CHEST pulmonary最新文献

{"title":"Epidemiology and Clinical Outcomes of Cardiac Arrhythmias in Pulmonary Arterial Hypertension","authors":"Thanaboon Yinadsawaphan MD ,&nbsp;Mustafa Suppah MD ,&nbsp;Srekar N. Ravi MD ,&nbsp;Juan M. Farina MD ,&nbsp;Robert L. Scott MD, PhD ,&nbsp;Dan Sorajja MD","doi":"10.1016/j.chpulm.2024.100132","DOIUrl":"10.1016/j.chpulm.2024.100132","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac arrhythmias can exacerbate symptoms and potentially lead to death in patients with pulmonary hypertension. However, there is limited evidence regarding the impact of cardiac arrhythmias in patients with pulmonary arterial hypertension (PAH).</div></div><div><h3>Research Question</h3><div>What are the prevalence, incidence, and impact of arrhythmias in patients with PAH?</div></div><div><h3>Study Design and Methods</h3><div>In a retrospective cohort study including 512 patients with PAH from 2001 to 2021 at 3 Mayo Clinic sites, demographic data at PAH diagnosis and clinical outcomes over a 10-year period were collected. The patients with PAH were categorized into 3 groups based on arrhythmic onset: (1) patients with arrhythmia before PAH diagnosis, (2) patients diagnosed with arrhythmia during PAH follow-up, and (3) patients without arrhythmia during PAH follow-up. Survival outcomes were analyzed using multivariable Cox proportional hazards regression, adjusted with the REVEAL 2.0 risk score.</div></div><div><h3>Results</h3><div>Among the 512 patients with PAH (mean age, 56.1 years; 81.8% female), the prevalence of cardiac arrhythmias at PAH diagnosis was 10.5%, consisting of atrial fibrillation (7%), atrial flutter (2%), and supraventricular tachycardia (0.8%). The cumulative incidences of new-onset arrhythmias at 1, 5, and 10 years were 6%, 18%, and 29%, respectively. Patients with arrhythmia diagnosed before and after PAH diagnosis exhibited significantly higher all-cause mortality rates with adjusted hazard ratio of 2.06 (95% CI, 1.36-3.12) and 1.57 (95% CI, 1.17-2.20), respectively. Similarly, both arrhythmic groups demonstrated shorter median time to the first all-cause hospitalization (9.5 and 15.9 vs 21.2 months) and a higher number of all-cause hospitalizations (0.38 and 0.64 vs 0.10 times per year) compared with the nonarrhythmic group.</div></div><div><h3>Interpretation</h3><div>Our results demonstrate that cardiac arrhythmias can develop in nearly one-third of patients with PAH within 10 years of PAH diagnosis and independently contribute to increased hospitalization frequency and mortality, in addition to the current REVEAL 2.0 risk score.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100132"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620847","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}

{"title":"Feasibility and Pathologic Outcomes of Peripheral Lung Vascular Targeted Photodynamic Therapy in a Normal Porcine Lung Model","authors":"Jason Beattie ,&nbsp;Mario Ghosn ,&nbsp;Kwanghee Kim ,&nbsp;Raymond Parrish ,&nbsp;Jie Chen ,&nbsp;Stephen B. Solomon ,&nbsp;Sebastien Monette ,&nbsp;Christopher Cheleuitte-Nieves ,&nbsp;Reza Bergemann ,&nbsp;Mohit Chawla ,&nbsp;Bryan C. Husta ,&nbsp;Or Kalchiem-Dekel ,&nbsp;Yaniv Cohen ,&nbsp;Dina Preise ,&nbsp;Zachary Sacks ,&nbsp;Avigdor Scherz ,&nbsp;Lonny Yarmus ,&nbsp;Jonathan A. Coleman ,&nbsp;Robert P. Lee","doi":"10.1016/j.chpulm.2024.100098","DOIUrl":"10.1016/j.chpulm.2024.100098","url":null,"abstract":"<div><h3>Background</h3><div>Bronchoscopic ablation of tumors in the lung periphery may offer unique advantages over traditional surgical resection or radiation. Bronchoscopic vascular targeted photodynamic therapy (VTP) is a second-generation photodynamic therapy that avoids excessive tissue extravasation and is rapidly cleared from the circulation. These advantages avoid prolonged photosensitivity and allow for infusion and illumination within the same procedure. The treatment effect and systemic inflammatory response precipitated by VTP may prove advantageous for anticancer effects, alone or in combination with immune oncology therapies.