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  1. Article: Mepolizumab and benralizumab in patients with severe asthma and a history of eosinophilic granulomatosis with polyangiitis.

    Desaintjean, Charlene / Ahmad, Kaïs / Traclet, Julie / Gerfaud-Valentin, Mathieu / Durel, Cecile-Audrey / Glerant, Jean-Charles / Hot, Arnaud / Lestelle, François / Mainbourg, Sabine / Nasser, Mouhamad / Seve, Pascal / Turquier, Ségolène / Devouassoux, Gilles / Cottin, Vincent

    Frontiers in medicine

    2024  Volume 11, Page(s) 1341310

    Abstract: Introduction: Asthma associated with eosinophilic granulomatosis with polyangiitis (EGPA) is often severe and corticosteroid-dependent, leading to significant morbidity. Mepolizumab and benralizumab are humanized monoclonal antibodies targeting ... ...

    Abstract Introduction: Asthma associated with eosinophilic granulomatosis with polyangiitis (EGPA) is often severe and corticosteroid-dependent, leading to significant morbidity. Mepolizumab and benralizumab are humanized monoclonal antibodies targeting interleukin 5 (IL-5) and its receptor, respectively. They have been shown to be effective in steroid-sparing in patients with severe eosinophilic asthma.
    Objective: Our aim was to evaluate the efficacy and safety of mepolizumab and benralizumab prescribed for severe asthma in patients with EGPA under "real-world" conditions.
    Methods: This was a retrospective analysis of patients with EGPA and persistent asthma who received either mepolizumab 100 or 300 mg administered every 4 weeks, or benralizumab 30 mg administered every 4 weeks for the initial 3 injections and followed by an injection every 8 weeks thereafter, whilst combined with oral glucocorticoids. The follow-up every 6 ± 3 months included an assessment of clinical manifestations, pulmonary function tests and eosinophil cell count. The primary outcome was the proportion of patients at 12 months receiving a daily oral dose of prednisone or equivalent of 4 mg or less with a BVAS of 0.
    Results: Twenty-six patients were included. After 12 months of treatment with mepolizumab or benralizumab, 32% of patients met the primary outcome and were receiving less than 4 mg of prednisone per day with a BVAS of 0. The median dose of prednisone was 10 mg per day at baseline, 9 mg at 6 months, and 5 mg at 12 months (
    Conclusion: In this real-world study in patients with severe asthma and a history of EGPA asthma, mepolizumab and benralizumab had a significant steroid-sparing effect and reduced asthma exacerbation, but no significant effect on lung function.
    Language English
    Publishing date 2024-03-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2775999-4
    ISSN 2296-858X
    ISSN 2296-858X
    DOI 10.3389/fmed.2024.1341310
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Changes in the management of chronic thromboembolic pulmonary hypertension over a 10-year period, in a French expert regional competence centre.

    Provost, Mathilde / Mornex, Jean-François / Nasser, Mouhamad / Zeghmar, Sabrina / Traclet, Julie / Ahmad, Kais / Lestelle, François / Chour, Ali / Diesler, Rémi / Cottin, Vincent / Turquier, Ségolène

    Respiratory medicine and research

    2023  Volume 84, Page(s) 101021

    Abstract: Over the last few years, the advent of balloon pulmonary angioplasty (BPA) had led to changes in the management of chronic thromboembolic pulmonary hypertension (CTEPH). We reviewed data from 98 CTEPH patients diagnosed during the last decade in a ... ...

    Abstract Over the last few years, the advent of balloon pulmonary angioplasty (BPA) had led to changes in the management of chronic thromboembolic pulmonary hypertension (CTEPH). We reviewed data from 98 CTEPH patients diagnosed during the last decade in a pulmonary hypertension (PH) expert centre. The management modalities of 2 periods (Period A: 2011-15 and Period B: 2016-20) were compared. Age (period A: 72 [58-80] years; period B: 69 [62-79] years), clinical (New York Heart Association (NYHA) functional class III-IV: 25/41, 61% vs 39/57, 68%), and hemodynamic assessments (pulmonary vascular resistance: 7.5 [6.2-8.7] WU vs 8.0 [6.0-10.2] WU) at baseline were not significantly different. Pulmonary endarterectomy was performed in less than one third of patients (12, 29.3% vs 15, 26.3%). For patients not eligible for surgery, medical therapy was mostly prescribed alone during period A (medical therapy alone, patients diagnosed in period A: 61% vs in period B: 17.5%) while it was associated with BPA during period B (medical therapy + BPA, 12% vs 61.4%). The 5-year survival rate was excellent for patients who underwent surgery (96.3%) or BPA (95.2%), but was only 42.1% for patients under oral medication only (p < 0.0001). Patients diagnosed with CTEPH who cannot be operated should undergo BPA. The survival rate after BPA is as good as after surgery and significantly better than that of oral medication only.
    MeSH term(s) Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Pulmonary Embolism/complications ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/surgery ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/epidemiology ; Hypertension, Pulmonary/etiology ; Chronic Disease ; Hemodynamics ; Vascular Resistance
    Language English
    Publishing date 2023-06-03
    Publishing country France
    Document type Review ; Journal Article
    ISSN 2590-0412
    ISSN (online) 2590-0412
    DOI 10.1016/j.resmer.2023.101021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Pneumatocoeles after bronchoscopic lung volume reduction with valves.

