Pub Date : 2025-06-01DOI: 10.1016/j.chpulm.2025.100152
Lissette Orozco MD , Bruno DiGiovine MD
Case Presentation
A 65-year-old woman presented with a 7-day history of generalized weakness, cough, and hemoptysis described as streaks of blood during the first 2 days, and as half a cup to a cup of bright red blood with clots thereafter. Seven weeks earlier she was hospitalized with COVID-19 pneumonia for which she received supplemental oxygen with high flow nasal cannula, remdesivir, dexamethasone, and tocilizumab.
Her medical history included stage 3a chronic kidney disease, multinodular goiter, hypertension, and type II diabetes mellitus. She denied recent use of anticoagulants or nonsteroidal antiinflammatory drugs. She denied any recent trauma including pulmonary contusion. The patient did not have any history of rash, hematuria, or known autoimmune disease preceding this episode of hemoptysis.
The patient had previous tobacco use with a 20 pack-year history and quit 7 years ago. She did not use alcohol or other recreational drugs. Family history was notable for breast cancer in her mother. She had no history of recent travel or exposure to sick contacts.
{"title":"A 65-Year-Old Woman With Massive Hemoptysis After COVID-19 Infection","authors":"Lissette Orozco MD , Bruno DiGiovine MD","doi":"10.1016/j.chpulm.2025.100152","DOIUrl":"10.1016/j.chpulm.2025.100152","url":null,"abstract":"<div><h3>Case Presentation</h3><div>A 65-year-old woman presented with a 7-day history of generalized weakness, cough, and hemoptysis described as streaks of blood during the first 2 days, and as half a cup to a cup of bright red blood with clots thereafter. Seven weeks earlier she was hospitalized with COVID-19 pneumonia for which she received supplemental oxygen with high flow nasal cannula, remdesivir, dexamethasone, and tocilizumab.</div><div>Her medical history included stage 3a chronic kidney disease, multinodular goiter, hypertension, and type II diabetes mellitus. She denied recent use of anticoagulants or nonsteroidal antiinflammatory drugs. She denied any recent trauma including pulmonary contusion. The patient did not have any history of rash, hematuria, or known autoimmune disease preceding this episode of hemoptysis.</div><div>The patient had previous tobacco use with a 20 pack-year history and quit 7 years ago. She did not use alcohol or other recreational drugs. Family history was notable for breast cancer in her mother. She had no history of recent travel or exposure to sick contacts.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205158","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 : 2025-06-01DOI: 10.1016/j.chpulm.2025.100156
Aristotle G. Leonhard MD , Jennifer McDowell MS , Katherine D. Hoerster PhD, MPH , Sophia Hayes MD, MS , Fernando Picazo MD, MS , Jason M. Castaneda MD , Kevin Josey PhD , Matthew Griffith MD , Jun Ma MD, PhD , Kevin I. Duan MD, MS , Laura C. Feemster MD, MS , David H. Au MD, MS , Lucas M. Donovan MD, MS
Background
Obesity is the single greatest driver of OSA severity, and clinical practice guidelines recommend weight management services for all patients with OSA and obesity.
Research Question
How often do patients with obesity and newly diagnosed OSA receive weight management services as part of the initial management strategy for OSA? What are the patient- and site-level predictors of receipt of these services?
Study Design and Methods
National electronic health record data from the Veterans Health Administration were used to identify patients with a BMI ≥ 30 kg/m2 and a new sleep study diagnostic of OSA. Patients with prior sleep studies, positive airway pressure therapy, or weight management services prior to OSA diagnosis were excluded. The primary study outcome was the receipt of new weight management services in the first 3 to 12 months following diagnosis of OSA. A mixed-effects logistic regression analysis was performed evaluating for patient- and site-level predictors of the receipt of weight management care.
Results
Among 152,976 patients included in our analysis, 15,304 (10.0%) received a weight management service following OSA diagnosis. Of these, 14,146 (9.2%) received a lifestyle-based weight management intervention, 1,790 (1.2%) received a weight management medication, and 29 (0.2%) underwent bariatric surgery. Female sex, Black race, higher BMI, comorbidity burden, and nonrural location were associated with greater receipt of weight management services. The odds of receiving weight management services were also greater among patients cared for at sites that reported greater proportions of patients receiving weight management care in the prior year.
Interpretation
A new OSA diagnosis is an opportunity to consider new treatments. Despite existing guidelines and the availability of services, our results show that patients with OSA and obesity rarely receive weight management care following diagnosis. New strategies are needed to overcome existing barriers to effective weight management care in patients newly diagnosed with OSA.
