Sargramostim, a recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) inhalation therapy, was recently approved for pharmaceutical use in Japan and shows promise as a treatment for autoimmune pulmonary alveolar proteinosis (APAP). For APAP patients with severe respiratory failure due to advanced lung fibrosis, lung transplantation is also a treatment option; however, APAP may recur after the procedure. Here, we report a case of successful sargramostim inhalation therapy for post-transplant APAP relapse in a patient who underwent living lung transplantation owing to severe fibrosis. Inhaled GM-CSF may be a useful treatment option for APAP recurrence in patients who have undergone lung transplantation.
Clinical trial registration
Pulmonary Alveolar Proteinosis GM-CSF Inhalation Efficacy Trial II registered to Japan Registry of Clinical Trials (jRCTs031220127).
沙格列莫司汀是一种重组人粒细胞-巨噬细胞集落刺激因子（GM-CSF）吸入疗法，最近在日本获准用于制药，有望治疗自身免疫性肺泡蛋白沉着症（APAP）。对于因晚期肺纤维化导致严重呼吸衰竭的 APAP 患者，肺移植也是一种治疗选择；然而，APAP 可能会在术后复发。在此，我们报告了一例因严重肺纤维化而接受活体肺移植的患者移植后 APAP 复发的成功沙格列莫司汀吸入疗法。吸入GM-CSF可能是治疗肺移植患者APAP复发的有效方法。临床试验注册：肺泡蛋白病 GM-CSF 吸入疗效试验 II 已在日本临床试验注册中心注册（jRCTs031220127）。
{"title":"Successful granulocyte-macrophage colony-stimulating factor inhalation therapy for recurrent autoimmune pulmonary alveolar proteinosis after lung transplantation: A case report","authors":"Hiroshi Ishimoto , Noriho Sakamoto , Hirokazu Yura , Takahiro Takazono , Takashi Kido , Keitaro Matsumoto , Konosuke Morimoto , Tomoya Nishino , Koh Nakata , Hiroshi Mukae","doi":"10.1016/j.resinv.2024.12.001","DOIUrl":"10.1016/j.resinv.2024.12.001","url":null,"abstract":"<div><div>Sargramostim, a recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) inhalation therapy, was recently approved for pharmaceutical use in Japan and shows promise as a treatment for autoimmune pulmonary alveolar proteinosis (APAP). For APAP patients with severe respiratory failure due to advanced lung fibrosis, lung transplantation is also a treatment option; however, APAP may recur after the procedure. Here, we report a case of successful sargramostim inhalation therapy for post-transplant APAP relapse in a patient who underwent living lung transplantation owing to severe fibrosis. Inhaled GM-CSF may be a useful treatment option for APAP recurrence in patients who have undergone lung transplantation.</div></div><div><h3>Clinical trial registration</h3><div>Pulmonary Alveolar Proteinosis GM-CSF Inhalation Efficacy Trial II registered to Japan Registry of Clinical Trials (jRCTs031220127).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 180-182"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927968","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}
Chronic obstructive pulmonary disease (COPD) is a pulmonary and systemic inflammatory disease, and the management of systemic comorbidities is important. We previously reported that a lower mean corpuscular hemoglobin concentration (MCHC) at admission was an independent prognostic factor for death in patients with COPD exacerbation. This study aimed to determine the association between MCHC levels and prognosis in patients with stable COPD.
Methods
Overall, 200 stable patients with COPD (mean age; 71.0 ± 8.4 years, male; 93.5%) from January 2014 to March 2020 who were followed up for 4.6 ± 0.7 years were included. During the observation period, 70 patients experienced COPD exacerbations.
Results
Significantly lower body mass index and more severe pulmonary function were observed in patients with COPD exacerbations than those without. The serum levels of aspartate aminotransferase and alanine aminotransferase, lymphocyte counts, and hemoglobin and MCHC levels in peripheral blood in patients with COPD exacerbation were significantly lower than those in patients without exacerbations. Multiple logistic regression analysis revealed that a lower MCHC level was an independent predictive factor of COPD exacerbations during the observation period, even after adjusting age, BMI, ACO merger, COPD grade, and emphysema severity, which were significantly different in univariate logistic regression analysis.
