Pulmonary pharmacology & therapeutics最新文献

{"title":"Impact on beclometasone dipropionate pharmacokinetics when switching to a low global warming potential propellant in a pressurised metered-dose inhaler","authors":"François Rony ,&nbsp;Maria Gloria Pittelli ,&nbsp;Cristina Contursi ,&nbsp;Ilaria Pacchetti ,&nbsp;Emanuele Rocco Calabrò ,&nbsp;Luca Vittorio Viganò ,&nbsp;Kusum S. Mathews ,&nbsp;Gianluigi Poli ,&nbsp;Katrin Van Leuven ,&nbsp;Matteo Martini","doi":"10.1016/j.pupt.2025.102356","DOIUrl":"10.1016/j.pupt.2025.102356","url":null,"abstract":"<div><h3>Introduction</h3><div>Use of high global warming potential propellants (e.g., HFA-134a) for pressurised metered-dose inhalers (pMDIs) is being phased down. Beclometasone dipropionate (BDP) is approved for the treatment of asthma in several countries via an HFA-134a propellant pMDI. This is being reformulated using the low global warming potential propellant HFA-152a. Two studies compared BDP pharmacokinetics delivered via pMDI using HFA-152a vs HFA-134a.</div></div><div><h3>Methods</h3><div>Both studies (N = 71/study) were single-dose (four inhalations of BDP), randomised, double-blind, crossover (Study 1, four-way; Study 2, two-way), in healthy volunteers. In Study 1, subjects inhaled BDP via HFA-134a pMDI in two periods (200 μg/actuation in one period, 100 μg/actuation in the other) and HFA-152a pMDI in the other two (200 or 100 μg/actuation). In Study 2, subjects inhaled BDP 200 μg/actuation via HFA-134a or HFA-152a pMDI using a spacer device.</div><div>pMDIs containing HFA-152a and HFA-134a were compared in terms of lung availability (BDP comparisons) and total systemic exposure (beclometasone-17-monopropionate comparisons [B17MP; active metabolite of BDP]), with bioequivalence concluded if the 90 % confidence intervals (CIs) of the geometric mean ratios of maximum plasma concentration (C_max) and area under the plasma concentration–time curve between time zero and the last quantifiable timepoint (AUC_0–t) were between 80 and 125 %.</div></div><div><h3>Results</h3><div>BDP C_max and AUC_0-t were equivalent for the two BDP 200 μg formulations, without (Study 1) and with spacer (Study 2). BDP 100 μg AUC_0-t met the bioequivalence criteria, but the C_max lower 90 % CI was marginally below the bioequivalence limit (79.46 %). B17MP C_max and AUC_0-t were bioequivalent with both propellants in all three comparisons.</div></div><div><h3>Conclusions</h3><div>Overall, bioequivalence was confirmed of HFA-152a and HFA-134a for BDP 200 μg/actuation, with and without a spacer. Although bioequivalence of the two formulations cannot be formally concluded for BDP 100 μg, the minimal difference suggests the two formulations can be considered therapeutically equivalent.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"89 ","pages":"Article 102356"},"PeriodicalIF":3.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug repurposing tactics in the USA: Known active pharmaceutical ingredients in new indications","authors":"Thomas P. Dooley","doi":"10.1016/j.pupt.2025.102348","DOIUrl":"10.1016/j.pupt.2025.102348","url":null,"abstract":"","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"89 ","pages":"Article 102348"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Clinical efficacy of inhaled corticosteroids in equine asthma: A meta-analysis and number needed to treat” [Pulm. Pharmacol. Therapeut. (88), March 2025, 102342]","authors":"Elena Pistocchini ,&nbsp;Alicia Maria Carrillo Heredero ,&nbsp;Melissa Mazan ,&nbsp;Laurent Couetil ,&nbsp;Simone Bertini ,&nbsp;Luigino Calzetta","doi":"10.1016/j.pupt.2024.102343","DOIUrl":"10.1016/j.pupt.2024.102343","url":null,"abstract":"","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"88 ","pages":"Article 102343"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bispecific domain antibody attenuates airway hyperresponsiveness and pulmonary inflammation in ovalbumin-lipopolysaccharide induced asthma model by inhibiting IL-23 and TNF-α","authors":"Chirag Ketan