Expert review of respiratory medicine最新文献_第2页

What constitutes an obstructive ventilatory impairment in a pediatric population? A comparative study of five definitions by scholarly societies. 在儿科人群中，什么构成阻塞性通气障碍？学术团体五种定义的比较研究。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-05-01 Epub Date: 2025-11-28 DOI: 10.1080/17476348.2025.2594207

Mariem Abdesalem, Ines Ghannouchi, Amine Souissi, Nadia Lazreg, Sonia Rouatbi, Helmi Ben Saad

{"title":"What constitutes an obstructive ventilatory impairment in a pediatric population? A comparative study of five definitions by scholarly societies.","authors":"Mariem Abdesalem, Ines Ghannouchi, Amine Souissi, Nadia Lazreg, Sonia Rouatbi, Helmi Ben Saad","doi":"10.1080/17476348.2025.2594207","DOIUrl":"10.1080/17476348.2025.2594207","url":null,"abstract":"Introduction: To ascertain the frequency of obstructive ventilatory impairment (OVI) among children/adolescents referred for spirometry, using definitions provided by various international respiratory societies.Methods: This cross-sectional, bi-centric study included 602 children/adolescents aged 6 to 18 years. Subjects completed a medical questionnaire, and clinical and anthropometric data were collected. Spirometric measurements were performed using two spirometers. OVI was assessed using five definitions: i) 2023-Global Initiative for Asthma (GINA): FEV1 < 80% and FEV1/FVC ≤ 0.90; ii) Irish College of General Practitioners (ICGP): FEV1/FVC < 0.70; iii) European Respiratory Society and American Thoracic Society (ERS-ATS): FEV1/FVC z-score < -1.645; iv) National Institute for Health and Care Excellence (NICE): FEV1/FVC < 0.70 or FEV1/FVC z-score < -1.645; and v) Canadian Thoracic Society (CTS): FEV1/FVC < 0.80 or a FEV1/FVC z-score < -1.645.Results: The frequency of OVI varied significantly (Chi-square test < 0.001) depending on the definition applied: ICGP (7.6%), ERS-ATS or NICE (19.3%), 2023-GINA (24.9%), and CTS (27.9%). This indicated that the definitions are not equivalent in identifying OVI.Conclusion: The rate of OVI in pediatric populations varies considerably based on the diagnostic criteria used. Clinicians and researchers should therefore interpret prevalence data cautiously and always specify which definition was applied.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"591-600"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598394","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

Harnessing breath biomarkers for pneumonia diagnosis and prognosis. 利用呼吸生物标志物进行肺炎诊断和预后。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-05-01 Epub Date: 2025-11-26 DOI: 10.1080/17476348.2025.2593629

Cosby G Arnold, Mitchell M McCartney, Cristina E Davis, Joseph P Mizgerd, Nicholas J Kenyon

{"title":"Harnessing breath biomarkers for pneumonia diagnosis and prognosis.","authors":"Cosby G Arnold, Mitchell M McCartney, Cristina E Davis, Joseph P Mizgerd, Nicholas J Kenyon","doi":"10.1080/17476348.2025.2593629","DOIUrl":"10.1080/17476348.2025.2593629","url":null,"abstract":"Introduction: Pneumonia is a major cause of death and disability worldwide. A host of pathogens causes pneumonia, and pneumonia presents with a remarkable heterogeneity of clinical symptoms and signs and has varied outcomes. Current approaches to pneumonia diagnosis and risk stratification lack precision such that there is no universally agreed upon biomarker or scoring system. These limitations have prompted calls for novel, noninvasive, and more precise approaches to better diagnosing pneumonia and predicting outcomes.Areas covered: We performed a comprehensive literature search through PubMed to identify studies reporting on breath biomarkers in pneumonia published up to 31 July 2025. This manuscript explores breath-based metabolomics as a novel approach to biomarker development in pneumonia. It describes breath collection methods, including devices available and types of breath samples for analysis. It reviews the potential role of exhaled breath analysis to expedite pneumonia diagnosis, monitor response to therapy, and predict clinical trajectory.Expert opinion: Breath-based metabolomics could improve the recognition and management of pneumonia. It is a noninvasive, potentially continuous method that provides a direct window into the lung for novel insights into the underlying biology of pneumonia.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"491-500"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12688321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory health in a changing environment: environment-adaptive therapies and revised dosing strategies. 环境变化中的呼吸健康：适应环境的疗法和修订的给药策略。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-23 DOI: 10.1080/17476348.2026.2659383

