Pub Date : 2026-01-08DOI: 10.1016/s2213-2600(25)00327-3
Jonathan H Noble, Orlagh Bean, Melissa Perry, Ross Sayers, Ryan Cullen, Bianca Black, Mark Holliday, Allie Eathorne, Nick Shortt, Louis Kirton, Blake Perry, Pepa Bruce, William Leung, Ian D Pavord, Mark Weatherall, Richard W Beasley
<h3>Background</h3>Recommendations for the use of inhaled corticosteroid-formoterol reliever-based regimens are limited by the absence of randomised controlled trials (RCTs) in patients with asthma using maintenance inhaled corticosteroids, and scarce evidence for the effect on type 2 airway inflammation. We aimed to examine the clinical efficacy and safety of maintenance inhaled corticosteroids plus budesonide–formoterol reliever or terbutaline reliever in patients with mild-to-moderate asthma.<h3>Methods</h3>This open-label, parallel-group, randomised, controlled, phase 4 trial was conducted at Wellington Hospital and two community-based primary care facilities in New Zealand. Eligible participants were aged 16–75 years, had a self-reported doctor's diagnosis of asthma, were using reliever only therapy or maintenance inhaled corticosteroids with short-acting β2-agonist reliever therapy, and were registered with a general practitioner. Participants had to have reported mean reliever use on two or more occasions per week in the 12 weeks before enrolment and had evidence of airway inflammation (FeNO ≥25 parts per billion [ppb]) at screening. Participants were randomly assigned (1:1) to budesonide–formoterol (budesonide 200 μg and formoterol 6 μg) reliever or terbutaline 250 μg reliever therapy using a computer-generated sequence in block sizes of four and six, stratified by region, baseline inhaled corticosteroids maintenance dose, and history of severe asthma exacerbation in the previous 12 months. All participants received maintenance budesonide 200 μg. During a 26-week treatment period, participants attended visits at weeks 0 (screening and randomisation), 13, and 26. The primary outcome was FeNO at week 26, measured in the intention-to-treat (ITT) population. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12622001304729 (completed).<h3>Findings</h3>Between March 28, 2023, and Aug 27, 2024, 290 participants were assessed for eligibility, 109 were ineligible, and 181 were randomly assigned to budesonide–formoterol (n=93) or terbutaline reliever therapy (n=88; ITT population). Participants had a mean age of 33·91 years (SD 15·54). 119 (66%) of 181 participants were female and 62 (34%) were male. Geometric mean FeNO was 62·18 ppb (SD 1·86) at baseline and 39·65 ppb (2·12) at week 26, for the budesonide–formoterol group and 68·03 ppb (1·97) at baseline and 52·98 ppb (2·27) at week 26 for the terbutaline group. Budesonide–formoterol reliever therapy resulted in a mean reduction in geometric mean FeNO of 18·50% (95% CI 2·72–31·73; p=0·024) at week 26 compared with terbutaline reliever therapy. 77 (83%) of 93 participants in the budesonide–formoterol group versus 69 (78%) of 88 in the terbutaline group had at least one adverse event (relative risk 1·06 [95% CI 0·91–1·22]; p=0·46). There were no deaths in the study.<h3>Interpretation</h3>Budesonide–formoterol reliever therapy resulted in a reduction in FeNO comp
{"title":"Budesonide–formoterol versus terbutaline reliever in adults with asthma using maintenance inhaled corticosteroids in New Zealand (INFORM ASTHMA): an open-label, parallel-group, randomised, controlled, phase 4 trial","authors":"Jonathan H Noble, Orlagh Bean, Melissa Perry, Ross Sayers, Ryan Cullen, Bianca Black, Mark Holliday, Allie Eathorne, Nick Shortt, Louis Kirton, Blake Perry, Pepa Bruce, William Leung, Ian D Pavord, Mark Weatherall, Richard W Beasley","doi":"10.1016/s2213-2600(25)00327-3","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00327-3","url":null,"abstract":"<h3>Background</h3>Recommendations for the use of inhaled corticosteroid-formoterol reliever-based regimens are limited by the absence of randomised controlled trials (RCTs) in patients with asthma using maintenance inhaled corticosteroids, and scarce evidence for the effect on type 2 airway inflammation. We aimed to examine the clinical efficacy and safety of maintenance inhaled corticosteroids plus budesonide–formoterol reliever or terbutaline reliever in patients with mild-to-moderate asthma.