Gala ,&nbsp;Sandeep ,&nbsp;Abhay H. Pande ,&nbsp;Shyam Sunder Sharma","doi":"10.1016/j.pupt.2025.102347","DOIUrl":"10.1016/j.pupt.2025.102347","url":null,"abstract":"<div><div>Asthma, a chronic multi-factorial pulmonary inflammatory condition with a high morbidity rate, is characterized by airway hyperresponsiveness and persistent pulmonary inflammation. There is a need to develop more effective treatment(s) for the management of asthma. In this study, we have investigated the therapeutic potential of BiSpekDAb (an engineered bispecific antibody comprising an anti-IL-23 domain antibody and an anti-TNF-α domain antibody fused together via flexible linkers to a half-life extension partner) in asthma. Asthma was established by sensitization and challenge of female Wistar rats with the combination of ovalbumin and lipopolysaccharide and the efficacy of BiSpekDAb was investigated by its subcutaneous administration for 11 days on each alternative day (6 doses) during the challenge phase. Significant deterioration of pulmonary functions, enhanced airway hyperresponsiveness, increase in the number of immune cells such as lymphocytes, eosinophils, neutrophils in blood circulation as well as in lungs, enhanced production of inflammatory cytokines (IL-23, TNF-α, IL-1β, IL-6, IL-22), allergic IgE antibodies, oxidative stress markers, and histopathological changes (thickening of epithelial lining, infiltration of immune cells, mast cell degranulation, and overproduction of mucus) were observed in asthma animals, and administration of BiSpekDAb attenuated airway hyperresponsiveness (AHR), pulmonary inflammation and other pathological changes. BiSpekDAb significantly inhibited IL-23 and TNF-α levels in the lungs of asthmatic rats. Our results suggest that targeting IL-23 and TNF-α simultaneously opens a new therapeutic window for biologics development aimed at mitigating pulmonary inflammation such as asthma.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"88 ","pages":"Article 102347"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel synergistic therapeutic approach in idiopathic pulmonary fibrosis: Combining the antifibrotic nintedanib with the anti-inflammatory baricitinib","authors":"Qin Wan ,&nbsp;Dongdong Li ,&nbsp;Shu Shang ,&nbsp;Haifeng Wu ,&nbsp;Faxiu Chen ,&nbsp;Qiugen Li","doi":"10.1016/j.pupt.2025.102346","DOIUrl":"10.1016/j.pupt.2025.102346","url":null,"abstract":"<div><h3>Background</h3><div>Baricitinib and nintedanib can target inflammation and fibrosis respectively, which are the two most important processes in idiopathic pulmonary fibrosis (IPF). However, it is still unknown whether targeting these two processes simultaneously can synergistically improve the therapeutic effect of IPF. Therefore, it is necessary to predict the possible translational potential through preclinical studies.</div></div><div><h3>Methods</h3><div>We evaluated both the <em>in vitro</em> and <em>in vivo</em> efficacy of a drug combination, nintedanib with baricitinb, a JAK1/JAK2 inhibitor. We first examined the fibroblast proliferation and myofibroblast differentiation of single agents or combinations by the MTT assay. Then we determined the migration of the fibroblasts by a wound healing assay. Meanwhile, we quantified the protein level of related growth factor or cytokines in the cell supernatant by ELISA. Finally, we investigated the therapeutic potential and mechanism in a bleomycin-induced mouse model.</div></div><div><h3>Results</h3><div>Our results showed that the combination of nintedanib and baricitinib was more effective in suppressing fibroblast proliferation, myofibroblast transformation and fibroblast migration compared to either agent alone. In a bleomycin-induced IPF mouse model, the combination therapy resulted in a higher survival rate, increased body weight, and a lower lung/body weight ratio compared to the individual drugs. Moreover, both drugs improved lung functions in mice, but their combined administration led to superior outcomes. Histopathological analysis also revealed that the combination therapy mitigated pulmonary inflammation and fibrosis to a greater extent than the individual compounds. Mechanistically, baricitinib appears to orchestrate the effects of nintedanib in IPF by modulating the expression of genes such as <em>il-6</em>, <em>tgf-β</em>, <em>col1α1</em> and <em>fibronectin</em>.