Mario Cazzola, Raffaella Pagliaro, Alfredo De Biase, Andrea Bianco, Maria Gabriella Matera, Vincenzo Patella

{"title":"Respiratory health in a changing environment: environment-adaptive therapies and revised dosing strategies.","authors":"Mario Cazzola, Raffaella Pagliaro, Alfredo De Biase, Andrea Bianco, Maria Gabriella Matera, Vincenzo Patella","doi":"10.1080/17476348.2026.2659383","DOIUrl":"10.1080/17476348.2026.2659383","url":null,"abstract":"Introduction: Chronic airway diseases, such as asthma and COPD, are major contributors to global morbidity and the healthcare burden. Due to their heterogeneity and sensitivity to environmental factors, including air pollution, tobacco smoke, and occupational exposures, they are critical models for examining how the environment shapes disease biology and treatment response.Areas covered: This expert narrative review integrates mechanistic, clinical, and epidemiological evidence on the impact of environmental exposures on the biology of airway disease and therapeutic outcomes. A structured literature search was performed, prioritizing mechanistic studies, large cohorts, randomized trials, and high-quality reviews relevant to asthma and COPD endotypes, phenotypes, and environment-adaptive therapies. The evidence indicates that environmental exposures modulate inflammatory pathways, oxidative stress, and drug responsiveness. These exposures often account for variability in clinical outcomes and apparent treatment resistance.Expert opinion: Environmental exposures should be recognized as core biological modifiers that directly impact therapeutic efficacy, dosing requirements, and safety. Incorporating a systematic approach to environmental assessment into precision respiratory medicine allows for environment-adaptive therapies, optimizes pharmacological interventions, and reduces the risk of overtreatment. Future research and clinical protocols should integrate exposure metrics to personalize therapy, improve symptom control, and enhance long-term outcomes for patients with asthma and COPD.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-19"},"PeriodicalIF":2.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694315","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 treprostinil for pulmonary hypertension associated with interstitial lung disease: advances, challenges, and future directions. 吸入曲前列地尼治疗与间质性肺病相关的肺动脉高压：进展、挑战和未来方向

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-23 DOI: 10.1080/17476348.2026.2661412

Marianne Riou, Léon Genecand, Matthieu Canuet, Tristan Dégot, Xavier Jaïs, Marie-Camille Chaumais, Etienne-Marie Jutant, David Montani

{"title":"Inhaled treprostinil for pulmonary hypertension associated with interstitial lung disease: advances, challenges, and future directions.","authors":"Marianne Riou, Léon Genecand, Matthieu Canuet, Tristan Dégot, Xavier Jaïs, Marie-Camille Chaumais, Etienne-Marie Jutant, David Montani","doi":"10.1080/17476348.2026.2661412","DOIUrl":"https://doi.org/10.1080/17476348.2026.2661412","url":null,"abstract":"Introduction: Inhaled treprostinil (iTre) has recently emerged as a therapeutic option for severe pulmonary hypertension associated with interstitial lung disease (PH-ILD), combining pulmonary vasodilatory, antiproliferative, and potential anti-fibrotic effects, while minimizing systemic exposure and ventilation-perfusion mismatch.Areas covered: This review provides a comprehensive overview of iTre in PH-ILD, including its mechanisms of action, clinical efficacy, safety profile, and emerging applications in fibrotic ILD.Expert opinion: The phase 3 INCREASE study demonstrated improvements in exercise capacity, reduction in N-terminal pro-brain natriuretic peptide levels, and attenuation of clinical worsening events with iTre. Post-hoc analyses suggest potential benefits on lung function and ILD exacerbations, particularly in idiopathic pulmonary fibrosis, while efficacy appears less pronounced in combined pulmonary fibrosis and emphysema or in patients with milder pulmonary vascular disease. iTre is generally well tolerated, with airway-related adverse events most common, and systemic effects limited. Emerging long-acting and dry-powder inhaled formulations aim to improve adherence, reduce dosing frequency, and extend the therapeutic potential to fibrotic ILD without PH. iTre has thus emerged as the first targeted therapy for PH-ILD, with unique pharmacological and biological properties. Remaining challenges include optimal patient selection, confirmation of long-term benefits, and integration with antifibrotic or other pulmonary vasodilator therapies.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-17"},"PeriodicalIF":2.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147792978","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