{"title":"Receipt of Weight Management Services Among Patients With OSA and Obesity","authors":"Aristotle G. Leonhard MD , Jennifer McDowell MS , Katherine D. Hoerster PhD, MPH , Sophia Hayes MD, MS , Fernando Picazo MD, MS , Jason M. Castaneda MD , Kevin Josey PhD , Matthew Griffith MD , Jun Ma MD, PhD , Kevin I. Duan MD, MS , Laura C. Feemster MD, MS , David H. Au MD, MS , Lucas M. Donovan MD, MS","doi":"10.1016/j.chpulm.2025.100156","DOIUrl":"10.1016/j.chpulm.2025.100156","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is the single greatest driver of OSA severity, and clinical practice guidelines recommend weight management services for all patients with OSA and obesity.</div></div><div><h3>Research Question</h3><div>How often do patients with obesity and newly diagnosed OSA receive weight management services as part of the initial management strategy for OSA? What are the patient- and site-level predictors of receipt of these services?</div></div><div><h3>Study Design and Methods</h3><div>National electronic health record data from the Veterans Health Administration were used to identify patients with a BMI ≥ 30 kg/m<sup>2</sup> and a new sleep study diagnostic of OSA. Patients with prior sleep studies, positive airway pressure therapy, or weight management services prior to OSA diagnosis were excluded. The primary study outcome was the receipt of new weight management services in the first 3 to 12 months following diagnosis of OSA. A mixed-effects logistic regression analysis was performed evaluating for patient- and site-level predictors of the receipt of weight management care.</div></div><div><h3>Results</h3><div>Among 152,976 patients included in our analysis, 15,304 (10.0%) received a weight management service following OSA diagnosis. Of these, 14,146 (9.2%) received a lifestyle-based weight management intervention, 1,790 (1.2%) received a weight management medication, and 29 (0.2%) underwent bariatric surgery. Female sex, Black race, higher BMI, comorbidity burden, and nonrural location were associated with greater receipt of weight management services. The odds of receiving weight management services were also greater among patients cared for at sites that reported greater proportions of patients receiving weight management care in the prior year.</div></div><div><h3>Interpretation</h3><div>A new OSA diagnosis is an opportunity to consider new treatments. Despite existing guidelines and the availability of services, our results show that patients with OSA and obesity rarely receive weight management care following diagnosis. New strategies are needed to overcome existing barriers to effective weight management care in patients newly diagnosed with OSA.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253852","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 : 2025-06-01DOI: 10.1016/j.chpulm.2025.100154
Christopher G. Slatore MD , Anne C. Melzer MD , Ian Ilea MSW , Liana Schweiger MD, MCR , Janel DeSalvo MD , Donald R. Sullivan MD, MCR , Sean P.M. Rice PhD , Renda S. Wiener MD, MPH , Santanu Datta PhD , James M. Davis MD , Christopher H. Chang MD , Kimberly A. Curlin MN, FNP-BC , Sara E. Golden PhD
Background
Many patients who undergo lung cancer screening (LCS) actively use cigarettes.
Research Question
What are the longitudinal, patient-reported smoking attitudes and behaviors across the LCS process in routine care settings, and are these smoking attitudes and behaviors associated with patient-centered communication?
Study Design and Methods
This prospective, longitudinal, repeated measures cohort study was conducted among patients undergoing LCS in 3 health care systems. Participants were surveyed by using validated measures of smoking attitudes and behaviors and patient-centered communication domains up to 1 year following low-dose CT (LDCT) imaging for LCS. For longitudinal analyses, a series of generalized estimating equations were applied to measure the adjusted associations of overall communication quality, LCS knowledge, and decision role concordance with smoking attitudes and behaviors.
Results
A total of 253 participants who currently used cigarettes or who had recently stopped were enrolled. Of these, 83 participants (36.7% of patients with nonmissing information) had moderate or high levels of nicotine dependence. Of 133 participants who were using cigarettes at baseline who contributed data, 24 (18%) were abstinent 12 months after baseline. During the screening period, no more than 33% of participants reported receiving cessation resources from their clinician at any given point. Almost 70% of participants reported high-quality communication at baseline, which was associated with a positive stage of cigarette use behavior change (adjusted OR, 2.27; 95% CI, 1.21-4.26). Longitudinal high-quality communication was associated with cigarette abstinence (adjusted OR, 3.63; 95% CI, 1.58-8.34). LCS knowledge and decision role concordance were not associated with smoking attitudes or behaviors.
Interpretation
Our results indicate that it may be challenging to substantially improve smoking behaviors through communication strategies. Additional interventions to increase smoking cessation are required.