</div></div><div><h3>Conclusion</h3><div>The synergistic targeting of inflammation by baricitinib and fibrosis by nintedanib preclinically improves IPF outcomes, thus suggesting their potential as a novel combination therapy for this condition.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"89 ","pages":"Article 102346"},"PeriodicalIF":3.3,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-life impact of genotype and severity of lung disease on efficacy of elexacaftor-tezacaftor-ivacaftor in people with cystic fibrosis","authors":"Shahid Sheikh ,&nbsp;Melissa Holtzlander ,&nbsp;Mariah Eisner ,&nbsp;Courtney Gushue ,&nbsp;Sabrina Palacios ,&nbsp;Kavitha Kotha ,&nbsp;Sehyr Imran ,&nbsp;Karen S. McCoy","doi":"10.1016/j.pupt.2025.102345","DOIUrl":"10.1016/j.pupt.2025.102345","url":null,"abstract":"<div><h3>Background</h3><div>Elexacaftor-tezacaftor-ivacaftor (ETI) therapy has shown improvement in lung function, BMI and reduction in pulmonary exacerbations but the impact of genotype and severity of lung disease on heterogeneity of ETI efficacy in real life is not known.</div></div><div><h3>Methods</h3><div>This is a prospective observational study. Clinical data at baseline and at one-year of therapy were compared for the total cohort and for two subgroups; genotype [homozygous vs. heterozygous for F508del], and severity of lung disease at ETI initiation (ppFEV₁ &lt;80 % vs. ≥80 %).</div></div><div><h3>Results</h3><div>Among the total cohort of 115 pwCF, median age of 23 (17, 32) years, 66 (58 %) were homozygous, 76 (66 %) had ppFEV₁ &lt;80 %. Significant increases in mean ppFEV₁ and mean BMI and decrease in MRSA and Pa culture positivity on sputum/throat swab were observed at one year of ETI therapy in the total cohort, and in groups based on either genotype or disease severity (p &lt; 0.05 in all). Comparing one-year prior to one-year on ETI therapy, significant improvements were noted in pulmonary exacerbations, hospital admissions, antibiotic courses, number of pwCF receiving daily chest therapy, dornase alfa and hypertonic saline in the total cohort and in all four subgroups (p &lt; 0.05 for all). Though improvements were not dependent on genotype, we noted larger mean differences in ppFEV₁, BMI, pulmonary exacerbations and antibiotic use in the group with more severe lung disease (ppFEV₁ &lt;80 %) after one year of ETI therapy.</div></div><div><h3>Conclusion</h3><div>ETI therapy improved clinical outcomes in pwCF which were impacted by severity of underlying lung disease.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"88 ","pages":"Article 102345"},"PeriodicalIF":3.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-10RA promotes lung cancer cell proliferation by increasing fatty acid oxidation via STAT3 signaling pathway","authors":"Wei Du ,&nbsp;Yuqing Ouyang ,&nbsp;Xiaofan Feng ,&nbsp;Chunyan Yu,&nbsp;Haoke Zhang,&nbsp;Siqi Chen,&nbsp;Zixuan Liu,&nbsp;Bo Wang,&nbsp;Xueying Li,&nbsp;Zihe Liu,&nbsp;Weimin Deng","doi":"10.1016/j.pupt.2025.102344","DOIUrl":"10.1016/j.pupt.2025.102344","url":null,"abstract":"<div><div>Metabolic reprogramming in tumor cells plays a crucial role in promoting cell proliferation and metastasis, and is currently recognized as a significant marker of tumor progression. Interleukin-10 receptor subunit alpha (IL-10RA), a member of the type II cytokine receptor family, is predominantly expressed on macrophages and T cells and plays a crucial role in regulating immune cell metabolism and immune response. However, its role in the energy metabolic pathways of tumor cells remains unclear. In this study, we found increased expression of IL-10RA in human non-small cell lung