Real-world effectiveness of molnupiravir and nirmatrelvir/ritonavir as treatments for COVID-19 in patients at high risk

Background Using a retrospective cohort study design, we aimed to evaluate the effectiveness of molnupiravir and nirmatrelvir/ritonavir in patients with SARS-CoV-2 who were highly vulnerable. Methods The impact of each drug was determined via comparisons with age-matched control groups of patients positive for SARS-CoV-2 who did not receive oral antiviral therapy. Results Administration of molnupiravir significantly reduced the risk of hospitalization (odds ratio [OR], 0.40; P < .001) and death (OR, 0.31; P < .001) among these patients based on data adjusted for age, previous SARS-CoV-2 infection, vaccination status, and time elapsed since the most recent vaccination. The reductions in risk were most profound among elderly patients (≥75 years old) and among those with high levels of drug adherence. Administration of nirmatrelvir/ritonavir also resulted in significant reductions in the risk of hospitalization (OR, 0.31; P < .001) and death (OR, 0.28; P < .001). Similar to molnupiravir, the impact of nirmatrelvir/ritonavir was more substantial among elderly patients and in those with high levels of drug adherence. Conclusions Collectively, these real-world findings suggest that although the risks of hospitalization and death due to COVID-19 have been reduced, antivirals can provide additional benefits to members of highly vulnerable patient populations

What to expect from the ERS International Congress 2023

For the second consecutive year, the European Respiratory Society (ERS) International Congress will be held in a hybrid format, in Milan, Italy and online, from 9 September to 13 September 2023. This year, the Congress will return to a 5-day programme covering the latest advances in science and clinical practice across the full range of respiratory topics. Thousands of researchers and health professionals will have the opportunity to share their knowledge and work at the world's largest respiratory meeting. In this article, we provide a glimpse of the ERS Congress 2023 including a summary of the Early Career Member (ECM) session, an overview of the Networking EXcellence Training (NEXT) programme, and the “top picks” from the programme selected by the members of the International Congress Programme Committee (ICPC). The full programme is available at: https://www.ersnet.org/congress-and-events/congress/programme/

Hydrogen peroxide in expired breath condensate of patients with inflammatory airway diseases

Hydrogen peroxide in expired breath condensate of patients with inflammatory airway diseases. Stelios Loukides MD, Pneumonology Dept Athens Army General Hospital. The aim of our study was to determine the concentration of exhaled hydrogen peroxide (H₂O₂) in patients with inflammatory airway diseases, to investigate which cells are the main source of hydrogen peroxide (H₂O₂) production in each disease and finally to evaluate the association between H₂O₂ levels, airway inflammation and disease severity. Thirty patients with bronchiectasis, fifty stable asthmatics with disease severity ranging from mild to moderate and finally thirty patients with stable COPD with disease severity ranging from mild to severe were studied. Mean concentration of H₂O₂ was significantly elevated in patients with inflammatory airway diseases compared to the values of control subjects for each disease. Eosinophils were the predominate cells which generate H₂O₂ in asthma, while neutrophils were responsible for the highest levels which were observed in bronchiectasis and COPD. The role of H₂O₂ concentration in predicting the severity of the disease as well as the inflammatory process, is limited in asthma and depends on the use of inhaled steroids (ICS) and the classification severity. In patients with bronchiectasis increased levels of exhaled H₂O₂ reflected the severity of the disease as well as the inflammatory process, were not decreased either by the use of ICS or the long term oral antibiotic treatment but were significantly affected by chronic colonization with Pseudomonas Aeruginosa. In patients with COPD the role of H₂O₂ concentration in predicting the severity of the disease as well as the inflammatory process depends on the classification severity and was not affected by the use of inhaled steroids.Σκοπός της μελέτης αυτής ήταν η μέτρηση των επιπέδων του υπεροξειδίου του υδρογόνου (H2O2) στο συμπύκνωμα του εκπνεόµενου αέρα ασθενών µε φλεγμονώδεις παθήσεις των αεραγωγών, ο καθορισμός των κυττάρων που συµµετέχουν στην παραγωγή του για κάθε νόσο ξεχωριστά, καθώς και η πιθανή συσχέτιση των επιπέδων του µε παραμέτρους που εκφράζουν φλεγμονή και βαρύτητα σε κάθε νόσο. Μελετήθηκαν τριάντα ασθενείς µε βρογχεκτασίες, πενήντα ασθενείς µε σταθερό άσθμα βαρύτητας από ήπιο έως µέτριο και τριάντα ασθενείς µε σταθερή ΧΑΠ βαρύτητας από ήπια έως σοβαρή. Η µέση συγκέντρωση του H₂O₂ ήταν στατιστικά σημαντικά υψηλότερη από αυτή των ομάδων ελέγχου για κάθε νόσο. Τα ηωσινόφιλα ήταν τα επικρατούντα κύτταρα που συµµετείχαν στην παραγωγή H₂O₂ στο άσθμα, ενώ τα ουδετερόφιλα ήταν υπεύθυνα για την υψηλή συγκέντρωση του H₂O₂ στις βρογχεκτασίες και στην ΧΑΠ. Ο ρόλος του H₂O₂ στην αξιολόγηση της υποκείμενης φλεγμονής και βαρύτητας στο άσθμα ήταν περιορισμένος µια και εξαρτώνταν από την λήψη εισπνεόμενων στεροειδών (ΕΣ) και την ταξινόμηση αυτής σε στάδια. Στους ασθενείς µε βρογχεκτασίες τα επίπεδα του H₂O₂ εξέφραζαν την υποκείμενη φλεγμονή της νόσου, την έκταση και την βαρύτητα αυτής, µη επηρεαζόμενα από την λήψη ΕΣ και αντιβιοτικών σε µακρό χρόνο, αλλά σημαντικά επηρεαζόμενα από τον χρόνιο αποικισμό µε Ψευδοµονάδα Aeruginosa. Τέλος στους ασθενείς µε ΧΑΠ ο ρόλος του H₂O₂ στην αξιολόγηση της υποκείμενης φλεγμονής και βαρύτητας επηρεαζόταν από την ταξινόμηση αυτής σε στάδια αλλά όχι από την λήψη ΕΣ

