Impact of bronchitis variability on outcomes of COPD.

Objective: This study aimed to evaluate the impact of serial bronchitic status over two consecutive years on clinical outcomes, including frequency of exacerbation and lung function decline rate.

Methods: We analysed data from 1265 participants enrolled in the Korea COPD Subgroup Study, a nationwide prospective observational chronic obstructive pulmonary disease (COPD) cohort. Bronchitic status was determined using subquestionnaires of the COPD Assessment Test at baseline and after 1 year, classifying patients into three serial bronchitic groups of persistently not bronchitic (NB), intermittently bronchitic (IB) and chronic bronchitis (CB).

Response to biologics along a gradient of T2 involvement in patients with severe asthma: a data-driven biomarker clustering approach.

Background: Asthma with low levels of T2-biomarkers is poorly understood.

Objective: To characterize severe asthma phenotypes and compare pre- to post-biologic change in asthma outcomes along a gradient of T2-involvement.

Methods: This was a registry-based, cohort study including data from 24 countries.

Efficacy and safety of HL-301 compared with erdosteine in acute bronchitis: a randomized, double-blind, non-inferiority trial.

Background/aims: This study evaluated the non-inferiority of HL-301 to erdosteine in terms of symptom relief and the anti- inflammatory effects in acute bronchitis patients not treated with antibiotics.

Methods: In a double-blind, non-inferiority trial, patients were randomized 1:1 to receive either HL-301 (300 mg twice daily) or erdosteine (300 mg three times daily) for seven days. The primary endpoint was change in total Bronchitis Severity Score (BSS) from baseline to day 7.

Factors Associated with Exertional Desaturation in Patients with Chronic Obstructive Pulmonary Disease.

The six minute walk test (6MWT) has a prognostic role in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to determine the factors associated with desaturation during the 6MWT in patients with COPD. This study utilized data from the prospective KOrea COPD Subgroup Study (KOCOSS) cohort.

Management of COPD With Cardiovascular Risk in Asia: A Review by the Asian Pacific Society of Respirology COPD Assembly.

Chronic obstructive pulmonary disease (COPD) has a high burden in Asia. These patients are also susceptible to various cardiovascular diseases (CVD). A panel of expert Asian pulmonologists explored the published literature to understand the impact of COPD and CVD on each other and to identify the cardiopulmonary risk factors in the region.

Development of a Scoring System to Predict Suboptimal Peak Inspiratory Flow in Patients With Chronic Obstructive Pulmonary Disease.

Background: Peak inspiratory flow rate (PIFR) is a critical indicator for the successful use of dry powder inhalers (DPIs). However, resource constraints often limit the practicality of measuring PIFR prior to DPI prescription.

Methods: A cross-sectional observational study was conducted across seven hospitals in Korea, including patients with chronic obstructive pulmonary disease (COPD).

Change in exacerbation rate of asthma patients before and after COVID-19 infection.

Background: COVID-19 had significant impact on healthcare utilization and disease outcomes worldwide. While overall asthma exacerbations reportedly declined during the pandemic, the specific effect of COVID-19 infection on subsequent exacerbation patterns in asthma patients remains unclear.

Methods: Using a nationwide health insurance claims database from South Korea, we identified patients who had both asthma and a confirmed COVID-19 diagnosis in 2020.

Race-neutral versus race-specific GLI reference equations on spirometry interpretation in the general population.

Pulmonary function interpretation is key to the diagnosis and management of respiratory diseases. The Global Lung Function Initiative (GLI) introduced the race-specific reference equations for spirometry in 2012, with subsequent development of the race-neutral reference equations in 2022. This study examined the effects of transitioning from the race-specific 2012-GLI to the race-neutral 2022-GLI reference equations on spirometry interpretation in Northeast Asians.

A Decade of Healthcare Quality Assessment for Chronic Obstructive Pulmonary Disease in South Korea: Trends and Implications (2014-2023).

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder associated with substantial morbidity and healthcare costs. Effective outpatient management can prevent exacerbations and reduce hospitalization rates. Since 2014, the South Korean government has conducted annual COPD quality assessment to improve disease management and ensure high-quality healthcare services.

Experimental modeling of pulmonary fibrosis and combined emphysema in mice using repeated doses of bleomycin and cigarette smoke extract.

Rationale: A high prevalence of smoking among idiopathic pulmonary fibrosis (IPF) patients increases the risk of emphysema. Combined pulmonary fibrosis and emphysema (CPFE) occurs predominantly in males, characterized by severe exercise-induced dyspnea, decreased diffusing capacity, and increased lung cancer risk. The exclusion of CPFE patients from clinical studies has limited understanding of its pathophysiology, treatment, and prognosis.

Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR).

Background: Asthma characterization using blood eosinophil count (BEC) (among other biomarkers and clinical indices) is recommended in severe asthma (SA), but the masking effect of oral corticosteroids (OCS), makes this challenging.

Aim: Our aim was to explore the effect of OCS use (both intermittent [iOCS] and long-term [LTOCS]) prior to biologic initiation on SA phenotype and biomarker profile in real-life and to characterize the burden of SA among patients prescribed LTOCS by biomarker profile.

Methods: This was a registry-based cohort study, including data from 23 countries collected between 2003 and 2023 and shared with the Internatonal Severe Asthma Registry (ISAR).