<h3>Methods</h3>This open-label, parallel-group, randomised, controlled, phase 4 trial was conducted at Wellington Hospital and two community-based primary care facilities in New Zealand. Eligible participants were aged 16–75 years, had a self-reported doctor's diagnosis of asthma, were using reliever only therapy or maintenance inhaled corticosteroids with short-acting β2-agonist reliever therapy, and were registered with a general practitioner. Participants had to have reported mean reliever use on two or more occasions per week in the 12 weeks before enrolment and had evidence of airway inflammation (FeNO ≥25 parts per billion [ppb]) at screening. Participants were randomly assigned (1:1) to budesonide–formoterol (budesonide 200 μg and formoterol 6 μg) reliever or terbutaline 250 μg reliever therapy using a computer-generated sequence in block sizes of four and six, stratified by region, baseline inhaled corticosteroids maintenance dose, and history of severe asthma exacerbation in the previous 12 months. All participants received maintenance budesonide 200 μg. During a 26-week treatment period, participants attended visits at weeks 0 (screening and randomisation), 13, and 26. The primary outcome was FeNO at week 26, measured in the intention-to-treat (ITT) population. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12622001304729 (completed).<h3>Findings</h3>Between March 28, 2023, and Aug 27, 2024, 290 participants were assessed for eligibility, 109 were ineligible, and 181 were randomly assigned to budesonide–formoterol (n=93) or terbutaline reliever therapy (n=88; ITT population). Participants had a mean age of 33·91 years (SD 15·54). 119 (66%) of 181 participants were female and 62 (34%) were male. Geometric mean FeNO was 62·18 ppb (SD 1·86) at baseline and 39·65 ppb (2·12) at week 26, for the budesonide–formoterol group and 68·03 ppb (1·97) at baseline and 52·98 ppb (2·27) at week 26 for the terbutaline group. Budesonide–formoterol reliever therapy resulted in a mean reduction in geometric mean FeNO of 18·50% (95% CI 2·72–31·73; p=0·024) at week 26 compared with terbutaline reliever therapy. 77 (83%) of 93 participants in the budesonide–formoterol group versus 69 (78%) of 88 in the terbutaline group had at least one adverse event (relative risk 1·06 [95% CI 0·91–1·22]; p=0·46). There were no deaths in the study.<h3>Interpretation</h3>Budesonide–formoterol reliever therapy resulted in a reduction in FeNO comp","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"506 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145947537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-06DOI: 10.1016/s2213-2600(25)00469-2
Preeti Shakya
No Abstract
没有抽象的
{"title":"A system that blames the sick","authors":"Preeti Shakya","doi":"10.1016/s2213-2600(25)00469-2","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00469-2","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"23 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-10-21DOI: 10.1016/S2213-2600(25)00292-9
Mélanie Roussel, Héloïse Bannelier, Soufiane Lebal, Christian Kassasseya, Donia Bouzid, Olivier Peyrony, Aurélien Baud, Anthony Chauvin, Agathe Beauvais, Nicolas Javaud, Judith Gorlicki, Jennifer Truchot, Pierrick Le Borgne, Richard Chocron, Tabassome Simon, Yonathan Freund