</div></div><div><h3>Research Question</h3><div>A baseline understanding of this modality’s effect on lung parenchyma is needed to provide further guidance toward its potential as a method for bronchoscopic ablation of lung tumors. We report on our initial experimentation with bronchoscopic lung VTP in normal pigs.</div></div><div><h3>Study Design and Methods</h3><div>We performed conventional bronchoscopy for deployment of optical fibers into the peripheral lung. We then infused the photosensitizer WST11 after which we immediately performed illumination of the optical fibers.</div></div><div><h3>Results</h3><div>Our results across 13 pigs with varied survival (between 1 day and 30 days) demonstrate initial feasibility and reasonable safety. Posttreatment radiology and pathology support measurable ablation fields and expected post-VTP changes.</div></div><div><h3>Interpretation</h3><div>Our preclinical evidence provides early rationale for the study of safety and feasibility of bronchoscopic VTP ablation of peripheral lung cancers in humans.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578831","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}

{"title":"Health State Utilities Associated With Treatment Burden in Cystic Fibrosis","authors":"Rory A. Cameron PhD, MScPH ,&nbsp;Jessie Matthews MSc ,&nbsp;Daniel Office BSc ,&nbsp;Mark Rowley ,&nbsp;Janice Abbott PhD ,&nbsp;Nicholas J. Simmonds MD ,&nbsp;Jennifer A. Whitty PhD ,&nbsp;Siobhán B. Carr MBBS, MSc","doi":"10.1016/j.chpulm.2024.100097","DOIUrl":"10.1016/j.chpulm.2024.100097","url":null,"abstract":"<div><h3>Background</h3><div>Although recent advancements in the treatment of cystic fibrosis (CF) have improved survival, reducing high levels of treatment burden remains a priority issue for many people with cystic fibrosis (pwCF). However, economic evaluations of novel interventions may fail to capture their impact on treatment burden due to a lack of suitable outcome measures. This study aimed to estimate health state utilities (HSUs) for changes in treatment burden associated with different CF treatments.</div></div><div><h3>Research Question</h3><div>What value do pwCF place on changes in treatment burden associated with IV antibiotic treatment of pulmonary exacerbations, use of inhaled medicines, and physiotherapy?</div></div><div><h3>Study Design and Methods</h3><div>Adults attending a specialist CF center were invited to participate in a web-based time trade-off interview. Participants valued their own health and five health state vignettes describing varying levels of intensity of physiotherapy, use of inhaled medicines, and IV antibiotic treatment. HSUs for additional instances of each treatment type were estimated using mixed effect linear regression models.</div></div><div><h3>Results</h3><div>Fifty one pwCF completed the interview (median age, 30 years; range, 19-66); 53% were female; mean FEV₁ % predicted was 65% (SD, 20%). Mean utility scores for own health were very similar between the EQ-5D index value (0.81; SD, 0.20) and the time trade-off value (0.82; SD, 0.20); however, limited concordance was observed at the individual level. Adjusted utility decrements associated with treatment burden were −0.037 (SE, 0.008) for an additional annual IV antibiotic treatment, −0.029 (SE, 0.014) for an additional daily physiotherapy session, and −0.019 (SE, 0.013) for an additional daily inhaled medicine.</div></div><div><h3>Interpretation</h3><div>In this study, increasing treatment burden was associated with decreasing HSU values. The utility decrements associated with treatment burden changes suggest meaningful differences in health-related quality of life for pwCF. These findings align with existing literature on the impact of treatment burden on health-related quality of life, and highlight the importance of considering treatment burden in economic evaluations of interventions in CF.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620843","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}