{"title":"Association of Communication With Smoking Attitudes and Behaviors Among Patients Undergoing Lung Cancer Screening","authors":"Christopher G. Slatore MD , Anne C. Melzer MD , Ian Ilea MSW , Liana Schweiger MD, MCR , Janel DeSalvo MD , Donald R. Sullivan MD, MCR , Sean P.M. Rice PhD , Renda S. Wiener MD, MPH , Santanu Datta PhD , James M. Davis MD , Christopher H. Chang MD , Kimberly A. Curlin MN, FNP-BC , Sara E. Golden PhD","doi":"10.1016/j.chpulm.2025.100154","DOIUrl":"10.1016/j.chpulm.2025.100154","url":null,"abstract":"<div><h3>Background</h3><div>Many patients who undergo lung cancer screening (LCS) actively use cigarettes.</div></div><div><h3>Research Question</h3><div>What are the longitudinal, patient-reported smoking attitudes and behaviors across the LCS process in routine care settings, and are these smoking attitudes and behaviors associated with patient-centered communication?</div></div><div><h3>Study Design and Methods</h3><div>This prospective, longitudinal, repeated measures cohort study was conducted among patients undergoing LCS in 3 health care systems. Participants were surveyed by using validated measures of smoking attitudes and behaviors and patient-centered communication domains up to 1 year following low-dose CT (LDCT) imaging for LCS. For longitudinal analyses, a series of generalized estimating equations were applied to measure the adjusted associations of overall communication quality, LCS knowledge, and decision role concordance with smoking attitudes and behaviors.</div></div><div><h3>Results</h3><div>A total of 253 participants who currently used cigarettes or who had recently stopped were enrolled. Of these, 83 participants (36.7% of patients with nonmissing information) had moderate or high levels of nicotine dependence. Of 133 participants who were using cigarettes at baseline who contributed data, 24 (18%) were abstinent 12 months after baseline. During the screening period, no more than 33% of participants reported receiving cessation resources from their clinician at any given point. Almost 70% of participants reported high-quality communication at baseline, which was associated with a positive stage of cigarette use behavior change (adjusted OR, 2.27; 95% CI, 1.21-4.26). Longitudinal high-quality communication was associated with cigarette abstinence (adjusted OR, 3.63; 95% CI, 1.58-8.34). LCS knowledge and decision role concordance were not associated with smoking attitudes or behaviors.</div></div><div><h3>Interpretation</h3><div>Our results indicate that it may be challenging to substantially improve smoking behaviors through communication strategies. Additional interventions to increase smoking cessation are required.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261663","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 : 2025-06-01DOI: 10.1016/j.chpulm.2025.100159
Angela Kaczorowski-Worthley BSN , Dinesh Pal Mudaranthakam PhD, MBA, MS , Janell Reichuber APRN , Chris Streiler MD , Sahil Pandya MD , Ryan Boente MD , Susan K. Mathai MD , Ayodeji Adegunsoye MD , Jeff Swigris DO, MS , Elizabeth R. Volkmann MD, MS , Joshua J. Solomon MD , Bryant R. England MD, PhD , Scott M. Matson MD
Background
Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) portends a devastating prognosis for patients, with survival typically being < 5 to 8 years after diagnosis. Limited clinical trial data exist to guide treatment strategies, and the efficacy of current strategies—immunomodulation and antifibrotics—remains uncertain. Large randomized controlled trials are costly, but pragmatic trial designs could reduce expenses. Establishing equipoise and assessing feasibility from both patient and expert perspectives are essential for developing these trials.
Research Question
What are the perceptions of RA-ILD experts and patients with interstitial lung disease surrounding equipoise, feasibility, and trial design?
Study Design and Methods
A qualitative study involving a panel of 10 RA-ILD experts and 3 patient panels was conducted. Experts were recruited via snowball sampling, and patient panels included 29 individuals with interstitial lung disease or their caregivers. Discussions were transcribed and analyzed using inductive coding, creating a thematic network based on the Attride-Stirling guidelines.
Results
Expert themes included variability in treatment strategies, prioritizing patient-reported outcomes and balancing pragmatism with data collection in trial design. Patient themes highlighted outcomes of importance, participation barriers, and the need for patient-centered research.
Interpretation
Both expert and patient panels endorsed using real-world clinical outcomes and patient-reported outcomes as primary trial end points. Pragmatic trials could reduce costs and expand inclusion criteria, highlighting the potential of patient-centered approaches in RA-ILD research.