Conclusion
MCHC levels are a significant biomarker for assessing the future risk of exacerbations in patients with COPD, indicating usefulness of measurement of MCHC levels in the management of patients with COPD.
{"title":"Lower mean corpuscular hemoglobin levels as a predictive factor of future exacerbations in patients with chronic obstructive pulmonary disease","authors":"Yukihiro Minegishi, Kento Sato, Sachie Nawa, Osamu Miyazaki, Toshinari Hanawa, Hiroaki Murano, Koya Abe, Kodai Furuyama, Maki Kobayashi, Hiroshi Nakano, Masamichi Sato, Takako Nemoto, Michiko Nishiwaki, Akira Igarashi, Sumito Inoue, Masafumi Watanabe","doi":"10.1016/j.resinv.2024.12.008","DOIUrl":"10.1016/j.resinv.2024.12.008","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD) is a pulmonary and systemic inflammatory disease, and the management of systemic comorbidities is important. We previously reported that a lower mean corpuscular hemoglobin concentration (MCHC) at admission was an independent prognostic factor for death in patients with COPD exacerbation. This study aimed to determine the association between MCHC levels and prognosis in patients with stable COPD.</div></div><div><h3>Methods</h3><div>Overall, 200 stable patients with COPD (mean age; 71.0 ± 8.4 years, male; 93.5%) from January 2014 to March 2020 who were followed up for 4.6 ± 0.7 years were included. During the observation period, 70 patients experienced COPD exacerbations.</div></div><div><h3>Results</h3><div>Significantly lower body mass index and more severe pulmonary function were observed in patients with COPD exacerbations than those without. The serum levels of aspartate aminotransferase and alanine aminotransferase, lymphocyte counts, and hemoglobin and MCHC levels in peripheral blood in patients with COPD exacerbation were significantly lower than those in patients without exacerbations. Multiple logistic regression analysis revealed that a lower MCHC level was an independent predictive factor of COPD exacerbations during the observation period, even after adjusting age, BMI, ACO merger, COPD grade, and emphysema severity, which were significantly different in univariate logistic regression analysis.</div></div><div><h3>Conclusion</h3><div>MCHC levels are a significant biomarker for assessing the future risk of exacerbations in patients with COPD, indicating usefulness of measurement of MCHC levels in the management of patients with COPD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 183-190"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966284","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}
Pub Date : 2025-01-01DOI: 10.1016/j.resinv.2024.11.013
Takuya Yazawa
{"title":"What is the cell of origin of lung neuroendocrine carcinoma?","authors":"Takuya Yazawa","doi":"10.1016/j.resinv.2024.11.013","DOIUrl":"10.1016/j.resinv.2024.11.013","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 40-41"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780074","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}
Although sex differences in the prevalence of sleep disordered breathing (SDB) is recognized, whether a sex difference exists among obese individuals with SDB with or without comorbidities has not been well investigated. This study aimed to explore the relationships of sex differences among SDB, obesity, and metabolic comorbidities.
Methods
This study evaluated 7713 community participants with nocturnal oximetry ≥2 nights. SDB was assessed by the 3% oxygen desaturation index corrected for sleep duration obtained by wrist actigraphy (Acti-ODI3%), and moderate-to-severe SDB was defined as Acti-ODI3% levels ≥15/h. Obesity was defined as body mass index ≥25 kg/m2.
Results
The prevalence of moderate-to-severe SDB was 21.6%/0% among those with obesity/without obesity in women under 40 years old. The adjusted odds ratios for moderate-to-severe SDB in those with both diabetes/metabolic syndrome and obesity compared to others were 86.4 (95%CI 24.2–308.8)/40.4 (95%CI 15.0–108.8) in pre-menopausal women. The association among SDB, obesity, and metabolic comorbidities showed significant interactions between pre-menopausal women and men or post-menopausal women.
Conclusions
Sex differences exist among the prevalence of SDB and the relationships among SDB, obesity, and metabolic comorbidities. Especially, pre-menopausal women are more vulnerable to the consequences of obesity. SDB prevalence may be impacted by the coexistence of obesity and diabetes or metabolic syndrome in pre-menopausal women.