{"title":"Association of Oxygen Saturation on Home Pulse Oximetry With Telephone Triage Decision","authors":"Diana C. Bouhassira MD ,&nbsp;Taylor Bernstein MPH ,&nbsp;Ashraf Fawzy MD, MPH ,&nbsp;Theodore J. Iwashyna MD, PhD ,&nbsp;Mariah L. Robertson MD, MPH","doi":"10.1016/j.chpulm.2024.100129","DOIUrl":"10.1016/j.chpulm.2024.100129","url":null,"abstract":"<div><h3>Background</h3><div>Given limited tools for objective assessment during telephone triage, home pulse oximeters may augment clinical decision-making in patients with respiratory conditions. However, there are well-documented concerns about clinically significant, race-discrepant pulse oximetry error.</div></div><div><h3>Research Question</h3><div>Is home pulse oximetry incorporated into telephone triage decision-making and is it associated with triage disposition?</div></div><div><h3>Study Design and Methods</h3><div>In this retrospective study, we reviewed electronic medical record documentation regarding telephone calls to the pulmonary clinic triage line at a university-affiliated tertiary care center. All adults who called the triage line with an acute complaint between May 1, 2023, and October 31, 2023, were included. We tested the association between reported abnormal oxygen saturation and triage decision.</div></div><div><h3>Results</h3><div>A total of 118 telephone triage notes were reviewed. Median patient age was 50 years (interquartile range, 34-62), with 85 calls (72%) from White patients and 24 calls (20%) from Black patients. Of the calls, 70% (n = 83) were for respiratory symptoms. Pulse oximeter use was reported in 29 notes. No notes documented consideration of factors that might influence pulse oximeter accuracy. Among calls for respiratory symptoms, 24 (29%) discussed home pulse oximetry. Twenty-one calls (18%) were referred to the emergency department or hospital, and 12 (10%) were referred for an urgent visit. In multivariable analysis, patients with respiratory symptoms and peripheral oxygen saturation &lt; 90% had 22.3 times the odds (95% CI, 1.9-258.9; <em>P</em> = .01) of being triaged to in-person care.</div></div><div><h3>Interpretation</h3><div>In this study, providers documented home pulse oximetry readings in 1 in 3 patients calling the pulmonary triage line with respiratory symptoms. Patients with abnormal oxygen saturation were more likely to be triaged to in-person evaluation. Given the current state of widely available, variably accurate, and racially biased pulse oximeters, there is an opportunity for standardization of how triaging providers assess home pulse oximetry data and counsel patients on their limitations.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611684","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}

{"title":"Validation of a High-Specificity Blood Autoantibody Test to Detect Lung Cancer in Pulmonary Nodules","authors":"Kathryn J. Long MD ,&nbsp;Gerard A. Silvestri MD ,&nbsp;Michael N. Kammer PhD ,&nbsp;Sarah Gibbs MD ,&nbsp;Wei Wu MD, PhD ,&nbsp;Monica Johal MPH ,&nbsp;Sudhakar Pipavath MD ,&nbsp;Trevor Pitcher PhD ,&nbsp;James Jett MD ,&nbsp;Viswam S. Nair MD","doi":"10.1016/j.chpulm.2024.100130","DOIUrl":"10.1016/j.chpulm.2024.100130","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary nodules (PNs) are frequently detected by chest CT scan, which is increasingly used in clinical practice. Accurately identifying malignant nodules can pose a diagnostic challenge; therefore, a high-specificity biomarker could help clinicians identify malignant nodules and ideally lead to the earlier diagnosis of lung cancer.</div></div><div><h3>Research Question</h3><div>What are the performance characteristics of a blood-based biomarker for identifying malignancy in patients with a CT-detected PN?