<p><strong>Background: </strong>Validated diagnostic strategies for pulmonary embolism allow raising the D-dimer threshold to 1000 ng/mL in selected patients with a low probability of pulmonary embolism, but adherence to this strategy in routine practice remains poor. Retrospective studies suggest that these rules could be replaced by a single clinical question as to whether pulmonary embolism is the most likely diagnosis. We aimed to assess the safety of a simplified approach that applies a 1000 ng/mL threshold when pulmonary embolism is unlikely and an age-adjusted threshold otherwise, including patients at a high probability for pulmonary embolism.</p><p><strong>Methods: </strong>In this prospective interventional study in 13 French hospital emergency departments, patients aged ≥18 years with a clinical suspicion of pulmonary embolism, who were not on full-dose anticoagulant therapy and had not had a thromboembolic event in the past 6 months, were included. The intervention consisted of ruling out pulmonary embolism without chest imaging in patients for whom pulmonary embolism was not considered the most likely diagnosis and had a D-dimer value <1000 ng/mL. The age-adjusted D-dimer threshold (500 ng/mL if aged <50 years or age × 10 ng/mL if aged ≥50 years) was used for the other patients. The primary outcome was the diagnostic failure rate (ie, occurrence of a thromboembolic event at 3 months of follow-up) among patients for whom pulmonary embolism was initially ruled out. Safety was established if the upper bound of the two-sided 95% CI for the diagnostic failure rate was less than 1·85% in patients for whom pulmonary embolism was ruled out at initial testing and in a subgroup of patients for whom it was ruled out without chest imaging. This study is registered with ClinicalTrials.gov (NCT06190392) and is complete.</p><p><strong>Findings: </strong>Between Jan 16 and Sept 5, 2024, 1365 patients were screened for eligibility and 1221 were included, of whom 80 (7%) were diagnosed with pulmonary embolism at initial testing. Pulmonary embolism was not considered the most likely diagnosis for 997 patients. The diagnostic failure rate was 0·00% (95% CI 0·00-0·34) and was 0·12% (0·01-0·55) after multiple imputation for 33 patients with no available follow-up, both within the safety threshold. In the prespecified subgroup of 796 patients for whom pulmonary embolism was ruled out without chest imaging, the diagnostic failure rate was 0·00% (0·00-0·46), also within the safety threshold. The strategy had a 32% chest imaging rate (384 of 1217 patients), an absolute reduction of 19% (16-21) compared with the fixed 500 ng/mL D-dimer threshold strategy (609 [50%] of 1215). There were 16 deaths during the 3-month follow-up.</p><p><strong>Interpretation: </strong>A global simplified strategy using a D-dimer threshold of 1000 ng/mL in patients for whom pulmonary embolism was not the most likely diagnosis, and an age-adjusted threshold for other patients, safely
背景：经过验证的肺栓塞诊断策略允许将d -二聚体阈值提高到1000ng /mL，但在常规实践中坚持这一策略仍然很差。回顾性研究表明，这些规则可以被一个单一的临床问题所取代，即肺栓塞是否是最可能的诊断。我们的目的是评估一种简化方法的安全性，该方法在不太可能发生肺栓塞的情况下应用1000 ng/mL阈值，在其他情况下应用年龄调整阈值，包括肺栓塞的高概率患者。方法：在法国13家医院急诊科进行的前瞻性介入研究中，纳入年龄≥18岁、临床怀疑肺栓塞、未接受全剂量抗凝治疗且在过去6个月内未发生血栓栓塞事件的患者。干预措施包括对肺栓塞不被认为是最可能的诊断并且具有d -二聚体值的患者在没有胸部影像学的情况下排除肺栓塞。研究结果：在2024年1月16日至9月5日期间，筛选了1365例患者，其中1221例被纳入，其中80例（7%）在初始测试中被诊断为肺栓塞。在997例患者中，肺栓塞不被认为是最可能的诊断。在33例无随访的患者中，多次输入诊断失败率为0.00% (95% CI 0.0000 - 0.34)，诊断失败率为0.12%(0.01 - 0.55)，均在安全阈值范围内。在预先指定的796例患者亚组中，在没有胸部影像学检查的情况下排除肺栓塞，诊断失败率为0.00%(0.0000 - 0.46)，也在安全阈值之内。该策略的胸部显像率为32%（1217例患者中的384例），与固定的500 ng/mL d -二聚体阈值策略（1215例患者中的609例[50%]）相比，绝对降低了19%（16-21）。在3个月的随访中有16例死亡。解释：在肺栓塞不是最可能诊断的患者中使用1000 ng/mL d -二聚体阈值的全球简化策略，以及其他患者的年龄调整阈值，安全地排除了诊断。这些发现表明，这种简化的策略可以安全地减少急诊科胸部成像的使用。资助：援助Publique-Hôpitaux de Paris （巴黎与巴黎的巴黎与巴黎的研究与创新）。