{"title":"Sex differences among sleep disordered breathing, obesity, and metabolic comorbidities; the Nagahama study","authors":"Takeshi Matsumoto , Kimihiko Murase , Yasuharu Tabara , Takuma Minami , Osamu Kanai , Hironobu Sunadome , Naomi Takahashi , Satoshi Hamada , Kiminobu Tanizawa , Tomoko Wakamura , Naoko Komenami , Kazuya Setoh , Takahisa Kawaguchi , Satoshi Morita , Yoshimitsu Takahashi , Takeo Nakayama , Susumu Sato , Toyohiro Hirai , Fumihiko Matsuda , Kazuo Chin","doi":"10.1016/j.resinv.2024.11.014","DOIUrl":"10.1016/j.resinv.2024.11.014","url":null,"abstract":"<div><h3>Background</h3><div>Although sex differences in the prevalence of sleep disordered breathing (SDB) is recognized, whether a sex difference exists among obese individuals with SDB with or without comorbidities has not been well investigated. This study aimed to explore the relationships of sex differences among SDB, obesity, and metabolic comorbidities.</div></div><div><h3>Methods</h3><div>This study evaluated 7713 community participants with nocturnal oximetry ≥2 nights. SDB was assessed by the 3% oxygen desaturation index corrected for sleep duration obtained by wrist actigraphy (Acti-ODI3%), and moderate-to-severe SDB was defined as Acti-ODI3% levels ≥15/h. Obesity was defined as body mass index ≥25 kg/m<sup>2</sup>.</div></div><div><h3>Results</h3><div>The prevalence of moderate-to-severe SDB was 21.6%/0% among those with obesity/without obesity in women under 40 years old. The adjusted odds ratios for moderate-to-severe SDB in those with both diabetes/metabolic syndrome and obesity compared to others were 86.4 (95%CI 24.2–308.8)/40.4 (95%CI 15.0–108.8) in pre-menopausal women. The association among SDB, obesity, and metabolic comorbidities showed significant interactions between pre-menopausal women and men or post-menopausal women.</div></div><div><h3>Conclusions</h3><div>Sex differences exist among the prevalence of SDB and the relationships among SDB, obesity, and metabolic comorbidities. Especially, pre-menopausal women are more vulnerable to the consequences of obesity. SDB prevalence may be impacted by the coexistence of obesity and diabetes or metabolic syndrome in pre-menopausal women.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 42-49"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780876","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}
Severe asthma is a critical condition for patients with asthma, characterized by frequent exacerbations, decreased pulmonary function, and unstable symptoms related to asthma. Consequently, the administration of systemic corticosteroids, which cause secondary damage because of their adverse effects, is considered. Recently, several types of molecular-targeted biological therapies have become available for patients with severe asthma, and they have a capacity to improve the pathophysiology of severe asthma. However, several clinical reports indicate that the effects differ depending on the biological targets of asthma in individual patients. In this review, the molecular mechanisms and clinical impact of biologic therapies in severe asthma are described. In addition, molecules targeted by possible future biologics are also addressed. Better understanding of the mechanistic basis for the role of biologics in severe asthma could lead to new therapeutic options for these patients.
{"title":"Molecular mechanisms and clinical impact of biologic therapies in severe asthma","authors":"Hiroki Tashiro, Yuki Kuwahara, Yuki Kurihara, Koichiro Takahashi","doi":"10.1016/j.resinv.2024.11.015","DOIUrl":"10.1016/j.resinv.2024.11.015","url":null,"abstract":"<div><div>Severe asthma is a critical condition for patients with asthma, characterized by frequent exacerbations, decreased pulmonary function, and unstable symptoms related to asthma. Consequently, the administration of systemic corticosteroids, which cause secondary damage because of their adverse effects, is considered. Recently, several types of molecular-targeted biological therapies have become available for patients with severe asthma, and they have a capacity to improve the pathophysiology of severe asthma. However, several clinical reports indicate that the effects differ depending on the biological targets of asthma in individual patients. In this review, the molecular mechanisms and clinical impact of biologic therapies in severe asthma are described. In addition, molecules targeted by possible future biologics are also addressed. Better understanding of the mechanistic basis for the role of biologics in severe asthma could lead to new therapeutic options for these patients.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 50-60"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790650","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}
Fractional exhaled nitric oxide (FeNO) has been utilized as a reliable biomarker for diagnosis, treatment response, and prediction of future risks in asthma care, that potentially ensures the efficacy of FeNO-guided asthma management. As previous systematic reviews reported limited efficacy with this approach, we evaluated the efficacy of FeNO-guided management in monitoring adults with asthma.