{"title":"Pragmatic Comparative Effectiveness Trials in Rheumatoid Arthritis-Associated Interstitial Lung Disease","authors":"Angela Kaczorowski-Worthley BSN , Dinesh Pal Mudaranthakam PhD, MBA, MS , Janell Reichuber APRN , Chris Streiler MD , Sahil Pandya MD , Ryan Boente MD , Susan K. Mathai MD , Ayodeji Adegunsoye MD , Jeff Swigris DO, MS , Elizabeth R. Volkmann MD, MS , Joshua J. Solomon MD , Bryant R. England MD, PhD , Scott M. Matson MD","doi":"10.1016/j.chpulm.2025.100159","DOIUrl":"10.1016/j.chpulm.2025.100159","url":null,"abstract":"<div><h3>Background</h3><div>Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) portends a devastating prognosis for patients, with survival typically being < 5 to 8 years after diagnosis. Limited clinical trial data exist to guide treatment strategies, and the efficacy of current strategies—immunomodulation and antifibrotics—remains uncertain. Large randomized controlled trials are costly, but pragmatic trial designs could reduce expenses. Establishing equipoise and assessing feasibility from both patient and expert perspectives are essential for developing these trials.</div></div><div><h3>Research Question</h3><div>What are the perceptions of RA-ILD experts and patients with interstitial lung disease surrounding equipoise, feasibility, and trial design?</div></div><div><h3>Study Design and Methods</h3><div>A qualitative study involving a panel of 10 RA-ILD experts and 3 patient panels was conducted. Experts were recruited via snowball sampling, and patient panels included 29 individuals with interstitial lung disease or their caregivers. Discussions were transcribed and analyzed using inductive coding, creating a thematic network based on the Attride-Stirling guidelines.</div></div><div><h3>Results</h3><div>Expert themes included variability in treatment strategies, prioritizing patient-reported outcomes and balancing pragmatism with data collection in trial design. Patient themes highlighted outcomes of importance, participation barriers, and the need for patient-centered research.</div></div><div><h3>Interpretation</h3><div>Both expert and patient panels endorsed using real-world clinical outcomes and patient-reported outcomes as primary trial end points. Pragmatic trials could reduce costs and expand inclusion criteria, highlighting the potential of patient-centered approaches in RA-ILD research.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243104","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 : 2025-04-08DOI: 10.1016/j.chpulm.2025.100169
Norah N. Zaza MD , Eduardo Lopez-Gutierrez BS , Dominic J. Vitello MD , Jessica Gardner BS , Thanh-Huyen T. Vu MD, PhD , Eleanor Riviera MSN , Sayyed Hamidi MD , Israel Rubinstein MD , Howard S. Gordon MD , David J. Bentrem MD
{"title":"Does a Patient-Centered Informational Video Impact Real-World Perception of Lung Cancer Screening Among At-Risk Veterans?","authors":"Norah N. Zaza MD , Eduardo Lopez-Gutierrez BS , Dominic J. Vitello MD , Jessica Gardner BS , Thanh-Huyen T. Vu MD, PhD , Eleanor Riviera MSN , Sayyed Hamidi MD , Israel Rubinstein MD , Howard S. Gordon MD , David J. Bentrem MD","doi":"10.1016/j.chpulm.2025.100169","DOIUrl":"10.1016/j.chpulm.2025.100169","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 4","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528601","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 : 2025-03-01DOI: 10.1016/j.chpulm.2024.100107
Cristiano Caruso MD, PhD , G. Walter Canonica MD , Manish Patel MBChB, PhD , Andrew Smith MBChB, PhD , Mark C. Liu MD , Rafael Alfonso-Cristancho MD, PhD , Robert G. Price MSc , Rupert W. Jakes PhD , Lydia Demetriou MSc , Antonio Valero MD , Thomas C. Köhler MD , Charles Pilette MD, PhD , Geoffrey Chupp MD , Guy Brusselle MD , Peter Howarth DM
Background
Mepolizumab, a monoclonal antibody targeting IL-5, is of proven clinical benefit in severe asthma; however, prospective, long-term, real-world data in severe asthma are required.
Research Question
What is the real-world benefit of 2 years of mepolizumab treatment in severe asthma?
Study Design and Methods
REALITI-A was a 2-year, international, prospective study enrolling adults with asthma on newly initiated mepolizumab 100 mg subcutaneously (physician decision). Outcomes in the 1-year premepolizumab vs 2-year follow-up periods included rates of clinically significant asthma exacerbations (CSEs) (deterioration requiring systemic corticosteroids and/or emergency department [ED] visit/hospitalization), exacerbations requiring ED visit/hospitalization, exacerbations requiring hospitalization, proportion of patients with no exacerbations, median daily maintenance oral corticosteroids (mOCSs) dose, proportion of patients discontinuing mOCSs completely, Asthma Control Questionnaire-5 score, FEV1, and adverse events (AEs).