Budesonide/formoterol via the Elpenhaler (R) device in asthmatic patients: A real-world effectiveness study (The BOREAS Study)

INTRODUCTION Very limited real-world data have been captured in the Greek asthmatic population regarding the effects of treatment with a fixed-dose combination of budesonide/formoterol via the Elpenhaler (R) device, on the course of the disease and its impact on the patients’ quality of life score. METHODS In this multicenter, observational study, 1230 adult asthmatic patients in Greece that had been recently prescribed a fixed-dose combination budesonide/formoterol, Elpenhaler (R) were enrolled. The primary endpoint was the evaluation of the effectiveness of the treatment at six months in symptom control using the 7-item Asthma Control Questionnaire (ACQ-7). The secondary endpoints included the quality of life score using the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), pulmonary function, patients’ satisfaction with the Elpenhaler (R) device, and safety. RESULTS In total, 60.3% (742/1230) of the participants were female and the mean age was 51.10 +/- 16.98 years. A statistically significant improvement of the mean ACQ-7 score was noted at 3 months (1.01 +/- 0.70) and 6 months (0.79 +/- 0.66), compared to baseline (2.18 +/- 0.91). Similar statistically significant results were noted for the MiniAQLQ score with an improvement from 4.58 +/- 1.06 at baseline to 5.95 +/- 0.79 at 3 months, and 6.21 +/- 0.74 at 6 months. The mean Forced Expiratory Volume at 1 second (FEV1) showed continuing improvement, being 2.36 +/- 0.86, 2.58 +/- 0.88, and 2.64 +/- 0.88 L, at baseline, 3, and 6 months, respectively. CONCLUSIONS These real-world data showed that the administration of a fixed dose combination of budesonide/formoterol using the Elpenhaler (R) device was well-tolerated and effective in significantly reducing the symptoms of asthma and improving the quality of life

The diverse roles of adiponectin in non-small-cell lung cancer: current data and future perspectives

In recent years, there is growing research interest for the biological role of adipose tissue-derived bioactive factors, mainly including adipokines, in various forms of cancer. Adiponectin (APN) is the most abundant circulating adipokine, and a key mediator of several cancer-related processes, such as cell proliferation, apoptosis, regulation of tumor cell invasion and angiogenesis. In this review we summarize and critically discuss the published literature on the diverse roles of APN in non-small-cell lung cancer, including its implication in lung cancer development, its use as a diagnostic and prognostic biomarker, and its correlation with cancer-related cachexia. The main challenges and future perspectives, mainly with regard to the potential development of APN-targeted therapeutic agents in cancer therapeutics, are also briefly presented and discussed

Falsely Elevated CA 15-3 Levels in Ovarian Sarcoidosis with Peritoneal Involvement and Ascites

A rare case of ovarian sarcoidosis with peritoneal and omental involvement presenting as an ovarian malignancy is presented. Clinical, laboratory, and radiological evaluation of the patient revealed ascites and high levels of serum CA 125 and CA 15.3. The diagnosis of sarcoidosis was confirmed with pathology findings on tissues obtained during surgical laparotomy. Establishing the diagnosis of sarcoidosis can be treacherous and was complicated in this case by the falsely elevated biomarkers and ascites