Methods
In this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Review and Meta-Analyses Statement and the Minds Manual for Guideline Development, we updated a Cochrane systematic review in 2016 by adding six papers reporting randomized controlled trials with a treatment duration ≥12 weeks published between June 2016 and July 2022, and conducted a sub-analysis of two groups stratified by the strategy used: the FeNO-alone and FeNO with symptom score groups.
Results
In thirteen RCTs included, FeNO-guided management improved the numbers of participants with one or more asthma exacerbations and the number of exacerbations per 52 weeks. Compared with conventional management, FeNO-guided management marginally improved asthma control questionnaire scores and decreased inhaled corticosteroid doses. In contrast, FeNO-guided management did not improve severe exacerbations requiring oral corticosteroids or hospitalization, percent predicted forced expiratory volume in 1 s, FeNO levels, or asthma-related quality of life scores. Subgroup analysis revealed that, compared with conventional management, both FeNO-symptom score- and FeNO alone-based management decreased the number of asthma exacerbations.
Conclusion
FeNO-guided management can effectively reduce exacerbations in adults with asthma.
{"title":"Assessing the utility of fractional exhaled nitric oxide-guided management in adult patients with asthma: A systematic review and meta-analysis","authors":"Hiroaki Tsurumaki , Yuki Abe , Keiji Oishi , Tadao Nagasaki , Tomoko Tajiri","doi":"10.1016/j.resinv.2024.12.010","DOIUrl":"10.1016/j.resinv.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Fractional exhaled nitric oxide (FeNO) has been utilized as a reliable biomarker for diagnosis, treatment response, and prediction of future risks in asthma care, that potentially ensures the efficacy of FeNO-guided asthma management. As previous systematic reviews reported limited efficacy with this approach, we evaluated the efficacy of FeNO-guided management in monitoring adults with asthma.</div></div><div><h3>Methods</h3><div>In this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Review and Meta-Analyses Statement and the Minds Manual for Guideline Development, we updated a Cochrane systematic review in 2016 by adding six papers reporting randomized controlled trials with a treatment duration ≥12 weeks published between June 2016 and July 2022, and conducted a sub-analysis of two groups stratified by the strategy used: the FeNO-alone and FeNO with symptom score groups.</div></div><div><h3>Results</h3><div>In thirteen RCTs included, FeNO-guided management improved the numbers of participants with one or more asthma exacerbations and the number of exacerbations per 52 weeks. Compared with conventional management, FeNO-guided management marginally improved asthma control questionnaire scores and decreased inhaled corticosteroid doses. In contrast, FeNO-guided management did not improve severe exacerbations requiring oral corticosteroids or hospitalization, percent predicted forced expiratory volume in 1 s, FeNO levels, or asthma-related quality of life scores. Subgroup analysis revealed that, compared with conventional management, both FeNO-symptom score- and FeNO alone-based management decreased the number of asthma exacerbations.</div></div><div><h3>Conclusion</h3><div>FeNO-guided management can effectively reduce exacerbations in adults with asthma.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 118-126"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847525","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}
Pub Date : 2025-01-01DOI: 10.1016/j.resinv.2024.12.004
Christian Domingo , Santiago Quirce , Ignacio Dávila , Astrid Crespo-Lessman , Ebymar Arismendi , Alfredo De Diego , Francisco Javier González-Barcala , Luis Pérez de Llano , Luis Cea-Calvo , Marta Sanchez- Jareño , Pilar López-Cotarelo , Luis Puente-Maestu
{"title":"Erratum to ‘Cough severity visual analog scale scores and quality of life in patients with refractory or unexplained chronic cough’ [Respir Investig 62(6) (2024), 987–994]","authors":"Christian Domingo , Santiago Quirce , Ignacio Dávila , Astrid Crespo-Lessman , Ebymar Arismendi , Alfredo De Diego , Francisco Javier González-Barcala , Luis Pérez de Llano , Luis Cea-Calvo , Marta Sanchez- Jareño , Pilar López-Cotarelo , Luis Puente-Maestu","doi":"10.1016/j.resinv.2024.12.004","DOIUrl":"10.1016/j.resinv.2024.12.004","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 94-95"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819102","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}
Pub Date : 2025-01-01DOI: 10.1016/j.resinv.2024.11.005
Motoko Tachihara
{"title":"Can TTF-1 be an effective biomarker for treatment selection in lung adenocarcinoma?","authors":"Motoko Tachihara","doi":"10.1016/j.resinv.2024.11.005","DOIUrl":"10.1016/j.resinv.2024.11.005","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 86-87"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814077","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}
Sodium-glucose co-transporter-2 inhibitors (SGLT2i) may contribute to better clinical outcomes in adults with diabetes and pneumonia owing to their potential anti-inflammatory effects. To investigate whether SGLT2i are associated with lower in-hospital mortality following pneumonia without heart failure than dipeptidyl peptidase-4 inhibitors (DPP-4i).
