Singh Sohal","doi":"10.1080/17476348.2025.2467341","DOIUrl":"10.1080/17476348.2025.2467341","url":null,"abstract":"Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease characterized by distorted alveolar structure and reduced lung compliance, and impaired ventilation-perfusion. Small airway disease (SAD) is often termed a 'quietzone' due to its asymptomatic nature. Around 30-40% of IPF patients exhibit SAD, which is associated with worse prognosis, higher fibrosis and emphysema scores, and elevated mortality risk. We used PubMed and Google Scholar for literature search.Areas covered: This review explores the pathophysiology of small airways in IPF, focusing on 1. Risk factors, including age, gender, smoking and occupational dust exposure, and ozone. 2. Diagnostic challenges: SAD is difficult to detect through traditional spirometry or high-resolution computed tomography imaging due to resolution limitations. 3. Early physiological changes of small airways include airway wall thickening, lumen distortion, and reduced terminal bronchioles, preceding microscopic fibrosis, occurs in the early process of IPF. 4. Pathological mechanisms: The review examines the underlying mechanisms driving small airway disease in IPF.Expert opinion: A comprehensive approach is essential to improve the understanding and management of SAD in IPF. Priorities include identifying therapeutic targets, advanced imaging and functional assessments. Forced oscillation technique should be introduced for early detection for small airway abnormalities in IPF.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411966","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

Strategies for preventing and reducing the impact of acute respiratory failure from pneumonia. 预防和减少肺炎引起的急性呼吸衰竭影响的战略。

Expert review of respiratory medicine Pub Date : 2025-02-15 DOI: 10.1080/17476348.2025.2464880

Joon Yong Moon, Mohamad El Labban, Ognjen Gajic, Yewande Odeyemi

{"title":"Strategies for preventing and reducing the impact of acute respiratory failure from pneumonia.","authors":"Joon Yong Moon, Mohamad El Labban, Ognjen Gajic, Yewande Odeyemi","doi":"10.1080/17476348.2025.2464880","DOIUrl":"10.1080/17476348.2025.2464880","url":null,"abstract":"Introduction: Pneumonia remains a leading cause of morbidity and mortality, particularly in critically ill patients with acute respiratory failure (ARF). This review discusses prevention strategies for pneumonia-induced ARF, categorized into primary, secondary, and tertiary prevention.Areas covered: A literature search was conducted through PubMed covering the years 2000-2024, using the keywords 'acute respiratory failure,' pneumonia prevention,\" 'risk stratification,' and 'preventive strategies.' Primary prevention focuses on reducing pneumonia risk through vaccination, smoking cessation, and comorbidity management. Secondary prevention involves early detection, risk assessment using clinical tools like the Pneumonia Severity Index (PSI) biomarkers, such as procalcitonin and C-reactive protein, appropriate antibiotic use, and emerging machine learning tools for real-time stratification. Tertiary prevention focuses on optimizing care with noninvasive respiratory support, lung-protective ventilation strategies, and ventilator bundles for intubated patients. Emerging therapies, including targeted use of corticosteroids and other immunomodulatory agents, are also discussed as promising adjuncts to current standards of care.Expert opinion: While these prevention strategies show potential, continued research is necessary to refine these interventions, explore newer therapies and evaluate long-term outcomes. Implementation of these strategies aims to reduce the impact of pneumonia-induced ARF on healthcare systems and improve patient survival and quality of care.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416626","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