cancer (NSCLC), and a correlation between increased IL-10RA expression and tumor stage, tumor size, and short overall survival of patients with NSCLC. IL-10RA overexpression significantly promoted the proliferation of NSCLC cell lines and enhanced glycolysis and fatty acid oxidation (FAO), thereby boosting energy production. Correspondingly, the downregulation of IL-10RA inhibited proliferation, glycolysis, and FAO in NSCLC cell lines. Bioinformatic analyses indicated that IL-10RA upregulates the signal transducer and activator of transcription 3 (STAT3) signaling pathway. STAT3 inhibitor effectively blocked the increase in FAO levels and cell proliferation induced by IL-10RA overexpression. These findings suggest that IL-10RA accelerates NSCLC cell proliferation by increasing FAO levels via the STAT3 pathway, highlighting IL-10RA as a potential therapeutic target for NSCLC.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"88 ","pages":"Article 102344"},"PeriodicalIF":3.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of inhaled corticosteroids in equine asthma: A meta-analysis and number needed to treat","authors":"Elena Pistocchini ,&nbsp;Alicia Maria Carrillo Heredero ,&nbsp;Melissa Mazan ,&nbsp;Laurent Couetil ,&nbsp;Simone Bertini ,&nbsp;Luigino Calzetta","doi":"10.1016/j.pupt.2024.102342","DOIUrl":"10.1016/j.pupt.2024.102342","url":null,"abstract":"<div><div>Equine asthma, a prevalent chronic inflammatory condition affecting the equine population, significantly compromises the performance and quality of life in affected horses. Inhaled corticosteroids (ICS) are often the first-line pharmacological intervention due to their potent anti-inflammatory properties. This meta-analysis investigates the clinical efficacy of ICS in treating equine asthma, emphasizing the number needed to treat (NNT) and the likelihood of achieving a clinical response. A comprehensive literature search identified relevant studies comparing ICS with placebo (PCB) controlled treatments. Data were synthesized from four clinical trials involving 252 asthmatic horses. Results indicate an overall NNT of 3.2 (95 % CI 2.3–4.7), meaning that approximately three horses must be treated with ICS for one to achieve a significant clinical response. Additionally, the relative risk of achieving clinical improvement with ICS versus PCB was 1.73 (95 % CI 1.47–2.02), demonstrating a marked increase in therapeutic effectiveness. Subgroup analysis revealed an NNT of 3.0 for severe cases, underscoring the efficacy of ICS across different severity levels. Despite potential biases noted in some studies, sensitivity analyses confirmed the robustness of these findings. The GRADE assessment rated the quality of evidence as high. These results highlight the therapeutic value of ICS in managing equine asthma, providing evidence-based recommendations for their clinical use. Future research should explore long-term outcomes and potential synergistic effects of ICS combined with other treatments to enhance clinical efficacy in managing equine asthma.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"88 ","pages":"Article 102342"},"PeriodicalIF":3.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ALDH2 attenuates radiation-induced lung injury by inhibiting ROS and epithelial-mesenchymal transition mediated by the TGF-β1/Smad pathway","authors":"Enping Li ,&nbsp;Jianliang Huang ,&nbsp;Jiale Huang ,&nbsp;Fuying Zhang ,&nbsp;Chengyou Li ,&nbsp;Mingkai Xia ,&nbsp;Zhuo Li ,&nbsp;Bo Peng ,&nbsp;Ying Liu ,&nbsp;Jinan Ma ,&nbsp;Mingsheng Lei","doi":"10.1016/j.pupt.2024.102334","DOIUrl":"10.1016/j.pupt.2024.102334","url":null,"abstract":"<div><div>Radiation-induced lung injury is a significant complication of thoracic malignant tumor radiotherapy, yet effective treatments remain scarce. Aldehyde dehydrogenase 2 (ALDH2) possesses antioxidant and anti-inflammatory properties, but its specific role in radiation-induced lung injury is not well understood. This study aimed to investigate the impact of ALDH2 on