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Article ; Online: Efficacy of Pirfenidone and Nintedanib in Interstitial Lung Diseases Other than Idiopathic Pulmonary Fibrosis: A Systematic Review.

Amati, Francesco / Stainer, Anna / Polelli, Veronica / Mantero, Marco / Gramegna, Andrea / Blasi, Francesco / Aliberti, Stefano

International journal of molecular sciences

2023 Volume 24, Issue 9

Abstract: Pirfenidone and nintedanib are antifibrotic medications approved for idiopathic pulmonary fibrosis treatment by regulatory agencies and available for clinical use worldwide. These drugs have been shown to reduce the rate of decline in forced vital ... ...

Abstract	Pirfenidone and nintedanib are antifibrotic medications approved for idiopathic pulmonary fibrosis treatment by regulatory agencies and available for clinical use worldwide. These drugs have been shown to reduce the rate of decline in forced vital capacity and the risk of acute exacerbation among patients with idiopathic pulmonary fibrosis. Recent data suggest that different interstitial lung diseases with a progressive pulmonary fibrosis phenotype can share similar pathogenetic and biological pathways and could be amenable to antifibrotic therapies. Indeed, historical management strategies in interstitial lung disease have failed to identify potential treatments once progression has occurred despite available drugs. In this systematic review, we summarized data on the efficacy of pirfenidone and nintedanib in interstitial lung diseases other than idiopathic pulmonary fibrosis as well as ongoing and upcoming clinical trials. We identify two well-designed trials regarding nintedanib demonstrating the efficacy of this drug in slowing disease progression in patients with interstitial lung diseases other than idiopathic pulmonary fibrosis. On the other hand, results on the use of pirfenidone in interstitial lung diseases other than idiopathic pulmonary fibrosis should be interpreted with more caution on the basis of trial limitations. Several randomized control trials are underway to improve the quality of evidence in the interstitial lung disease field.
MeSH term(s)	Humans ; Idiopathic Pulmonary Fibrosis/drug therapy ; Idiopathic Pulmonary Fibrosis/pathology ; Lung Diseases, Interstitial/drug therapy ; Indoles/therapeutic use ; Pyridones/therapeutic use ; Treatment Outcome
Chemical Substances	nintedanib (G6HRD2P839) ; pirfenidone (D7NLD2JX7U) ; Indoles ; Pyridones
Language	English
Publishing date	2023-04-25
Publishing country	Switzerland
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms24097849
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Identify Drug-Resistant Pathogens in Patients with Community-Acquired Pneumonia.

Amati, Francesco / Bindo, Francesco / Stainer, Anna / Gramegna, Andrea / Mantero, Marco / Nigro, Mattia / Bussini, Linda / Bartoletti, Michele / Blasi, Francesco / Aliberti, Stefano

Advances in respiratory medicine

2023 Volume 91, Issue 3, Page(s) 224–238

Abstract: A substantial increase in broad-spectrum antibiotics as empirical therapy in patients with community-acquired pneumonia (CAP) has occurred over the last 15 years. One of the driving factors leading to that has been some evidence showing an increased ... ...

Abstract	A substantial increase in broad-spectrum antibiotics as empirical therapy in patients with community-acquired pneumonia (CAP) has occurred over the last 15 years. One of the driving factors leading to that has been some evidence showing an increased incidence of drug-resistant pathogens (DRP) in patients from a community with pneumonia, including methicillin-resistant
MeSH term(s)	Humans ; Methicillin-Resistant Staphylococcus aureus ; Community-Acquired Infections/drug therapy ; Pneumonia/drug therapy ; Pneumonia/epidemiology ; Anti-Bacterial Agents/therapeutic use
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-05-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2893877-X
ISSN	2543-6031 ; 2451-4934
ISSN (online)	2543-6031
ISSN	2451-4934
DOI	10.3390/arm91030018
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Article ; Online: Vasoactive drugs for the treatment of pulmonary hypertension associated with interstitial lung diseases: a systematic review.

Bongiovanni, Gabriele / Tonutti, Antonio / Stainer, Anna / Nigro, Mattia / Kellogg, Dean L / Nambiar, Anoop / Gramegna, Andrea / Mantero, Marco / Voza, Antonio / Blasi, Francesco / Aliberti, Stefano / Amati, Francesco

BMJ open respiratory research

2024 Volume 11, Issue 1

Abstract: Objectives: Vasoactive drugs have exhibited clinical efficacy in addressing pulmonary arterial hypertension, manifesting a significant reduction in morbidity and mortality. Pulmonary hypertension may complicate advanced interstitial lung disease (PH-ILD) ...