From fibrosis to thrombosis: a systematic review and meta-analysis of venous thromboembolism risk in interstitial lung disease. 从纤维化到血栓形成：间质性肺病静脉血栓栓塞风险的系统回顾和荟萃分析

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-21 DOI: 10.1080/17476348.2026.2661949

Narat Srivali, Federica De Giacomi

{"title":"From fibrosis to thrombosis: a systematic review and meta-analysis of venous thromboembolism risk in interstitial lung disease.","authors":"Narat Srivali, Federica De Giacomi","doi":"10.1080/17476348.2026.2661949","DOIUrl":"10.1080/17476348.2026.2661949","url":null,"abstract":"Introduction: Interstitial lung disease (ILD) is characterized by chronic inflammation and fibrosis, with emerging evidence suggesting increased venous thromboembolism (VTE) risk. We conducted a systematic review and meta-analysis to quantify VTE risk in ILD patients compared to controls.Methods: We searched MEDLINE, EMBASE, and Cochrane databases from inception to January 2026 for observational studies examining ILD-VTE associations. Two investigators independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Random-effects meta-analyses examined overall VTE risk, specific subtypes (pulmonary embolism, deep vein thrombosis), and idiopathic pulmonary fibrosis (IPF)-specific populations.Results: Nine studies involving 7,892 ILD patients from six countries were included. ILD was associated with significantly elevated VTE risk (pooled RR 3.04, 95% CI: 1.96-4.70, p < 0.00001; moderate certainty evidence), with stronger associations for pulmonary embolism (RR 4.52, 95% CI: 1.84-11.10; moderate certainty) than deep vein thrombosis (RR 1.93, 95% CI: 1.15-3.23; low certainty). In IPF-specific populations, elevated VTE risk remained significant (RR 2.76, 95% CI: 1.71-4.45; moderate certainty). Substantial heterogeneity was observed (I2 = 80-95%).Conclusions: ILD is associated with three-fold increased VTE risk, particularly pulmonary embolism. These findings support heightened VTE awareness, risk stratification, and prophylaxis consideration during high-risk periods in ILD patients.Protocol registration: CRD420261285724.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725209","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

Time for proper physiological assessment: the role of cardiopulmonary exercise testing in helping step-up therapy in difficult-to-treat and severe asthma. 适当的生理评估时间：心肺运动试验在帮助加强治疗难治性和重度哮喘中的作用。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-07 DOI: 10.1080/17476348.2026.2656470

Ariel Fabian Floriani, Francesco Menzella

{"title":"Time for proper physiological assessment: the role of cardiopulmonary exercise testing in helping step-up therapy in difficult-to-treat and severe asthma.","authors":"Ariel Fabian Floriani, Francesco Menzella","doi":"10.1080/17476348.2026.2656470","DOIUrl":"10.1080/17476348.2026.2656470","url":null,"abstract":"Introduction: Persistent exertional dyspnea remains a major unmet need in patients with difficult-to-treat and severe asthma, even in the era of optimized inhaled therapy and biologics. Resting lung function and inflammatory biomarkers often fail to explain exercise intolerance, leading to empirical step-up therapy without clear physiological justification.Areas covered: This review discusses the role of cardiopulmonary exercise testing (CPET) in the evaluation of exertional dyspnea in difficult-to-treat and severe asthma, within the treatable traits framework. The review focuses on the main CPET-derived physiological patterns, including ventilatory limitation, dynamic hyperinflation, ventilatory inefficiency, dysfunctional breathing, deconditioning, cardiovascular limitation, exercise-induced laryngeal obstruction, and normal exercise physiology. It also examines how CPET may influence step-up decisions, support trait-directed interventions, and inform pharmacoeconomic considerations. A pragmatic clinical framework for selective integration of CPET into severe asthma assessment is proposed.Expert opinion: CPET may represent a valuable physiological adjunct in selected patients with difficult-to-treat or severe asthma and persistent exertional dyspnea insufficiently explained by resting assessments. Its integration into the assessment pathway may help contextualize symptoms, distinguish asthma-driven exercise limitation from non-inflammatory or non-asthmatic causes of dyspnea, and support more mechanism-based management. However, current evidence supports CPET primarily as a tool for physiological phenotyping and trait reclassification rather than as a prospectively validated guide to treatment escalation, biologic stewardship, or long-term outcome improvement.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.7,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611030","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