Results
After 2 years’ follow-up, 73% of patients (599 of 822) had no record of mepolizumab discontinuation. During the 2-year follow-up vs premepolizumab period (N = 822), rates of CSEs, exacerbations requiring ED visit/hospitalization, or hospitalization only were reduced by 74%, 79%, and 73%, respectively (odds ratio for no CSEs, 10.0; 95% CI, 7.55- 13.25). Median daily mOCS dose decreased from 10.0 (quartile 1, 5.0; quartile 3, 14.7) mg at week 0 (n = 297) to 0.0 (quartile 1, 0.0; quartile 3, 5.0) mg at weeks 101 to 104 (n = 168), and the proportion of patients discontinuing mOCSs increased progressively to 43% at 1 year and 57% at 2 years. There was a 1.53-point reduction in Asthma Control Questionnaire-5 scores from baseline at 2 years. At months 21 to 24, least square mean FEV1 improved by 142 mL from baseline. Ninety (11%) and 7 (< 1%) patients experienced mepolizumab-related AEs and serious AEs during the follow-up period, respectively.
Interpretation
In patients with severe asthma, real-world mepolizumab treatment for 2 years was well tolerated and was associated with sustained reductions in exacerbations and progressive reductions in mOCS use.
{"title":"Prospective REALITI-A Study","authors":"Cristiano Caruso MD, PhD , G. Walter Canonica MD , Manish Patel MBChB, PhD , Andrew Smith MBChB, PhD , Mark C. Liu MD , Rafael Alfonso-Cristancho MD, PhD , Robert G. Price MSc , Rupert W. Jakes PhD , Lydia Demetriou MSc , Antonio Valero MD , Thomas C. Köhler MD , Charles Pilette MD, PhD , Geoffrey Chupp MD , Guy Brusselle MD , Peter Howarth DM","doi":"10.1016/j.chpulm.2024.100107","DOIUrl":"10.1016/j.chpulm.2024.100107","url":null,"abstract":"<div><h3>Background</h3><div>Mepolizumab, a monoclonal antibody targeting IL-5, is of proven clinical benefit in severe asthma; however, prospective, long-term, real-world data in severe asthma are required.</div></div><div><h3>Research Question</h3><div>What is the real-world benefit of 2 years of mepolizumab treatment in severe asthma?</div></div><div><h3>Study Design and Methods</h3><div>REALITI-A was a 2-year, international, prospective study enrolling adults with asthma on newly initiated mepolizumab 100 mg subcutaneously (physician decision). Outcomes in the 1-year premepolizumab vs 2-year follow-up periods included rates of clinically significant asthma exacerbations (CSEs) (deterioration requiring systemic corticosteroids and/or emergency department [ED] visit/hospitalization), exacerbations requiring ED visit/hospitalization, exacerbations requiring hospitalization, proportion of patients with no exacerbations, median daily maintenance oral corticosteroids (mOCSs) dose, proportion of patients discontinuing mOCSs completely, Asthma Control Questionnaire-5 score, FEV<sub>1</sub>, and adverse events (AEs).</div></div><div><h3>Results</h3><div>After 2 years’ follow-up, 73% of patients (599 of 822) had no record of mepolizumab discontinuation. During the 2-year follow-up vs premepolizumab period (N = 822), rates of CSEs, exacerbations requiring ED visit/hospitalization, or hospitalization only were reduced by 74%, 79%, and 73%, respectively (odds ratio for no CSEs, 10.0; 95% CI, 7.55- 13.25). Median daily mOCS dose decreased from 10.0 (quartile 1, 5.0; quartile 3, 14.7) mg at week 0 (n = 297) to 0.0 (quartile 1, 0.0; quartile 3, 5.0) mg at weeks 101 to 104 (n = 168), and the proportion of patients discontinuing mOCSs increased progressively to 43% at 1 year and 57% at 2 years. There was a 1.53-point reduction in Asthma Control Questionnaire-5 scores from baseline at 2 years. At months 21 to 24, least square mean FEV<sub>1</sub> improved by 142 mL from baseline. Ninety (11%) and 7 (< 1%) patients experienced mepolizumab-related AEs and serious AEs during the follow-up period, respectively.</div></div><div><h3>Interpretation</h3><div>In patients with severe asthma, real-world mepolizumab treatment for 2 years was well tolerated and was associated with sustained reductions in exacerbations and progressive reductions in mOCS use.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579515","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}
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