The effects of benralizumab on lung volumes and airway resistance in severe eosinophilic asthma: a real-world study

Introduction: Add-on biological monoclonal antibodies such as benralizumab (anti-IL-5Ra) are recommended by international guidelines to reduce exacerbations in severe eosinophilic asthma (SEA). However, few studies have assessed the impact of these therapies on lung function-related outcomes. Our goal was to evaluate the effectiveness of benralizumab on lung function, including lung volumes and airway resistance, in SEA patients in Portugal. Methods: This was a real-world, observational, prospective, multicentric study including adult patients diagnosed with SEA (January-June 2023). Spirometry and plethysmography were performed at baseline (T0) and after six months of treatment (T6) with benralizumab to assess: total lung capacity (TLC), residual volume (RV), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), mean forced expiratory flow between 25% and 75% of FVC (mFEF-25/75), intrathoracic gas volume (ITGV), and respiratory airway resistance (Raw). Descriptive statistics (with categorical variables described as frequencies and continuous values as mean and standard deviation (SD)) and paired t-test and Cohen's d effect size were calculated (analyses performed in StataCorp v.15.1; StataCorp LLC, TX, USA). Results: Overall, 30 SEA patients were evaluated, mostly women (n=18, 60.0%), with atopy (n=22, 73.3%), a mean age of 58.4 years (SD 11.7), and assisted by pulmonology (n=19, 63.3%) or immunology-allergology (n=11, 36.7%) services. Mean eosinophilia at baseline was 1103.57 cells/mcL (SD 604.88; minimum-maximum 460-2400); after the use of benralizumab, the count dropped to zero. After six months of treatment, a significant increase (p900 cells/mcL count; n=15) presented better responses in FEV1 (p=0.001) and mFEF-25/75 (p=0.007). Conclusions: A notable eosinophil depletion with add-on benralizumab led to significant improvements in SEA patients' respiratory function (static lung volumes and airway resistance) in real-world settings after six months. The significant deflating effect of benralizumab on patients' hyperinflated lungs led to enhanced expiratory flow (increased FEV1 and mFEF-25/75) and air trapping (decreased RV/TLC), suggesting this antibody improves bronchial obstruction, lung hyperinflation, and airway resistance. Further studies in a larger population are required to confirm these findings.info:eu-repo/semantics/publishedVersio

The Extended <i>H</i>_∞ Particle Filter for Attitude Estimation Applied to Remote Sensing Satellite CBERS-4

An extension of the linear H∞ filter, presented here as the extended H∞ particle filter (EH∞PF), is used in this work for attitude estimation, which presents a process and measurement model with nonlinear functions. The simulations implemented use orbit and attitude data from CBERS-4 (China–Brazil Earth Resources Satellite-4), making use of the robustness characteristics of the H∞ filter. The CBERS-4 is the fifth satellite of an advantageous international scientific interaction between Brazil and China for the development of remote sensing satellites used for strategic application in monitoring water resources and controlling deforestation in the Legal Amazon. In the extended H∞ particle filter (EH∞PF) the nature of the system, composed of dynamics and noises, seeks to degrade the state estimate. The EH∞PF deals with this by aiming for robustness, using a performance parameter in its cost function, in addition to presenting an advantageous feature of using a reduced number of particles for state estimation. The justification for the application of this method is because the non-Gaussian uncertainties that appear in the attitude sensors impair the estimation process and the EH∞PF minimizes in signal estimation the worst effects of disturbance signals without a priori knowledge of them, as shown in the results, in addition to presenting good precision within the prescribed requirements, with 100 particles representing a processing time 2.09 times less than the PF with 500 particles

The Portuguese Severe Asthma Registry: Development, Features, and Data Sharing Policies

The Portuguese Severe Asthma Registry (Registo de Asma Grave Portugal, RAG) was developed by an open collaborative network of asthma specialists. RAG collects data from adults and pediatric severe asthma patients that despite treatment optimization and adequate management of comorbidities require step 4/5 treatment according to GINA recommendations. In this paper, we describe the development and implementation of RAG, its features, and data sharing policies. The contents and structure of RAG were defined in a multistep consensus process. A pilot version was pretested and iteratively improved. The selection of data elements for RAG considered other severe asthma registries, aiming at characterizing the patient’s clinical status whilst avoiding overloading the standard workflow of the clinical appointment. Features of RAG include automatic assessment of eligibility, easy data input, and exportable data in natural language that can be pasted directly in patients’ electronic health record and security features to enable data sharing (among researchers and with other international databases) without compromising patients’ confidentiality. RAG is a national web-based disease registry of severe asthma patients, available at asmagrave.pt. It allows prospective clinical data collection, promotes standardized care and collaborative clinical research, and may contribute to inform evidence-based healthcare policies for severe asthma