Indwelling pleural catheters for the treatment of malignant pleural effusions; where are we now? 胸腔留置导尿管治疗恶性胸腔积液我们现在在哪里？

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-30 DOI: 10.1080/17476348.2025.2582248

William E Thinnes, Jennifer D Duke, James Katsis, Samira Shojaee

{"title":"Indwelling pleural catheters for the treatment of malignant pleural effusions; where are we now?","authors":"William E Thinnes, Jennifer D Duke, James Katsis, Samira Shojaee","doi":"10.1080/17476348.2025.2582248","DOIUrl":"10.1080/17476348.2025.2582248","url":null,"abstract":"Introduction: Malignant pleural effusions (MPE) affect many patients with advanced malignant disease and lead to significant symptomatic burden. Management is primarily focused on controlling symptoms. IPCs are considered an alternative treatment strategy to chemical pleurodesis and in randomized clinical trials, are shown to have comparable outcomes with regards to symptom management such as dyspnea score and quality of life, and are associated with shorter length of hospital stay. Additional studies have examined the optimal drainage strategy for IPCs and the combination of IPC and pleurodesis. The most common complication is infection, and management differs based on the specific infection type. For many patients, IPCs are likely a cost-effective option for management of MPE compared to alternative approaches.Areas covered: This review article details the role of the indwelling pleural catheter (IPC) for symptom control, strategies for management, removal, complications, cost-effectiveness, and future directions.Expert opinion: There are various management options for MPE, each with their own advantages and disadvantages. Management should be personalized, with full knowledge of the patient's life expectancy, pleural space physiology, risks and benefits of each approach, and most importantly patient preferences.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"359-367"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380239","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

Managing treatment failure in pleural infection. 胸膜感染治疗失败的处理。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-12-08 DOI: 10.1080/17476348.2025.2600106

Malvika Bhatnagar, Rebecca Burney, Eihab O Bedawi

{"title":"Managing treatment failure in pleural infection.","authors":"Malvika Bhatnagar, Rebecca Burney, Eihab O Bedawi","doi":"10.1080/17476348.2025.2600106","DOIUrl":"10.1080/17476348.2025.2600106","url":null,"abstract":"Introduction: Pleural infection is a common condition associated with significant morbidity, mortality, and prolonged hospital stay. Whilst antibiotics and chest tube drainage comprise initial management, over one-third of patients experience medical treatment failure, necessitating intrapleural enzyme therapy (IET) or surgery. This review examines advances in diagnosis and management of treatment failure in pleural infection.Areas covered: A literature search of PubMed, Embase, and Cochrane Library (January 2005- April 2025) was performed using keywords related to pleural infection, diagnostics, biomarkers, and treatment interventions. Treatment failure emerged as a multifactorial process involving delayed presentation, structural and physiological barriers such as increased pleural fluid viscosity, septation formation, pleural thickening, and biofilm development, alongside host factors and microbiological complexity. We review current strategies including antibiotics, chest tube drainage, IET (tPA + DNase), and surgical options, alongside emerging modalities such as next-generation sequencing, pleural biopsy, medical thoracoscopy, saline irrigation, and indwelling catheters.Expert opinion: Early identification of treatment failure within 48 hours is crucial for guiding escalation. A precision medicine approach integrating microbiological, radiological, and host-response data may redefine standards of care and improve outcomes. Future priorities include early risk stratification, biomarker-guided therapy, microbiome-informed antibiotic strategies, and improving global access to effective treatments.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"425-436"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673198","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

Mesenchymal stromal cell-derived extracellular vesicles as a next-generation therapy for ARDS: mechanisms, advances, and future directions. 间充质间质细胞衍生的细胞外囊泡作为下一代治疗ards的方法：机制、进展和未来方向。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-11-06 DOI: 10.1080/17476348.2025.2583354

Zaquer Suzana Munhoz Costa-Ferro, Kátia Nunes da Silva, Rachel Santana Cunha, Gabriel Berbert de Oliveira, Pedro Augusto Dias Vieira Leite, Erik Aranha Rossi, Bruno Solano de Freitas Souza, Patricia Rieken Macedo Rocco

