Respiratory medicine
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Respiratory medicine · May 2019
Disease burden and efficacy of mepolizumab in patients with severe asthma and blood eosinophil counts of ≥150-300 cells/μL.
In patients with severe eosinophilic asthma, treatment decisions can be determined by blood eosinophil counts; however, a specific blood eosinophil threshold has not been defined for starting mepolizumab treatment. ⋯ There is a high unmet clinical need in patients with blood eosinophil counts ≥150-300 cells/μL, and a clinically meaningful benefit is seen with mepolizumab in this subgroup. Mepolizumab is an efficacious treatment option for patients with blood eosinophil counts ≥150 cells/μL.
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Respiratory medicine · Apr 2019
Review Comparative StudyAcute exacerbation of interstitial lung disease after procedures.
Interstitial lung disease (ILD) is a category of diffuse parenchymal lung diseases characterized by inflammation and/or fibrosis. The best characterized ILD is idiopathic pulmonary fibrosis (IPF). Acute exacerbation of IPF is a dreaded occurrence with grim prognosis and suboptimal treatment options. ⋯ This review summarizes the available information on AE-ILD and discusses the procedures reported to cause AE-ILD. We also discuss proposed mechanisms, risk factors, treatment and prognosis. This review should help to inform decision-making about risks versus benefits of procedures that are commonly recommended to diagnose ILD.
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Respiratory medicine · Apr 2019
Comparative Study Clinical TrialEffect of bronchial thermoplasty on structural changes and inflammatory mediators in the airways of subjects with severe asthma.
Bronchial thermoplasty (BT) is a novel technique used in the treatment of subjects with severe refractory asthma. Radiofrequency is provided to airway walls during bronchoscopy in order to reduce airway remodeling. Several clinical studies have reported an improvement in subjects' symptoms following BT. However, how BT affects the airway architectures and inflammatory mediators in the airways has not been yet fully elucidated. ⋯ and Clinical Relevance: This study suggests that BT reduces airway smooth muscle mass and the airway innervation without affecting vasculature and the production of inflammatory mediators in the airways of subjects with severe asthma.
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Respiratory medicine · Apr 2019
Comparative StudyOutcomes of lung disease-associated pulmonary hypertension and impact of elevated pulmonary vascular resistance.
The clinical characteristics, hemodynamic changes and outcomes of lung disease-associated pulmonary hypertension (LD-PH) are poorly defined. ⋯ Despite less severe PH and less right heart sequelae, LD-PH has an equally poor clinical outcome when compared to iPAH. A PVR ≥7 Wood units in LD-PH patients was associated with 3-fold higher mortality.
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Respiratory medicine · Apr 2019
Comparative StudyClinical, serological and radiological features of a prospective cohort of Interstitial Pneumonia with Autoimmune Features (IPAF) patients.
The term Interstitial Pneumonia with Autoimmune Features (IPAF) describes patients with Interstitial Lung Diseases (ILDs) and clinical or serological features of autoimmune diseases insufficient to reach a specific classification of a Connective Tissue Disease (CTD). Currently, retrospective studies on IPAF patients have proven to be heterogeneous in general characteristics, outcomes and High-Resolution Computed Tomography (HRCT) pattern. This study aims to describe for the first time the clinical, serological and radiological features of a prospective cohort of IPAF patients. This cohort is then compared to a group of patients with Idiopathic Pulmonary Fibrosis (IPF). ⋯ This is the first report of a prospective cohort of IPAF patients. IPAF patients seem to have a less severe lung disease than IPF. IPAF criteria probably need to be revisited and validated, but their capacity to recruit patients with incomplete forms or early onset of CTD could be useful for further research.