{"title":"D-Dimer thresholds for diagnosis of pulmonary embolism based on a single question: is it the most likely diagnosis? A prospective, multicentre, open-label, single-arm interventional study.","authors":"Mélanie Roussel, Héloïse Bannelier, Soufiane Lebal, Christian Kassasseya, Donia Bouzid, Olivier Peyrony, Aurélien Baud, Anthony Chauvin, Agathe Beauvais, Nicolas Javaud, Judith Gorlicki, Jennifer Truchot, Pierrick Le Borgne, Richard Chocron, Tabassome Simon, Yonathan Freund","doi":"10.1016/S2213-2600(25)00292-9","DOIUrl":"10.1016/S2213-2600(25)00292-9","url":null,"abstract":"<p><strong>Background: </strong>Validated diagnostic strategies for pulmonary embolism allow raising the D-dimer threshold to 1000 ng/mL in selected patients with a low probability of pulmonary embolism, but adherence to this strategy in routine practice remains poor. Retrospective studies suggest that these rules could be replaced by a single clinical question as to whether pulmonary embolism is the most likely diagnosis. We aimed to assess the safety of a simplified approach that applies a 1000 ng/mL threshold when pulmonary embolism is unlikely and an age-adjusted threshold otherwise, including patients at a high probability for pulmonary embolism.</p><p><strong>Methods: </strong>In this prospective interventional study in 13 French hospital emergency departments, patients aged ≥18 years with a clinical suspicion of pulmonary embolism, who were not on full-dose anticoagulant therapy and had not had a thromboembolic event in the past 6 months, were included. The intervention consisted of ruling out pulmonary embolism without chest imaging in patients for whom pulmonary embolism was not considered the most likely diagnosis and had a D-dimer value <1000 ng/mL. The age-adjusted D-dimer threshold (500 ng/mL if aged <50 years or age × 10 ng/mL if aged ≥50 years) was used for the other patients. The primary outcome was the diagnostic failure rate (ie, occurrence of a thromboembolic event at 3 months of follow-up) among patients for whom pulmonary embolism was initially ruled out. Safety was established if the upper bound of the two-sided 95% CI for the diagnostic failure rate was less than 1·85% in patients for whom pulmonary embolism was ruled out at initial testing and in a subgroup of patients for whom it was ruled out without chest imaging. This study is registered with ClinicalTrials.gov (NCT06190392) and is complete.</p><p><strong>Findings: </strong>Between Jan 16 and Sept 5, 2024, 1365 patients were screened for eligibility and 1221 were included, of whom 80 (7%) were diagnosed with pulmonary embolism at initial testing. Pulmonary embolism was not considered the most likely diagnosis for 997 patients. The diagnostic failure rate was 0·00% (95% CI 0·00-0·34) and was 0·12% (0·01-0·55) after multiple imputation for 33 patients with no available follow-up, both within the safety threshold. In the prespecified subgroup of 796 patients for whom pulmonary embolism was ruled out without chest imaging, the diagnostic failure rate was 0·00% (0·00-0·46), also within the safety threshold. The strategy had a 32% chest imaging rate (384 of 1217 patients), an absolute reduction of 19% (16-21) compared with the fixed 500 ng/mL D-dimer threshold strategy (609 [50%] of 1215). There were 16 deaths during the 3-month follow-up.</p><p><strong>Interpretation: </strong>A global simplified strategy using a D-dimer threshold of 1000 ng/mL in patients for whom pulmonary embolism was not the most likely diagnosis, and an age-adjusted threshold for other patients, safely","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":" ","pages":"29-37"},"PeriodicalIF":32.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-10-22DOI: 10.1016/S2213-2600(25)00248-6
Isabelle Sermet-Gaudelus, Alexia Letierce, Laureline Berteloot, Anne-Sophie Bonnel, Yuxin Chen, Punit Makani, Mairead Kelly-Aubert, Feriel Kanoun, Lucille Penalva, Nesrine Bouleghem, Tiphaine Bihouee, Stéphanie Bui, Harriet Corvol, Véronique Houdouin, Marie Mittaine, Aurelie Tatopoulos, Laurence Weiss, Nathalie Wizla, Nathalie Kapel, Antoine Bessou, H A W M Tiddens, Daan Caudri, Philippe Reix, Christophe Marguet