</div></div><div><h3>Study Design and Methods</h3><div>Banked plasma samples from 2 independent prospective observational cohorts of patients presenting with benign or malignant PNs 8 to 30 mm in size were tested using a 7-autoantibody panel. Sensitivity, specificity, and positive predictive value of the autoantibody test (AAT) to identify cancer were calculated for the individual and combined cohorts.</div></div><div><h3>Results</h3><div>Overall, 447 patients (263 and 184 from each cohort) were included in the analysis with a prevalence of malignancy of 55%. The performance of the AAT between the 2 cohorts was similar. The AAT demonstrated a specificity of 90% (95% CI, 85%-93%), a positive predictive value of 66% (95% CI, 52%-77%), sensitivity of 16% (95% CI, 12%-22%), and false-positive rate of 10% in the combined cohort. Using a pretest probability of cancer cutoff of 20% improved the positive predictive value to 76% (95% CI, 61%-88%) and resulted in a 52% decrease in the number of false-positive test results. In the subset of patients who had 18F-fluorodeoxyglucose PET imaging performed for clinical purposes (n = 222), specificity of the AAT was higher (93% vs 58%, <em>P</em> &lt; .001), but the sensitivity was lower than 18F-fluorodeoxyglucose PET scan (17% vs 75%, <em>P</em> &lt; .001).</div></div><div><h3>Interpretation</h3><div>This study validates the specificity of a blood-based autoantibody biomarker for identifying malignancy in patients with indeterminate PNs. This rule-in biomarker may help to expedite workup of malignant nodules.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: NCT01752114; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620849","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}

{"title":"A 77-Year-Old Man With Unexplained Hypoxemia","authors":"Patrick Pasqualicchio DO ,&nbsp;Maria Siow MD ,&nbsp;Shanaka Peiris MD ,&nbsp;Imran Arif MD ,&nbsp;Rishi Sukhija MD ,&nbsp;Jean Elwing MD ,&nbsp;Arun Jose MD","doi":"10.1016/j.chpulm.2024.100119","DOIUrl":"10.1016/j.chpulm.2024.100119","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571494","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}

{"title":"High BMI and COPD Outcomes in Alpha-1 Antitrypsin Deficiency","authors":"Michael A. Campos MD ,&nbsp;Leonard Riley MD ,&nbsp;Jorge Lascano MD ,&nbsp;Brian Garnet MD ,&nbsp;Robert Sandhaus MD, PhD","doi":"10.1016/j.chpulm.2024.100113","DOIUrl":"10.1016/j.chpulm.2024.100113","url":null,"abstract":"<div><h3>Background</h3><div>Elevations in BMI impact morbidity in patients with COPD in general, but little is known about its impact in patients with COPD due to alpha-1 antitrypsin deficiency (AATD-COPD).</div></div><div><h3>Research Question</h3><div>What is the prevalence and clinical impact of high BMI in AATD-COPD?</div></div><div><h3>Study Design and Methods</h3><div>A total of 646 patients completed clinical and health-related quality of life (HRQoL) questionnaires for 2 years. Patients were grouped by baseline BMI categories (underweight, normal, overweight, obese, and morbidly obese) to compare symptoms, exacerbations, HRQoL, and 5- and 10-year survival. Relation between changes in BMI over time on HRQoL was assessed.</div></div><div><h3>Results</h3><div>The cohort’s mean age ± SD (55 ± 9.2 years), sex distribution (50.1% male), and mean % FEV₁ ± SD (36.6% ± 17.0%) was similar across all BMI categories. One-third (31.6%) had normal BMI, 5.6% were underweight, and 62% had a high BMI (37.3% overweight, 16.1% obese, and 9.4% morbidly obese). Patients with a high BMI had significantly worse St. George’s Respiratory questionnaire (SGRQ) and 36-Item Short Form Survey (SF-36) physical composite scores than patients with normal weight. Patients with morbid obesity had the highest odds of being in the worst SGRQ (OR, 3.8; 95% CI, 1.9-7.8) and SF-36 physical composite (OR, 4.2; 95% CI, 2.1-8.1) quartiles and experienced more emergency department visits and hospitalizations than patients with normal weight (<em>P</em> &lt; .05). Patients who transitioned to a higher BMI category over time reported worsening of SGRQ and SF-36 physical composite scores (<em>P</em> &lt; .05) and vice versa. Despite their higher morbidity, no difference in survival was observed between patients with high BMI and normal BMI after a mean follow-up of 9 years.