Methods
Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified patients with diabetes aged ≥65 years treated with SGLT2i or DPP-4i who were admitted and managed for pneumonia from April 2016 to October 2020. We then compared in-hospital mortality, the need for mechanical ventilation, and discharges to locations (other than home) between the SGLT2i and DPP-4i groups using multivariable logistic regression analyses fitted with generalized estimating equations.
Results
We analyzed the data of 27,334 patients (mean age, 78.8 years; male, 71.2%), including 535 and 26,799 patients regularly treated with SGLT2i and DPP-4i, respectively. No significant differences were observed between the SGLT2i and DPP-4i groups in in-hospital mortality rate (3.4% vs. 5.9%; odds ratio [OR], 0.64; 95% confidence interval [CI], 0.40–1.05), the need for mechanical ventilation (1.5% vs. 1.8%; OR, 0.78; 95%Cl, 0.39–1.59), and discharge to locations other than home (8.1% vs. 14.1%; OR, 0.72; 95%Cl, 0.51–1.02). The association between the diabetic treatment and in-hospital mortality remained insignificant across weight subgroups (underweight: OR, 0.47; 95%Cl, 0.13–1.67; normal weight: OR, 0.66; 95%Cl, 0.34–1.25; and overweight/obesity: OR 1.06; 95%Cl, 0.43–2.65).
Conclusions
Regular SGLT2i use in patients with diabetes admitted with pneumonia without heart failure may not be associated with improved in-hospital mortality outcomes compared with DPP-4i use.
{"title":"Sodium-glucose co-transporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors on in-hospital mortality following pneumonia without heart failure: A retrospective cohort study of older adults with diabetes","authors":"Hiroki Maki , Toshiaki Isogai , Nobuaki Michihata , Hiroki Matsui , Kiyohide Fushimi , Hideo Yasunaga","doi":"10.1016/j.resinv.2024.11.016","DOIUrl":"10.1016/j.resinv.2024.11.016","url":null,"abstract":"<div><h3>Background</h3><div>Sodium-glucose co-transporter-2 inhibitors (SGLT2i) may contribute to better clinical outcomes in adults with diabetes and pneumonia owing to their potential anti-inflammatory effects. To investigate whether SGLT2i are associated with lower in-hospital mortality following pneumonia without heart failure than dipeptidyl peptidase-4 inhibitors (DPP-4i).</div></div><div><h3>Methods</h3><div>Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified patients with diabetes aged ≥65 years treated with SGLT2i or DPP-4i who were admitted and managed for pneumonia from April 2016 to October 2020. We then compared in-hospital mortality, the need for mechanical ventilation, and discharges to locations (other than home) between the SGLT2i and DPP-4i groups using multivariable logistic regression analyses fitted with generalized estimating equations.</div></div><div><h3>Results</h3><div>We analyzed the data of 27,334 patients (mean age, 78.8 years; male, 71.2%), including 535 and 26,799 patients regularly treated with SGLT2i and DPP-4i, respectively. No significant differences were observed between the SGLT2i and DPP-4i groups in in-hospital mortality rate (3.4% vs. 5.9%; odds ratio [OR], 0.64; 95% confidence interval [CI], 0.40–1.05), the need for mechanical ventilation (1.5% vs. 1.8%; OR, 0.78; 95%Cl, 0.39–1.59), and discharge to locations other than home (8.1% vs. 14.1%; OR, 0.72; 95%Cl, 0.51–1.02). The association between the diabetic treatment and in-hospital mortality remained insignificant across weight subgroups (underweight: OR, 0.47; 95%Cl, 0.13–1.67; normal weight: OR, 0.66; 95%Cl, 0.34–1.25; and overweight/obesity: OR 1.06; 95%Cl, 0.43–2.65).</div></div><div><h3>Conclusions</h3><div>Regular SGLT2i use in patients with diabetes admitted with pneumonia without heart failure may not be associated with improved in-hospital mortality outcomes compared with DPP-4i use.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 88-93"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814096","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}
No previous studies have compared respiratory clinics and respiratory specialized facilities regarding causative diseases for bloody sputum and hemoptysis in Japan.