<p><strong>Background: </strong>Elexacaftor-tezacaftor-ivacaftor (ETI) is a cystic fibrosis transmembrane conductance regulator (CFTR) modulator that improves clinical outcomes in adolescents with cystic fibrosis. We aimed to investigate the effect of ETI on lung structural damage.</p><p><strong>Methods: </strong>The Modul-CF prospective observational study is based at 33 paediatric cystic fibrosis reference centres in France. In the present analysis, we assessed the adolescent cohort of individuals with cystic fibrosis (aged 12-18 years) from the Modul-CF study who initiated treatment with ETI as part of routine care. These individuals were either homozygous for F508del and previously treated with lumacaftor-ivacaftor (LI), or F508del homozygous or compound heterozygous for F508del with a minimal function or residual function variant and naive to CFTR modulator treatment. The primary outcome measure was chest CT to investigate the effect of CFTR restoration on the natural history of cystic fibrosis lung disease. Secondary outcomes were sweat chloride, weight and height Z scores, quality of life, pulmonary function tests, lung clearance index at 2·5% of starting concentration (LCI<sub>2·5</sub>) from nitrogen multiple breath washout, and proinflammatory biomarkers in sputum (calprotectin, neutrophil elastase, IL-1β, IL-6, IL-8, and TNF-α) and blood (C-reactive protein and polymorphonuclear neutrophils). Outcome data were collected from baseline (in the 4 weeks before commencement of ETI [denoted month 0]) up to 1 year of ETI treatment (denoted month 12), with low-dose inspiratory-controlled chest CT done at month 0 and month 12. Changes in outcome measures from month 0 to month 12 were assessed with non-parametric Wilcoxon tests. Modul-CF was registered with ClinicalTrials.gov, NCT04301856, and is ongoing and open to recruitment. The data cutoff for the present analysis was July 28, 2023.</p><p><strong>Findings: </strong>Between March 22, 2021, and May 25, 2022, a total of 330 adolescents with cystic fibrosis were enrolled in the study, of whom 320 were treated with ETI for 12 months and included in analyses (mean age at ETI initiation 14·1 years [SD 1·5]; 162 [51%] female and 158 [49%] male participants). Of the 320 participants, 112 (35%) were switched from LI to ETI, and 208 (65%) were CFTR modulator-naive. In the overall population, improvement in percent predicted FEV<sub>1</sub> (ppFEV<sub>1</sub>) was observed from the first month of ETI treatment and was sustained at 12 months (mean absolute ppFEV<sub>1</sub> change from month 0 to month 12, 14·0% [95% CI 12·4-15·7], p<0·0001, n=306). From month 0 to month 12, there were significant reductions in lung hyperinflation on plethysmography, and in mucus plugs, bronchial wall thickening, and bronchial dilatation on chest CT. Significant improvements were also observed in sweat chloride, weight Z score, LCI<sub>2.5</sub>, quality of life, and sputum and blood proinflammatory biomarkers. In 188 p
{"title":"Effect of elexacaftor-tezacaftor-ivacaftor on bronchial dilatations in adolescents with cystic fibrosis: a multicentre prospective observational study.","authors":"Isabelle Sermet-Gaudelus, Alexia Letierce, Laureline Berteloot, Anne-Sophie Bonnel, Yuxin Chen, Punit Makani, Mairead Kelly-Aubert, Feriel Kanoun, Lucille Penalva, Nesrine Bouleghem, Tiphaine Bihouee, Stéphanie Bui, Harriet Corvol, Véronique Houdouin, Marie Mittaine, Aurelie Tatopoulos, Laurence Weiss, Nathalie Wizla, Nathalie Kapel, Antoine Bessou, H A W M Tiddens, Daan Caudri, Philippe Reix, Christophe Marguet","doi":"10.1016/S2213-2600(25)00248-6","DOIUrl":"10.1016/S2213-2600(25)00248-6","url":null,"abstract":"<p><strong>Background: </strong>Elexacaftor-tezacaftor-ivacaftor (ETI) is a cystic fibrosis transmembrane conductance regulator (CFTR) modulator that improves clinical outcomes in adolescents with cystic fibrosis. We aimed to investigate the effect of ETI on lung structural damage.