Publications by authors named "Kostikas K"
Small airway disease/dysfunction (SAD) is crucial in obstructive airway diseases but is less investigated in interstitial lung disease (ILD). There are only a few physiological studies investigating SAD in the context of pulmonary fibrosis. Oscillometry is a simple technique that assesses SAD with minimal patient effort.
View Article and Find Full Text PDFRemission of asthma can occur as part of the natural history of the disease; however, the use of biologics can result in disease remission in some patients. In this post hoc analysis of the RELIght study, we aimed to evaluate clinical remission in real life among patients treated with mepolizumab, to detect possible differences between "remitters" and "nonremitters," and to evaluate possible predictors of remission. Clinical remission was defined as the absence of asthma exacerbations, discontinuation of oral corticosteroids (OCS), achievement of asthma control (Asthma Control Test [ACT] ≥ 20), and stable or improved lung function.
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- The STEPINCOPD study investigated the factors influencing the escalation or de-escalation of inhaled COPD therapies in clinical practice, especially after updated guidelines were released in 2019 and 2020.
- Conducted over 12 weeks with 1429 patients from various centers in Greece, the study focused on understanding why patients had changes in their inhaled medication based on GOLD's 2021 recommendations.
- Findings revealed that reasons for treatment changes included lack of response to previous treatment and COPD exacerbations, with a high adherence rate (over 80%) to the GOLD recommendations among physicians, influenced by factors such as their age and patients' CAT scores.
Background: Clinical trials and real-world experience have provided evidence for the clinical benefits of mepolizumab, an anti-IL-5 biologic, in severe asthma. However, limited data exist regarding the impact of mepolizumab on airway remodeling.
Objective: We sought to investigate the effect of mepolizumab on airway structural remodeling in patients treated for severe asthma in routine clinical care.
Article Synopsis
- The studies NAVIGATOR and DESTINATION evaluated the effectiveness of tezepelumab in treating severe, uncontrolled asthma.
- Results showed that a higher percentage of patients receiving tezepelumab experienced a complete clinical response and on-treatment clinical remission compared to those on placebo.
- Conclusion suggests that tezepelumab significantly improves patient outcomes, leading to better lung function and fewer asthma exacerbations over time.
Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous progressive lung condition characterized by long-term respiratory symptoms and airflow limitation. Appropriate bronchodilation is the cornerstone of COPD treatment, leading to better health status as well as benefits in prognosis and mortality.
Methods: In the current open, noninterventional, observational study, 716 patients diagnosed with COPD of variable severity were administered a fixed-dose combination (FDC) of fluticasone propionate and salmeterol (500 + 50 mcg) through the Elpenhaler® device.
Objective: Monocyte count and red cell distribution width (RDW) have shown prognostic potential in patients with fibrotic lung diseases. Their kinetics and prognostic usefulness of peripheral blood indices in patients with interstitial lung diseases (ILDs) undergoing surgical lung biopsy for diagnostic reasons have not been studied.
Patients And Methods: We retrospectively included consecutive patients with ILD who underwent surgical lung biopsy for diagnostic purposes Between 07/11/2019 and 11/10/2022.
Article Synopsis
- The study investigates how pre-biologic biomarker levels, specifically immunoglobulin E (IgE), blood eosinophil count (BEC), and fractional exhaled nitric oxide (FeNO), influence asthma treatment outcomes when patients start biologic therapy.
- Conducted across 23 countries with over 3750 patients, the research focused on changes in exacerbation rates, symptom control, and lung function about a year after starting treatment.
- Results showed that higher levels of BEC and FeNO were linked to significant improvements in lung function for specific biologic therapies, while IgE was not a strong predictor of treatment effectiveness.
Background: Six biologic agents are now approved for patients with severe asthma. This meta-analysis aimed to assess the efficacy and safety of licensed biologic agents in patients with severe asthma, including the recently approved tezepelumab.
Methods: We searched MEDLINE, Embase and CENTRAL to identify randomised controlled trials involving licensed biologics until 31 January 2023.
Article Synopsis
- The study aimed to determine whether an educational video about airway collapsibility during sleep would improve the acceptance of CPAP treatment in patients with severe obstructive sleep apnea.
- A total of 145 patients were analyzed, with one group receiving standard care and the other group watching the video before their treatment.
- Results showed that 80% of patients who watched the video accepted CPAP therapy, compared to 57% in the standard care group, highlighting the video's positive impact on CPAP acceptance.
This meta-analysis compares the efficacy and safety of inhaled systemic corticosteroids for COPD exacerbations.Following a pre-registered protocol, we appraised eligible randomised controlled trials (RCTs) according to Cochrane methodology, performed random-effects meta-analyses for all outcomes prioritised in the European Respiratory Society COPD core outcome set and rated the certainty of evidence as per Grading of Recommendations Assessment, Development and Evaluation methodology.We included 20 RCTs totalling 2140 participants with moderate or severe exacerbations.