Abstract	Objectives: Vasoactive drugs have exhibited clinical efficacy in addressing pulmonary arterial hypertension, manifesting a significant reduction in morbidity and mortality. Pulmonary hypertension may complicate advanced interstitial lung disease (PH-ILD) and is associated with high rates of disability, hospitalisation due to cardiac and respiratory illnesses, and mortality. Prior management hinged on treating the underlying lung disease and comorbidities. However, the INCREASE trial of inhaled treprostinil in PH-ILD has demonstrated that PH-ILD can be effectively treated with vasoactive drugs. Methods: This comprehensive systematic review examines the evidence for vasoactive drugs in the management of PH-ILD. Results: A total of 1442 pubblications were screened, 11 RCTs were considered for quantitative synthesis. Unfortunately, the salient studies are limited by population heterogeneity, short-term follow-up and the selection of outcomes with uncertain clinical significance. Conclusions: This systematic review underscores the necessity of establishing a precision medicine-oriented strategy, directed at uncovering and addressing the intricate cellular and molecular mechanisms that underlie the pathophysiology of PH-ILD. Prospero registration number: CRD42023457482.
MeSH term(s)	Humans ; Hypertension, Pulmonary/drug therapy ; Hypertension, Pulmonary/etiology ; Lung Diseases, Interstitial/complications ; Lung Diseases, Interstitial/drug therapy ; Lung Diseases, Interstitial/epidemiology ; Comorbidity
Language	English
Publishing date	2024-03-13
Publishing country	England
Document type	Systematic Review ; Journal Article
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2023-002161
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Article ; Online: Transient 2D FEM-fluid network coupling for thermo-mechanical whole gas turbine engine simulations

Giuntini Sabrina / Andreini Antonio / Facchini Bruno / Mantero Marco / Pirotta Marco / Olmes Sven

E3S Web of Conferences, Vol 197, p

modelling features and applications

2020 Volume 10012

Abstract: In order to control the thermo-mechanical stresses that large heavy-duty power generation turbines have to face nowadays in their frequent operational transients, the analysis of the heat transfer between main flow, secondary air systems and structural ... ...

Abstract	In order to control the thermo-mechanical stresses that large heavy-duty power generation turbines have to face nowadays in their frequent operational transients, the analysis of the heat transfer between main flow, secondary air systems and structural components has to consider multi-physics coupled interactions, and has to be carried out with a whole engine modelling approach, simulating the entire machine in the real operating conditions. This is fundamental to guarantee a reliable assessment of life timing consumption and optimize clearances and temperature picks, through an efficient secondary air system design. It is here proposed a comprehensive description of modelling features and assumptions needed for the transient thermo-mechanical characterization of the whole engine through the application of a FEM-fluid network coupling methodology developed in collaboration with Ansaldo Energia and based on the open source code CalculiX®. In the present work the transient thermal modelling capability of the procedure will be verified through its application to a real whole engine geometry under a realistic transient cycle, comparing results with those of a reference FEM code.
Keywords	Environmental sciences ; GE1-350
Subject code	670
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	EDP Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of severe COPD exacerbations: focus on beclomethasone dipropionate/formoterol/glycopyrronium bromide.

Mantero, Marco / Radovanovic, Dejan / Santus, Pierachille / Blasi, Francesco

International journal of chronic obstructive pulmonary disease

2018 Volume 13, Page(s) 2319–2333

Abstract: The major determinant of the decline in lung function, quality of life, and the increased mortality risk in patients with COPD is represented by severe acute exacerbations of the disease, that is, those requiring patients' hospitalization, constituting a ...

