Publications by authors named "Mark Hew"

Background: Mepolizumab can induce an early response and clinical remission in people with severe eosinophilic asthma (SEA).

Objective: To find whether early response to mepolizumab (100 mg) could predict future asthma remission and to identify the best predictor of treatment response to mepolizumab for achieving remission.

Methods: The Australian Mepolizumab Registry was used to investigate the early response to mepolizumab at 3 and 6 months and relate this to clinical remission at 12 months.

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Background: Long-term changes in medication dispensings post cystic fibrosis transmembrane conductance regulator (CFTR) modulator initiation have not been described. Our study aimed to investigate changes in medication use following the initiation of modulator therapy in people with cystic fibrosis (PwCF) in Australia.

Methods: Using a 10% sample of the Australian Pharmaceutical Benefits Scheme (PBS) data between 2013 and 2022, linear regression was used to analyse dispensings in PwCF who initiated any modulator (cases) and matched PwCF controls not dispensed a modulator.

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Article Synopsis
  • Abnormal breathlessness during intense exercise can result from several conditions like exercise-induced bronchospasm, laryngeal obstruction, or breathing pattern disorders, often missed in regular tests.
  • A retrospective study involved 24 patients, including professional athletes, where advanced testing revealed specific conditions in 66.7% of cases, leading to tailored treatment plans.
  • Significant findings included that 38% had exercise-induced laryngeal obstruction, predominantly in younger athletes, and highlighted the need for specialized follow-up and interventions based on individual diagnoses.
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Patients with severe eosinophilic asthma, characterised by a high disease burden, benefit from mepolizumab, which improves symptoms and reduces exacerbations, potentially leading to clinical remission in a subgroup. This study aimed to identify treatment response trajectories to mepolizumab for severe eosinophilic asthma and to assess the achievement of clinical remission.Data from the Australian Mepolizumab Registry were used to assess treatment responses at 3, 6, and 12 months.

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Background: Allergen immunotherapy (AIT) is the only disease-modifying treatment for allergic disorders. We have recently discovered that allergen-specific memory B cells (Bmem) are phenotypically altered after 4 months of sublingual AIT for ryegrass pollen allergy. Whether these effects are shared with subcutaneous allergen immunotherapy (SCIT) and affect the epitope specificity of Bmem remain unknown.

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Article Synopsis
  • - A study focused on the use of psychotropic medications in people living with cystic fibrosis (PwCF) in Australia from 2013 to 2022 found that over 41% of PwCF were prescribed these medications, indicating a higher prevalence compared to the general population.
  • - The research revealed that antidepressant and anxiolytic medications were most commonly prescribed to adult females, with usage significantly increasing over the years, while psychostimulant use rose notably among adolescent males.
  • - The findings highlight the need for further investigation into the reasons behind the disparities in psychotropic medication use among different age and sex groups within PwCF, aiming to improve treatment guidelines and health outcomes.
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Background: Biologic asthma therapies reduce exacerbations and long-term oral corticosteroids (LTOCS) use in randomized controlled trials (RCTs); however, there are limited data on outcomes among patients ineligible for RCTs. Hence, we investigated responsiveness to biologics in a real-world population of adults with severe asthma.

Methods: Adults in the International Severe Asthma Registry (ISAR) with ≥24 weeks of follow-up were grouped into those who did, or did not, initiate biologics (anti-IgE, anti-IL5/IL5R, anti-IL4/13).

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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.
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  • There is currently no agreed-upon definition for asthma remission in real life, and the factors that help patients achieve it after starting biologics are not well understood.
  • A study analyzed data from 23 countries to see how many adults with severe asthma reached multidomain-defined remission after beginning biologic treatment, using specific criteria for remission.
  • Results showed that less than a quarter of participants achieved full remission, with higher chances for those with fewer exacerbations, lower corticosteroid use, and better control and lung function before treatment, suggesting that early intervention is crucial for better outcomes.
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Aim: Speech pathology is the first-line treatment for inducible laryngeal obstruction (ILO) and involves behavioral techniques to address symptoms and modify maladaptive laryngeal postures. Benefit from speech pathology is reliant on patients engaging in treatment sessions, regular home practice, and generalizing techniques to everyday activities. There is limited research exploring engagement in speech pathology treatment for ILO, particularly from the patient perspective.

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Background: Lung ultrasound (LUS) is increasingly used as an extension of physical examination, informing clinical diagnosis, and decision making. There is particular interest in the assessment of patients with pulmonary congestion and extravascular lung water, although gaps remain in the evidence base underpinning this practice as a result of the limited evaluation of its inter-rater reliability and comparison with more established radiologic tests.

Methods: 30 patients undergoing haemodialysis were prospectively recruited to an observational cohort study (NCT01949402).

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Background: Exacerbation frequency strongly influences treatment choices in patients with severe asthma.

Research Question: What is the extent of the variability of exacerbation rate across countries and its implications in disease management?

Study Design And Methods: We retrieved data from the International Severe Asthma Registry, an international observational cohort of patients with a clinical diagnosis of severe asthma. We identified patients aged ≥ 18 years who did not initiate any biologics prior to baseline visit.

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Background: House dust mite (HDM) is the most common allergen trigger globally for allergic rhinitis and atopic asthma.

Objectives: To expedite accurate confirmation of allergen sensitization, we designed fluorescent allergen tetramers to directly stain specific IgE on basophils to detect specific allergen sensitization using the flow cytometric CytoBas assay.

Methods: Recombinant proteins of major HDM allergens (component), Der f 1, Der p 1, and Der p 2 were biotinylated and conjugated with fluorochrome streptavidins as tetramers.

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Background: There is little agreement on clinically useful criteria for identifying real-world responders to biologic treatments for asthma.

Objective: To investigate the impact of pre-biologic impairment on meeting domain-specific biologic responder definitions in adults with severe asthma.

Methods: This was a longitudinal, cohort study across 22 countries participating in the International Severe Asthma Registry (https://isaregistries.

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Background: Food allergy is a leading cause of anaphylaxis worldwide. Allergen-specific immunotherapy is the only treatment shown to modify the natural history of allergic disease, but application to food allergy has been hindered by risk of severe allergic reactions and short-lived efficacy. Allergen-derived peptides could provide a solution.

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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.
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