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- Vaccination is essential for controlling COVID-19, but hesitancy is a challenge, especially among patients with severe asthma; this study explores their vaccination experiences.
- A questionnaire was distributed to patients with severe asthma across 12 European countries, revealing that 88% of participants had been or planned to be vaccinated, while 9.5% hesitated and 3% refused; beliefs about vaccines influenced these decisions.
- Most patients reported mild or no side effects and noted minimal impact on asthma symptoms post-vaccination, with nearly all vaccinated individuals recommending the vaccine to others in their situation.
Article Synopsis
- Previous studies on how comorbidities affect the effectiveness of biologic agents in asthma were limited in size and duration, lacking comparisons between different biologic classes.
- This cohort study analyzed data from the International Severe Asthma Registry across 21 countries to assess changes in asthma outcomes after starting biologic therapy in patients with type 2-related comorbidities.
- Results showed that patients with chronic rhinosinusitis (CRS) and nasal polyps (NPs) experienced significantly better outcomes, including fewer exacerbations and improved asthma control, while allergic rhinitis and atopic dermatitis did not influence therapy effectiveness.
Article Synopsis
- The study analyzed COVID-19 patients in Greece to compare baseline characteristics and mortality predictors during the Delta and Omicron variant waves.
- A total of 979 patients were included, with key findings showing Delta patients were younger, required longer hospital stays, and had higher levels of specific biomarkers compared to Omicron patients.
- Despite these differences, there was no significant disparity in mortality risk or ICU admissions between the two groups; factors such as age and certain medical conditions were identified as independent mortality predictors for the Delta patients.
Article Synopsis
- The study aimed to evaluate the prevalence and impact of comorbidities in adults with severe asthma, as their presence can complicate asthma management practices.* -
- Data was analyzed from the International Severe Asthma Registry, identifying 30 comorbidities linked to asthma, with findings indicating a significant percentage of patients experience multiple comorbidities that affect their asthma outcomes.* -
- Results showed that patients with specific comorbidities like allergic rhinitis and nasal polyposis had higher rates of asthma exacerbations and were more likely to require long-term oral corticosteroids, highlighting the need for effective management strategies.*
Background: Echocardiographic markers of right ventricular dysfunction or pressure overload (RV) have been used in risk assessment of patients with acute pulmonary embolism (APE). Nevertheless, the role of echocardiography in these patients is incompletely determined. We evaluated the right ventricular function using 'non-conventional' markers of RV in patients with APE.
View Article and Find Full Text PDFBackground: In this study, we compare management of patients with high-risk chronic obstructive pulmonary disease (COPD) in the United States to national and international guidelines and quality standards, including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST).
Methods: Patients were identified from the DARTNet Practice Performance Registry and categorized into three high-risk cohorts in each year from 2011 to 2019: newly diagnosed (≤12 months after diagnosis), already diagnosed, and patients with potential undiagnosed COPD. Patients were considered high-risk if they had a history of exacerbations or likely exacerbations (respiratory consult with prescribed medication).
Interstitial lung diseases (ILDs) comprise a rather heterogeneous group of diseases varying in pathophysiology, presentation, epidemiology, diagnosis, treatment and prognosis. Even though they have been recognized for several years, there are still areas of research debate. In the majority of ILDs, imaging modalities and especially high-resolution Computed Tomography (CT) scans have been the cornerstone in patient diagnostic approach and follow-up.
View Article and Find Full Text PDFThe SARS-CoV-2 infection (COVID-19) pandemic created an unprecedented chain of events at a global scale, with European counties initially following individual pathways on the confrontation of the global healthcare crisis, before organizing coordinated public vaccination campaigns, when proper vaccines became available. In the meantime, the viral infection outbreaks were determined by the inability of the immune system to retain a long-lasting protection as well as the appearance of SARS-CoV-2 variants with differential transmissibility and virulence. How do these different parameters regulate the domestic impact of the viral epidemic outbreak? We developed two versions of a mathematical model, an original and a revised one, able to capture multiple factors affecting the epidemic dynamics.
View Article and Find Full Text PDFBackground: Baseline characteristics could potentially guide asthma treatments. We evaluated whether baseline eosinophil levels affect the efficacy of mometasone/indacaterol/glycopyrronium (MF/IND/GLY) in patients with inadequately controlled asthma.
Method: In this post hoc analysis of IRIDIUM study, efficacy of high-dose MF/IND/GLY (160/150/50 μg, once-daily [o.