    Lestelle, Francois / Fumat, Romane / Didier, Alain / Collot, Samia / Egenod, Thomas / Faviez, Guillaume / Hermant, Christophe / Plat, Gavin / Guibert, Nicolas

    ERJ open research

    2021  Volume 7, Issue 2

    Abstract: Pneumatocoele is a very rare complication of Zephyr EBV, probably due to chest tube insertion and suction of a trapped and emphysematous lung. Complete healing and functional improvements are possible without the need for valve removal. ...

    Abstract Pneumatocoele is a very rare complication of Zephyr EBV, probably due to chest tube insertion and suction of a trapped and emphysematous lung. Complete healing and functional improvements are possible without the need for valve removal.
    Language English
    Publishing date 2021-04-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2827830-6
    ISSN 2312-0541
    ISSN 2312-0541
    DOI 10.1183/23120541.00747-2020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Phenotypes and outcome of diffuse pulmonary non-amyloid light chain deposition disease.

    Lestelle, François / Beigelman, Catherine / Rotzinger, David / Si-Mohamed, Salim / Nasser, Mouhamad / Wemeau, Lidwine / Hirschi, Sandrine / Prevot, Grégoire / Roux, Antoine / Bunel, Vincent / Gomez, Emmanuel / Sohier, Laurent / Pradier, Helene Morisse / Gaubert, Martine Reynaud / Gondouin, Anne / Lazor, Romain / Glerant, Jean-Charles / Bejui, Françoise Thivolet / Colombat, Magali /
    Cottin, Vincent

    Respiratory research

    2024  Volume 25, Issue 1, Page(s) 159

    Abstract: Background: Light chain deposition disease (LCDD) is a very rare entity. Clinical manifestations of LCDD vary according to the organs involved. Data on pulmonary LCDD are scarce and limited to small series or case reports. This study aimed to describe ... ...

    Abstract Background: Light chain deposition disease (LCDD) is a very rare entity. Clinical manifestations of LCDD vary according to the organs involved. Data on pulmonary LCDD are scarce and limited to small series or case reports. This study aimed to describe the characteristics and outcome of diffuse pulmonary non-amyloid LCDD localized to the lungs.
    Study design and methods: A multicenter retrospective cohort study was conducted. Clinical characteristics were collected, and chest CTs were centrally reviewed. The diagnosis of pulmonary non-amyloid LCDD was confirmed by immunohistochemistry.
    Results: Thirty-one cases were identified (68% female), with a median age at diagnosis of 50 years (IQR 20). Baseline FEV1/FVC was < 0.70 in 45% of patients. Mean (± SD) FEV1 and DLCO were 86% ± 26.2 and 52% ± 23.9, respectively. CT revealed peculiar patterns of thin-walled cysts (58%) and thin-walled cystic bronchiectases (27%). Increased serum kappa light chain was found in 87% of patients. Histological analysis showed kappa light chain deposits in all patients, except one with lambda chain deposits. Median annual FEV1 decline was 127 ml (IQR 178) and median DLCO decline was 4.3% (IQR 4.3). Sixteen patients received immunomodulatory treatment or chemotherapy; serum light chain levels decreased in 9 cases (75%), without significant improvement in FEV1 (p = 0.173). Overall, 48% of patients underwent bilateral lung transplantation. Transplant-free survival at 5 and 10 years were 70% and 30%, respectively. An annual FEV1 decline greater than 127 ml/year was associated with increased risk of death or transplantation (p = 0.005).
    Conclusions: Diffuse pulmonary LCDD is characterised by female predominance, a peculiar imaging pattern with bronchiectasis and/or cysts, progressive airway obstruction and severe DLCO impairment, and poor outcome. Lung transplantation is a treatment of choice.
    MeSH term(s) Humans ; Female ; Young Adult ; Adult ; Male ; Immunoglobulin Light Chains ; Retrospective Studies ; Lung/diagnostic imaging ; Lung/pathology ; Bronchiectasis ; Cysts/pathology ; Phenotype
    Chemical Substances Immunoglobulin Light Chains
    Language English
    Publishing date 2024-04-10
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-024-02798-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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