Clinical characteristic of patients with COPD-A.

Background: The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) document proposed the COPD-A subtype as a condition of COPD with asthma. We examined the characteristics of COPD-A patients and analyzed them according to smoking history and inhaled corticosteroid (ICS) use.

Methods: Patients in the COPD cohort with a history of asthma were included.

Prediction Pathway for Severe Asthma Exacerbations: A Bayesian Network Analysis.

Background: Accurate risk prediction of exacerbations is pivotal in severe asthma management. Multiple risk factors are at play, but the pathway of risk prediction remains unclear.

Research Question: How do the interplays of clinically relevant predictors lead to severe exacerbations in patients with severe asthma?

Study Design And Methods: Patients with severe asthma (n = 6,814, aged ≥ 18 years), biologic naive, were identified from the Severe Asthma Registry (2017-2021).

Prevention of Cardiovascular and Other Systemic Adverse Outcomes in Patients with Asthma Treated with Biologics.

Although clinical trials have documented the oral corticosteroid (OCS)-sparing effect of biologics in patients with severe asthma, little is known about whether this translates to a reduction of new-onset OCS-related adverse outcomes. To compare the risk of developing new-onset OCS-related adverse outcomes between biologic initiators and noninitiators. This was a longitudinal cohort study using pooled data from the International Severe Asthma Registry (ISAR; 16 countries) and the Optimum Patient Care Research database (OPCRD; United Kingdom).

Comparing Heterogenous Phenotypes of Chronic Obstructive Pulmonary Disease: Network Analysis and Penalized Generalized Linear Model.

Background And Objective: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, with chronic bronchitis (CB) and emphysema phenotypes. The aim of our study was to compare the distinct patterns of correlation networks for respiratory symptoms and predictors of future exacerbations of different COPD phenotypes.

Methods: CB and emphysema were identified using a questionnaire and computed tomography images, respectively, and also included patients with preserved ratio impaired spirometry (PRISm).

Impact of Biologics Initiation on Oral Corticosteroid Use in the International Severe Asthma Registry and the Optimum Patient Care Research Database: A Pooled Analysis of Real-World Data.

Background: For severe asthma (SA) management, real-world evidence on the effects of biologic therapies in reducing the burden of oral corticosteroid (OCS) use is limited.

Objective: To estimate the efficacy of biologic initiation on total OCS (TOCS) exposure in patients with SA from real-world specialist and primary care settings.

Methods: From the International Severe Asthma Registry (ISAR, specialist care) and the Optimum Patient Care Research Database (OPCRD, primary care, United Kingdom), adult biologic initiators were identified and propensity score-matched with non-initiators (ISAR, 1:1; OPCRD, 1:2).

Asthma Alleviation by Ginsenoside Rb1 via Promotion of Treg Proliferation and Inflammatory T Cell Inhibition.

Background: Regulatory T cells (Tregs) are living drugs with feasibility, tolerability, and therapeutic benefits. Although Tregs are linked to asthma prognosis through inflammation regulation, no therapeutic agents specifically designed to manage asthma by upregulating Tregs have been developed to date.

Methods: We screened a library of 250 natural products using a cytometric bead array.

Clinical characteristics of the early responders in the treatment of chronic cough.

Background: Chronic cough (CC) is defined by cough more than 8 weeks. Common causes of CC are upper airway cough syndrome (UACS), asthma, eosinophilic bronchitis (EB), and gastroesophageal reflux diseases (GERD). However, we do not know the characteristics of responding to treatment early.

Efficacy and Safety of YJP-40 in Patients with Acute Bronchitis: A Randomized, Double-Blind, Parallel Group Study.

Background: Pelargonium sidoides has been known to be effective in treating respiratory diseases. P. sidoides extract (Umckamin®, Han Wha Pharmaceuticals) was approved in Korea for acute bronchitis.

Effects of Vaccination on Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Cohort Study.

Background: Coronavirus disease 2019 (COVID-19) vaccination may offer benefits for patients with chronic obstructive pulmonary disease (COPD). However, the evidence on whether the vaccination decreases the frequency of acute exacerbation of COPD (AECOPD) is limited.

Methods: This study enrolled 41,606 individuals diagnosed with COPD using the Korean National Health Insurance System-severe acute respiratory syndrome coronavirus 2 (NHIS SARS-CoV-2) database between 2020 and 2021.

Prognostic Factors for Responders of Home-Based Pulmonary Rehabilitation-Secondary Analysis of a Randomized Controlled Trial.

Background: Home-based pulmonary rehabilitation (PR) is an effective alternative to center-based PR. However, not all participants exhibit sufficient therapeutic improvement, highlighting the need to identify appropriate candidates to maximize cost-effectiveness. This study aimed to identify the factors associated with favorable outcomes in home-based PR, focusing on the role of digital therapeutics (DTx).

Adherence to Pharmacological Management Guidelines for Stable Chronic Obstructive Lung Disease.

Background: This study evaluated adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and Korean guidelines in the prescription patterns of respiratory specialists for stable chronic obstructive pulmonary disease (COPD) management.

Methods: Data were collected on medications from 2011 to 2022 using the Korea COPD Subtype Study (KOCOSS) cohort. Patients were divided into two groups: those registered before and after 2019, and we analyzed the percentage of patients meeting the recommended treatment criteria established by each guideline.