Abstract	The major determinant of the decline in lung function, quality of life, and the increased mortality risk in patients with COPD is represented by severe acute exacerbations of the disease, that is, those requiring patients' hospitalization, constituting a substantial social and health care burden in terms of morbidity and medical resource utilization. Different long-term therapeutic strategies have been proposed so far in order to prevent and/or reduce the clinical and social impact of these events, the majority of which were extrapolated from trials initially focused on the effect of long-acting muscarinic antagonist and subsequently on the efficacy of long-acting β2-agonists in combination or not with inhaled corticosteroids. The option to employ all three classes of molecules combined, despite the limited amount of evidence in our possession, represents a choice currently proposed by international guidelines; however, current recommendations are often based mainly on observational studies or on the results of secondary outcomes in randomized controlled trials. The present narrative review evaluates the available trials that investigated the efficacy of inhaled therapy to prevent COPD exacerbations and especially severe ones, with a particular focus on beclomethasone dipropionate/formoterol/glycopyrronium bromide fixed dose combination, which is the first treatment that comprises all the three drug classes, specifically tested for the prevention of moderate and severe COPD exacerbations.
MeSH term(s)	Administration, Inhalation ; Adrenergic beta-2 Receptor Agonists/pharmacokinetics ; Adrenergic beta-2 Receptor Agonists/therapeutic use ; Beclomethasone/pharmacokinetics ; Beclomethasone/therapeutic use ; Bronchodilator Agents ; Disease Progression ; Drug Therapy, Combination ; Formoterol Fumarate/pharmacokinetics ; Formoterol Fumarate/therapeutic use ; Glucocorticoids/pharmacokinetics ; Glucocorticoids/therapeutic use ; Glycopyrrolate/pharmacokinetics ; Glycopyrrolate/therapeutic use ; Humans ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/metabolism ; Quality of Life ; Randomized Controlled Trials as Topic
Chemical Substances	Adrenergic beta-2 Receptor Agonists ; Bronchodilator Agents ; Glucocorticoids ; Beclomethasone (KGZ1SLC28Z) ; Glycopyrrolate (V92SO9WP2I) ; Formoterol Fumarate (W34SHF8J2K)
Language	English
Publishing date	2018-07-30
Publishing country	New Zealand
Document type	Journal Article ; Review
ISSN	1178-2005
ISSN (online)	1178-2005
DOI	10.2147/COPD.S147484
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Article ; Online: Pharmacotherapeutic management of bronchial infections in adults: non-cystic fibrosis bronchiectasis and chronic obstructive pulmonary disease.

Di Pasquale, Marta / Aliberti, Stefano / Mantero, Marco / Gramegna, Andrea / Blasi, Francesco

Expert opinion on pharmacotherapy

2020 Volume 21, Issue 16, Page(s) 1975–1990

Abstract: Introduction: Effective management of both acute and chronic bronchial infections is mandatory due to their high frequency rate, the relevant morbidity and mortality and the significant burden to health care systems, especially with the aging of ... ...

Abstract	Introduction: Effective management of both acute and chronic bronchial infections is mandatory due to their high frequency rate, the relevant morbidity and mortality and the significant burden to health care systems, especially with the aging of population. Bacteria are the main causative pathogens, followed by viruses, and less commonly by fungi. The clinical evaluation of new therapeutic associations is mandatory to cope with the increases in resistance, in association with better infection control and antimicrobial policies. Areas covered: The authors searched Medline for any article published in English language up until March 1, 2020 that concerns the treatment of acute exacerbations and chronic infections in chronic obstructive respiratory disease and bronchiectasis. Expert opinion: As acute exacerbations are a main common and detrimental event in patients with COPD and bronchiectasis, effective antimicrobial therapies and regimens should be optimized. The development of new molecules or combination regimens is vital to patients with severe and/or difficult-to-treat infections. Moreover, chronic infection control is mandatory in these patients to their improve quality of life, respiratory function and prognosis as well as for reducing health care costs.
MeSH term(s)	Administration, Inhalation ; Administration, Oral ; Adult ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/therapeutic use ; Bacterial Infections/drug therapy ; Bacterial Infections/microbiology ; Bronchiectasis/drug therapy ; Bronchiectasis/microbiology ; Disease Progression ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Humans ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Pulmonary Disease, Chronic Obstructive/microbiology ; Quality of Life
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2020-08-18
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2001535-5
ISSN	1744-7666 ; 1465-6566
ISSN (online)	1744-7666
ISSN	1465-6566
DOI	10.1080/14656566.2020.1793958
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Article: Erratum to: The evidence on tiotropium bromide in asthma: from the rationale to the bedside.

Radovanovic, Dejan / Santus, Pierachille / Blasi, Francesco / Mantero, Marco

Multidisciplinary respiratory medicine

2017 Volume 12, Page(s) 17

Abstract: This corrects the article DOI: 10.1186/s40248-017-0094-3.]. ...