</div></div><div><h3>Interpretation</h3><div>BMI above normal is prevalent in patients with AATD-COPD and is associated with greater comorbidity and poor HRQoL but does not impact survival. HRQoL is inversely affected by BMI changes over time.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579516","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}

{"title":"Exercise Capacity Following Pulmonary Embolism in Children and Adolescents","authors":"Mackenzie Parker MD ,&nbsp;Joshua Greer PhD ,&nbsp;Surendranath Veeram Reddy MD ,&nbsp;Maria Bano MD ,&nbsp;Manal Al-Qahtani MD ,&nbsp;Jeannie Dillenbeck MD ,&nbsp;Sean Rinzler MD ,&nbsp;Michael D. Nelson PhD ,&nbsp;Ang Gao PhD ,&nbsp;Song Zhang PhD ,&nbsp;Andrew R. Tomlinson MD ,&nbsp;Tony G. Babb PhD ,&nbsp;Ayesha Zia MD, MSCS","doi":"10.1016/j.chpulm.2024.100073","DOIUrl":"10.1016/j.chpulm.2024.100073","url":null,"abstract":"<div><h3>Background</h3><div>Self-reported physical activity after pediatric pulmonary embolism (PE) is reduced after diagnosis. However, objectively measured exercise capacity and mechanisms of exercise pathophysiology after PE are unknown.</div></div><div><h3>Research Question</h3><div>Does exercise capacity 1 year after acute PE in children differ from control patients?</div></div><div><h3>Study Design and Methods</h3><div>This case-control study compared exercise capacity and responses to maximal exercise in PE survivors with control patients. We also investigated the association of low exercise capacity after PE with prespecified clinical/radiologic features at PE diagnosis and elucidated the cause of functional limitations. The primary study outcome was exercise capacity defined by peak oxygen consumption (<span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span><span>o</span>₂peak) as a percent predicted on cardiopulmonary exercise testing (CPET), with &lt; 80% predicted <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span><span>o</span>₂peak considered abnormal/low. Ventilatory inefficiency was defined as ratio of ventilation to CO₂ production on CPET slope &gt; 30 and abnormal stroke volume augmentation as oxygen pulse &lt; 10 mL/beat at peak exercise. Logistic regression was performed to assess the association of prespecified variables with low <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span><span>o</span>₂peak.</div></div><div><h3>Results</h3><div>We compared 25 consecutive pediatric PE survivors who completed CPET 1 year after diagnosis with 25 control patients who underwent CPET within the same period and were otherwise healthy. Exercise capacity was reduced in eight of the 25 PE survivors (32%) at 1 year after diagnosis vs two of the 25 control participants (8%) (<em>P</em> = .034). PE survivors with low exercise capacity demonstrated elevated ratio of ventilation to CO₂ production on CPET slope (<em>P</em> = .01) and a decreased oxygen pulse at peak exercise (<em>P</em> = .001), consistent with cardiovascular limitation. In univariable analysis, PE category, pulmonary vascular obstruction by the Qanadli index, or right ventricular dysfunction at diagnosis was not associated with low exercise capacity.</div></div><div><h3>Interpretation</h3><div>In this study, abnormal exercise capacity of cardiopulmonary origin occurred in one of three pediatric PE survivors despite anticoagulation and irrespective of PE severity, degree of pulmonary vascular obstruction, or right ventricular dysfunction at diagnosis. Cardiorespiratory fitness should be formally considered to develop rehabilitation interventions after pediatric PE.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398898","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}