radiation-induced lung injury and elucidate the underlying mechanisms. Through analysis of radiation-induced lung injury datasets, intervention with ALDH2 agonists and inhibitors in an in vivo radiation-induced lung injury model, and establishment of an in vitro radiation-induced lung injury model using A549 stable cells with varying ALDH2 expressions, we discovered that ALDH2 expression is reduced in radiation-induced lung injury. Enrichment analysis suggested that ALDH2 may mitigate radiation-induced lung injury by modulating oxidative stress and inflammation levels. Additionally, single-cell data analysis reveals that ALDH2 is primarily localized in myeloid macrophages within the lungs, with its expression also being reduced in lung cancer patients. Subsequent examination of mouse pathological sections, reactive oxygen species (ROS), and inflammatory factor levels confirmed that ALDH2 can lessen radiation-induced lung injury by suppressing ROS and inflammatory factors. Both in vivo and in vitro Western blot analysis further validated that ALDH2 can attenuate epithelial-mesenchymal transition and inhibit the TGF-β1/Smad pathway. Therefore, ALDH2 shows promise in reducing radiation-induced lung injury by inhibiting ROS and TGF-mediated epithelial-mesenchymal transition, making it a potential target for the treatment of radiation-induced lung injury.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"87 ","pages":"Article 102334"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triple inhaled therapy in asthma: Beliefs, behaviours and doubts","authors":"D. Bagnasco ,&nbsp;I. Ansotegui ,&nbsp;I. Baiardini ,&nbsp;A. Benfante ,&nbsp;J.A. Bernstein ,&nbsp;A. Bikov ,&nbsp;B. Bondi ,&nbsp;L.P. Boulet ,&nbsp;C. Panaitescu ,&nbsp;G.W. Canonica ,&nbsp;H. Chong-Neto ,&nbsp;L. Dubuske ,&nbsp;R. El-Owaidy ,&nbsp;M. Ferraris ,&nbsp;M. Filipovic ,&nbsp;F.J. Gonzalez-Barcala ,&nbsp;G. Guidos Fogelbach ,&nbsp;J.C. Ivancevich ,&nbsp;E. Jusufovic ,&nbsp;K. Kowal ,&nbsp;F. Braido","doi":"10.1016/j.pupt.2024.102333","DOIUrl":"10.1016/j.pupt.2024.102333","url":null,"abstract":"<div><div>Long-acting muscarinic antagonists (LAMA) in association with inhaled corticosteroids (ICS) plus long-acting beta-2 agonists (LABA) are recommended by the GINA report as further option in step 4 and first choice in step 5 treatment. Despite consistent evidence of its efficacy and safety, inhaled triple therapy (ITT) is still not largely used in patients with asthma.</div><div>With the aim to explore belief and behaviours of asthma specialists, an ad hoc survey has been developed by a panel of Interasma Scientific Network (INESnet) experts and subsequently defined by two Delphi rounds among an international group of physicians. The questionnaire has been distributed through Interasma social media between June and September 2023.</div><div>Besides a descriptive analysis, to assess the responses gathered from the questionnaire, Spearman's non-parametric statistical method was employed.</div><div>Totally, three hundred fourteen questionnaires were completed. Clinicians' attitudes and behaviours toward timing and methodologies adopted in prescribing ITT, were analysed. 35.7 % specialists consider ITT as a relevant therapeutic option, 61.8 % that is second option after reaching high dose of ICS-LABA and 89.2 % agreed that optimization of inhaled therapy should be attempted before the use of biological drugs. Persistent flow limitation and high reversibility are considered predictive factors of response.</div><div>Specialists consider ITT a resource in asthma management. Although its efficacy in decreasing exacerbation rate and improving lung function were well known, the survey revealed persistent uncertainties among clinicians in positioning it highlighting the need for further measures to effectively integrate research findings into day-to-day clinical practice.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"87 ","pages":"Article 102333"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}