Introduction: Severe asthma is associated with airway inflammation and airway obstruction. In the phase 3 NAVIGATOR study, tezepelumab treatment significantly improved pre-bronchodilator forced expiratory volume in 1 s (FEV) compared with placebo in patients with severe, uncontrolled asthma. This analysis assessed the effect of tezepelumab versus placebo on additional lung function parameters in patients from NAVIGATOR.
Methods: NAVIGATOR was a multicenter, randomized, double-blind, placebo-controlled study. Patients (12-80 years old) receiving medium- or high-dose inhaled corticosteroids and at least one additional controller medication, with or without oral corticosteroids, were randomized 1:1 to tezepelumab 210 mg or placebo subcutaneously every 4 weeks for 52 weeks. Changes from baseline to week 52 in pre-bronchodilator FEV, post-bronchodilator FEV, forced vital capacity (FVC), pre-bronchodilator FEV/FVC ratio, pre-bronchodilator forced expiratory flow between 25 and 75% of vital capacity (FEF), and morning and evening peak expiratory flow (PEF) were assessed.
Results: Tezepelumab treatment improved all evaluated lung function parameters over 52 weeks compared with placebo [least-squares mean difference (95% confidence interval): pre-bronchodilator FEV, 0.13 (0.08, 0.18) L; post-bronchodilator FEV, 0.12 (0.07, 0.16) L; FVC, 0.13 (0.07, 0.19) L; FEV/FVC ratio, 2.06% (1.22%, 2.90%); FEF, 0.13 (0.07, 0.19) L/s; morning PEF, 16.6 (8.1, 25.1) L/min; and evening PEF, 14.9 (6.3, 23.4) L/min]. Improvements were observed as early as weeks 1-2 and were maintained over 52 weeks. Greater improvements in lung function compared with placebo were observed in patients with a disease duration of less than 20 years, those with baseline post-bronchodilator FEV reversibility of at least 20%, and in patients with a baseline post-bronchodilator FEV/FVC ratio of less than 0.7.
Conclusion: These findings further support the benefits of tezepelumab treatment in improving airflow limitation in patients with severe, uncontrolled asthma.
Clinical Trial Registration: NAVIGATOR (NCT03347279).
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http://dx.doi.org/10.1007/s12325-023-02659-y | DOI Listing |
Fam Cancer
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Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Multiple endocrine neoplasia type 1 (MEN1) syndrome is an autosomal dominant disorder caused by a germline pathogenic variant in the MEN1 tumor suppressor gene. Patients with MEN1 have a high risk for primary hyperparathyroidism (PHPT) with a penetrance of nearly 100%, pituitary adenomas (PitAd) in 40% of patients, and neuroendocrine neoplasms (NEN) of the pancreas (40% of patients), duodenum, lung, and thymus. Increased MEN1-related mortality is mainly related to duodenal-pancreatic and thymic NEN.
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Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec H2X 0A9, Canada.
The abnormally viscous and thick mucus is a hallmark of cystic fibrosis (CF). How the mutated CF gene causes abnormal mucus remains an unanswered question of paramount interest. Mucus is produced by the hydration of gel-forming mucin macromolecules that are stored in intracellular granules prior to release.
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J Coll Physicians Surg Pak
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Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
The Valsalva manoeuvre is widely recognised for its effectiveness in reverting supra-ventricular tachycardia (SVT) in patients with good coordination. However, this is not applicable in sedated ventilated patients and there is a dearth of literature regarding the application of Valsalva in unconscious patients on mechanical ventilation. The authors, for the first time, present a novel non-pharmacological method to treat SVT in critically ill patients on mechanical ventilation, employing the high positive end-expiratory pressure (PEEP) technique.
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Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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