{"title":"A National Survey of Spirometry Interpretation Practices","authors":"Kevin Hachey MD, MPH ,&nbsp;Sande Okelo MD, PhD ,&nbsp;Francesca Duncan MD ,&nbsp;Aaron Baugh MD ,&nbsp;Stephanie Lovinsky-Desir MD ,&nbsp;Joseph P. Smith MD","doi":"10.1016/j.chpulm.2024.100118","DOIUrl":"10.1016/j.chpulm.2024.100118","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571493","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}

{"title":"Long-Term Efficacy of Dupilumab in Moderate-to-Severe Asthma Phenotyped by Blood Eosinophils and Exhaled Nitric Oxide","authors":"Michael E. Wechsler MD ,&nbsp;Ian D. Pavord MD ,&nbsp;Alberto Papi MD ,&nbsp;Kenneth R. Chapman MD ,&nbsp;Arman Altincatal MS ,&nbsp;Nami Pandit-Abid PharmD ,&nbsp;Juby A. Jacob-Nara MD ,&nbsp;Paul J. Rowe MD ,&nbsp;Yamo Deniz MD ,&nbsp;Elizabeth Laws PhD ,&nbsp;Bolanle Akinlade MD ,&nbsp;Nikhil Amin MD ,&nbsp;Heribert W. Staudinger MD ,&nbsp;David J. Lederer MD ,&nbsp;Megan Hardin MD","doi":"10.1016/j.chpulm.2024.100072","DOIUrl":"10.1016/j.chpulm.2024.100072","url":null,"abstract":"<div><h3>Background</h3><div>Asthma treatment aims to reduce symptom severity and exacerbation risk. Dupilumab, a human monoclonal antibody, blocks the shared receptor for IL-4/IL-13, key drivers of type 2 inflammation. In the Evaluation of Dupilumab in Patients With Persistent Asthma (QUEST) study (NCT02414854), add-on dupilumab every 2 weeks vs placebo was shown to significantly reduce severe asthma exacerbations and improve prebronchodilator (BD) FEV₁ in patients with uncontrolled, moderate-to-severe asthma. Treatment effects were greater in patients with elevated baseline type 2 biomarkers (blood eosinophil count ≥ 150 cells/μL or fractional exhaled nitric oxide ≥ 25 parts per billion).</div></div><div><h3>Research Question</h3><div>What is dupilumab’s long-term efficacy (up to 3 years) in patients with moderate-to-severe type 2 asthma?</div></div><div><h3>Study Design and Methods</h3><div>Patients enrolled in QUEST (receiving placebo or dupilumab), who completed 96 weeks of dupilumab treatment in the open-label extension Long-Term Safety Evaluation of Dupilumab in Patients With Asthma (TRAVERSE) study (NCT02134028), were included. This prespecified analysis evaluated long-term efficacy in patient populations identified by baseline type 2 biomarker level. End points were annualized exacerbation rate (AER) and change from baseline in pre-BD FEV₁ (L), asthma control (5-item Asthma Control Questionnaire), and asthma-related quality of life (Asthma Quality of Life Questionnaire).</div></div><div><h3>Results</h3><div>A total of 663 patients were included. AER was 1.72 to 2.24 at QUEST baseline in dupilumab groups across type 2 populations. AER decreased in populations with elevated type 2 biomarkers to 0.36 to 0.49 during QUEST’s 52-week treatment period, which was sustained over 96 weeks in TRAVERSE. In patients with low type 2 biomarker levels, there was no clinically meaningful AER reduction in QUEST or TRAVERSE, but rates remained below parent study baseline. Similar trends were seen with improvements in pre-BD FEV₁, 5-item Asthma Control Questionnaire, and Asthma Quality of Life Questionnaire; greatest improvements were seen in groups with one or more elevated type 2 biomarker.</div></div><div><h3>Intrepretation</h3><div>This study suggests that long-term dupilumab treatment results in sustained and clinically meaningful efficacy in patients with moderate-to-severe type 2 asthma characterized by elevated blood eosinophil count and/or fractional exhaled nitric oxide.</div></div><div><h3>Clinical Trial Registration</h3><div>ClinicalTrials.gov; No.: NCT02134028; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691503","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}