{"title":"Mesenchymal stromal cell-derived extracellular vesicles as a next-generation therapy for ARDS: mechanisms, advances, and future directions.","authors":"Zaquer Suzana Munhoz Costa-Ferro, Kátia Nunes da Silva, Rachel Santana Cunha, Gabriel Berbert de Oliveira, Pedro Augusto Dias Vieira Leite, Erik Aranha Rossi, Bruno Solano de Freitas Souza, Patricia Rieken Macedo Rocco","doi":"10.1080/17476348.2025.2583354","DOIUrl":"10.1080/17476348.2025.2583354","url":null,"abstract":"Introduction: Acute respiratory distress syndrome (ARDS) is a life-threatening syndrome characterized by diffuse alveolar damage, severe hypoxemia, and dysregulated inflammation. Despite improvements in lung-protective ventilation and supportive care, mortality remains high, highlighting the need for therapies targeting core mechanisms of injury and repair. Mesenchymal stromal cells (MSCs) have demonstrated therapeutic potential largely via paracrine mechanisms, with extracellular vesicles (EVs) emerging as a cell-free alternative that retains key MSC benefits while overcoming limitations related to cell viability, engraftment, and scalability.Areas covered: This review synthesizes current evidence on MSC-derived EVs (MSC-EVs) in ARDS, encompassing mechanisms of action, preclinical efficacy, delivery strategies, and translational challenges. Studies published from 2015 to 2025 were retrieved from PubMed, Web of Science, and ClinicalTrials.gov. Emphasis is placed on immunomodulatory effects, restoration of alveolar - capillary barrier integrity, and transfer of functional proteins, mRNAs, and microRNAs.Expert opinion: MSC-EVs represent a promising, disease-modifying therapy with potential to reduce ventilation duration, extracorporeal support, and overall healthcare burden. Key challenges remain, including standardized manufacturing, validated potency assays, and identification of patient selection biomarkers. Integration of bioengineering innovations, GMP-compliant production pipelines, and stratified clinical trial designs will be critical to accelerate translation and enable definitive evaluation in late-phase studies.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"407-423"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403304","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

Is dual bronchodilation a cost-effective alternative to ICS/LABA in COPD? A Colombian healthcare system evaluation. 对于慢性阻塞性肺病患者，双重支气管扩张是ICS/LABA的一种经济有效的替代方案吗？哥伦比亚医疗保健系统评估。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-30 DOI: 10.1080/17476348.2025.2582249

Jefferson Antonio Buendía, Diana Guerrero Patiño

{"title":"Is dual bronchodilation a cost-effective alternative to ICS/LABA in COPD? A Colombian healthcare system evaluation.","authors":"Jefferson Antonio Buendía, Diana Guerrero Patiño","doi":"10.1080/17476348.2025.2582249","DOIUrl":"10.1080/17476348.2025.2582249","url":null,"abstract":"Background: Chronic obstructive pulmonary disease (COPD) is a major public health challenge in Colombia, particularly among older adults. Although ICS/LABA combinations like fluticasone/salmeterol (FSC) are widely used, dual bronchodilation with umeclidinium/vilanterol (UMEC/VI) may offer clinical and economic advantages.The objective of this paper is to evaluate the long-term cost-effectiveness of UMEC/VI versus FSC in patients with moderate to severe COPD from the perspective of the Colombian healthcare system.Methods: A Markov model with four health states (moderate, severe, very severe COPD, and death) simulated the disease course over a lifetime horizon. Clinical efficacy and utilities were derived from randomized trials and meta-analyses; costs were sourced from national databases. Deterministic and probabilistic sensitivity analyses assessed uncertainty. The economic advantage of UMEC/VI was primarily driven by its ability to reduce moderate and severe exacerbations, which represent nearly 88% of total COPD-related healthcare costs in Colombia.Results: UMEC/VI yielded 8.74 additional QALYs compared to FSC, with an incremental cost of $7,039 USD, resulting in an ICER of $805 per QALY-well below Colombia's WTP threshold of $5,180. Sensitivity analyses confirmed model robustness; UMEC/VI remained cost-effective in 64% of simulations.Conclusion: UMEC/VI is a highly cost-effective alternative to FSC for moderate to severe COPD in Colombia, offering improved clinical outcomes and economic value for resource-constrained health systems.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"447-455"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380349","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