Abstract	[This corrects the article DOI: 10.1186/s40248-017-0094-3.].
Language	English
Publishing date	2017-06-01
Publishing country	Italy
Document type	Published Erratum
ZDB-ID	2677839-7
ISSN	2049-6958 ; 1828-695X
ISSN (online)	2049-6958
ISSN	1828-695X
DOI	10.1186/s40248-017-0099-y
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Article: The evidence on tiotropium bromide in asthma: from the rationale to the bedside.

Radovanovic, Dejan / Santus, Pierachille / Blasi, Francesco / Mantero, Marco

Multidisciplinary respiratory medicine

2017 Volume 12, Page(s) 12

Abstract: Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new ... ...

Abstract	Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma. In large randomized clinical trials enrolling patients with moderate to severe asthma, add-on therapy with tiotropium has demonstrated to be efficacious in improving lung function, decreasing risk of exacerbation and slowing the worsening of disease; accordingly, tiotropium demonstrated to be non inferior compared to long acting beta-agonists in the maintenance treatment along with medium to high inhaled corticosteroids. In view of the numerous ancillary effects acting on inflammation, airway remodeling, mucus production and cough reflex, along with the good safety profile and the broad spectrum of efficacy demonstrated in different disease phenotypes, tiotropium can represent a beneficial alternative in the therapeutic management of poorly controlled asthma. The present extensive narrative review presents the pharmacological and pathophysiological basis that guided the rationale for the introduction of tiotropium in asthma treatment algorithm, with a particular focus on its conventional and unconventional effects; finally, data on tiotropium efficacy and safety. from recent randomized clinical trials performed in all age categories will be extensively discussed.
Language	English
Publishing date	2017-05-04
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2677839-7
ISSN	2049-6958 ; 1828-695X
ISSN (online)	2049-6958
ISSN	1828-695X
DOI	10.1186/s40248-017-0094-3
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Article ; Online: Treatable traits in interstitial lung diseases: a call to action.

Amati, Francesco / Spagnolo, Paolo / Oldham, Justin M / Ryerson, Christopher J / Stainer, Anna / Gramegna, Andrea / Mantero, Marco / Lacedonia, Donato / Sverzellati, Nicola / Richeldi, Luca / Blasi, Francesco / Aliberti, Stefano

The Lancet. Respiratory medicine

2023 Volume 11, Issue 2, Page(s) 125–128

MeSH term(s)	Humans ; Lung Diseases, Interstitial/therapy ; Disease Progression ; Phenotype ; Lung
Language	English
Publishing date	2023-01-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2686754-0
ISSN	2213-2619 ; 2213-2600
ISSN (online)	2213-2619
ISSN	2213-2600
DOI	10.1016/S2213-2600(23)00002-4
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Article ; Online: Walking the path of treatable traits in interstitial lung diseases.

Amati, Francesco / Spagnolo, Paolo / Ryerson, Christopher J / Oldham, Justin M / Gramegna, Andrea / Stainer, Anna / Mantero, Marco / Sverzellati, Nicola / Lacedonia, Donato / Richeldi, Luca / Blasi, Francesco / Aliberti, Stefano

Respiratory research

2023 Volume 24, Issue 1, Page(s) 251

Abstract: Interstitial lung diseases (ILDs) are complex and heterogeneous diseases. The use of traditional diagnostic classification in ILD can lead to suboptimal management, which is worsened by not considering the molecular pathways, biological complexity, and ... ...

Abstract	Interstitial lung diseases (ILDs) are complex and heterogeneous diseases. The use of traditional diagnostic classification in ILD can lead to suboptimal management, which is worsened by not considering the molecular pathways, biological complexity, and disease phenotypes. The identification of specific "treatable traits" in ILDs, which are clinically relevant and modifiable disease characteristics, may improve patient's outcomes. Treatable traits in ILDs may be classified into four different domains (pulmonary, aetiological, comorbidities, and lifestyle), which will facilitate identification of related assessment tools, treatment options, and expected benefits. A multidisciplinary care team model is a potential way to implement a "treatable traits" strategy into clinical practice with the aim of improving patients' outcomes. Multidisciplinary models of care, international registries, and the use of artificial intelligence may facilitate the implementation of the "treatable traits" approach into clinical practice. Prospective studies are needed to test potential therapies for a variety of treatable traits to further advance care of patients with ILD.
MeSH term(s)	Humans ; Artificial Intelligence ; Lung ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/epidemiology ; Lung Diseases, Interstitial/therapy ; Phenotype
Language	English
Publishing date	2023-10-24
Publishing country	England
Document type	Letter
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/s12931-023-02554-8
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