</p><p><strong>Methods: </strong>The Modul-CF prospective observational study is based at 33 paediatric cystic fibrosis reference centres in France. In the present analysis, we assessed the adolescent cohort of individuals with cystic fibrosis (aged 12-18 years) from the Modul-CF study who initiated treatment with ETI as part of routine care. These individuals were either homozygous for F508del and previously treated with lumacaftor-ivacaftor (LI), or F508del homozygous or compound heterozygous for F508del with a minimal function or residual function variant and naive to CFTR modulator treatment. The primary outcome measure was chest CT to investigate the effect of CFTR restoration on the natural history of cystic fibrosis lung disease. Secondary outcomes were sweat chloride, weight and height Z scores, quality of life, pulmonary function tests, lung clearance index at 2·5% of starting concentration (LCI<sub>2·5</sub>) from nitrogen multiple breath washout, and proinflammatory biomarkers in sputum (calprotectin, neutrophil elastase, IL-1β, IL-6, IL-8, and TNF-α) and blood (C-reactive protein and polymorphonuclear neutrophils). Outcome data were collected from baseline (in the 4 weeks before commencement of ETI [denoted month 0]) up to 1 year of ETI treatment (denoted month 12), with low-dose inspiratory-controlled chest CT done at month 0 and month 12. Changes in outcome measures from month 0 to month 12 were assessed with non-parametric Wilcoxon tests. Modul-CF was registered with ClinicalTrials.gov, NCT04301856, and is ongoing and open to recruitment. The data cutoff for the present analysis was July 28, 2023.</p><p><strong>Findings: </strong>Between March 22, 2021, and May 25, 2022, a total of 330 adolescents with cystic fibrosis were enrolled in the study, of whom 320 were treated with ETI for 12 months and included in analyses (mean age at ETI initiation 14·1 years [SD 1·5]; 162 [51%] female and 158 [49%] male participants). Of the 320 participants, 112 (35%) were switched from LI to ETI, and 208 (65%) were CFTR modulator-naive. In the overall population, improvement in percent predicted FEV<sub>1</sub> (ppFEV<sub>1</sub>) was observed from the first month of ETI treatment and was sustained at 12 months (mean absolute ppFEV<sub>1</sub> change from month 0 to month 12, 14·0% [95% CI 12·4-15·7], p<0·0001, n=306). From month 0 to month 12, there were significant reductions in lung hyperinflation on plethysmography, and in mucus plugs, bronchial wall thickening, and bronchial dilatation on chest CT. Significant improvements were also observed in sweat chloride, weight Z score, LCI<sub>2.5</sub>, quality of life, and sputum and blood proinflammatory biomarkers. In 188 p","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":" ","pages":"38-48"},"PeriodicalIF":32.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-25DOI: 10.1016/s2213-2600(25)00463-1
Stuart Kyle
{"title":"The Ramp to Nowhere: When hope slips through the cracks in care","authors":"Stuart Kyle","doi":"10.1016/s2213-2600(25)00463-1","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00463-1","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"4 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/s2213-2600(25)00458-8
Cahal McQuillan
No Abstract
没有抽象的
{"title":"Ammonia: green energy or fuel for disaster?","authors":"Cahal McQuillan","doi":"10.1016/s2213-2600(25)00458-8","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00458-8","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"366 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-12DOI: 10.1016/s2213-2600(25)00400-x
Zachary C Rich, Matthew J Reynolds, Diane E Stover
{"title":"Nicotine-free generations: a bold policy for public health","authors":"Zachary C Rich, Matthew J Reynolds, Diane E Stover","doi":"10.1016/s2213-2600(25)00400-x","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00400-x","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"143 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145730717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.1016/s2213-2600(25)00411-4
Shir Lynn Lim, Christian Hassager
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