Methods
We retrospectively compared causative diseases for bloody sputum and hemoptysis between 3 respiratory clinics (clinic group) and 7 departments of respiratory medicine at hospitals (hospital group) in Japan.
Results
We collected data from 231 patients (median age, 51 years; age range, 24–96 years; 109 men (47.2%)) in the clinic group and 556 patients (median age, 73 years; age range, 21–98 years; 302 men (54.3%)) in the hospital group. In the former group, the main causative disease was acute bronchitis (91 patients, 39.4%), acute upper respiratory tract infection (34 patients, 14.7%), and bronchiectasis (BE) (29 patients, 12.6%). In the latter group, the main causative diseases were BE (102 patients, 18.3%), lung cancer (97 patients, 17.4%), and non-tuberculous mycobacterial disease (NTM) (89 patients, 16%). In particular, in patients ≥60 years old, BE was an important causative disease for bloody sputum and hemoptysis in both groups.
Conclusions
The present study is the first to compare respiratory clinics and respiratory specialized facilities. Depending on the facility in which the patient is examined, lung cancer, BE, and NTM were identified as diseases requiring special attention as causes of bloody sputum and hemoptysis.
{"title":"Causative diseases of bloody sputum and hemoptysis in respiratory clinics in Japan","authors":"Ryo Atsuta , Hiroaki Fujii , Yu Hara , Hiroshi Tanaka , Kei Nakamura , Yasushi Obase , Shusaku Haranaga , Hidenori Takahashi , Masaharu Shinkai , Jiro Terada , Jun Ikari , Hideki Katsura , Kazuko Yamamoto , Takuji Suzuki , Etsuko Tagaya , Soichiro Hozawa , Hiroshi Mukae , Takeshi Kaneko","doi":"10.1016/j.resinv.2024.12.006","DOIUrl":"10.1016/j.resinv.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>No previous studies have compared respiratory clinics and respiratory specialized facilities regarding causative diseases for bloody sputum and hemoptysis in Japan.</div></div><div><h3>Methods</h3><div>We retrospectively compared causative diseases for bloody sputum and hemoptysis between 3 respiratory clinics (clinic group) and 7 departments of respiratory medicine at hospitals (hospital group) in Japan.</div></div><div><h3>Results</h3><div>We collected data from 231 patients (median age, 51 years; age range, 24–96 years; 109 men (47.2%)) in the clinic group and 556 patients (median age, 73 years; age range, 21–98 years; 302 men (54.3%)) in the hospital group. In the former group, the main causative disease was acute bronchitis (91 patients, 39.4%), acute upper respiratory tract infection (34 patients, 14.7%), and bronchiectasis (BE) (29 patients, 12.6%). In the latter group, the main causative diseases were BE (102 patients, 18.3%), lung cancer (97 patients, 17.4%), and non-tuberculous mycobacterial disease (NTM) (89 patients, 16%). In particular, in patients ≥60 years old, BE was an important causative disease for bloody sputum and hemoptysis in both groups.</div></div><div><h3>Conclusions</h3><div>The present study is the first to compare respiratory clinics and respiratory specialized facilities. Depending on the facility in which the patient is examined, lung cancer, BE, and NTM were identified as diseases requiring special attention as causes of bloody sputum and hemoptysis.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 156-162"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872822","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}
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