2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T611,This scoping review aimed to explore psychological and related biopsychosocial factors influencing adherence to biologic therapies among individuals with asthma. Despite the proven efficacy of biologics for severe type 2 inflammation, real-world adherence remains variable. The review sought to identify individual, clinical, and contextual determinants that facilitate or hinder adherence behaviors. A systematic search of PubMed, Scopus, and APA PsycINFO identified 14 studies published between 2018 and 2025. Most were observational or retrospective and conducted in the United States. Adherence rates were generally moderate to high but varied across biologics. Systemic barriers included high out-of-pocket costs, complex insurance procedures, and limited access to specialist care. Clinically, patients with milder symptoms or low perceived treatment benefit were more likely to discontinue. Psychological barriers-such as fear of injections, illness denial, depression, and stigma-were recurrent yet understudied. Facilitators included perceived efficacy, emotional reassurance, shared decision-making, and supportive treatment settings. Adherence to biologic therapies in asthma reflects a multidimensional interplay between systemic, clinical, and psychological influences. Integrating psychological assessment, patient education, and system-level support is essential to sustain long-term engagement. Future research should address psychological mechanisms and develop tailored interventions to enhance adherence and improve clinical outcomes.31:T808,Abstract Purpose of Review This scoping review aimed to explore psychological and related biopsychosocial factors influencing adherence to biologic therapies among individuals with asthma. Despite the proven efficacy of biologics for severe type 2 inflammation, real-world adherence remains variable. The review sought to identify individual, clinical, and contextual determinants that facilitate or hinder adherence behaviors. Recent Findings A systematic search of PubMed, Scopus, and APA PsycINFO identified 14 studies published between 2018 and 2025. Most were observational or retrospective and conducted in the United States. Adherence rates were generally moderate to high but varied across biologics. Systemic barriers included high out-of-pocket costs, complex insurance procedures, and limited access to specialist care. Clinically, patients with milder symptoms or low perceived treatment benefit were more likely to discontinue. Psychological barriers—such as fear of injections, illness denial, depression, and stigma—were recurrent yet understudied. Facilitators included perceived efficacy, emotional reassurance, shared decision-making, and supportive treatment settings. Summary Adherence to biologic therapies in asthma reflects a multidimensional interplay between systemic, clinical, and psychological influences. Integrating psychological assessment, patient education, and system-level support is essential to sustain long-term engagement. Future research should address psychological mechanisms and develop tailored interventions to enhance adherence and improve clinical outcomes. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"mepolizumab: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on mepolizumab (generic). Clinician-written summaries and actionable practice insights. 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Proteins such as GSN, NCF2, and EPX may eventually help clinicians track therapeutic response in SEA, though validation in larger cohorts is needed before clinical use."}},{"doi":"10.1016/s2213-2600(26)00150-5","pmid":"42624803","title":"Symptom burden to characterise, predict, and prevent asthma attacks: a patient-level meta-analysis of randomised trials and translational prospective studies","journal_title":"The Lancet Respiratory Medicine","journal_issn":"2213-2600","published_at":"2026-08-20T00:00:00.000Z","url":"https://doi.org/10.1016/s2213-2600(26)00150-5","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-27T06:17:04.984Z","updated_at":"2026-08-27T06:17:04.984Z","tags":[{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"condition","value":"Severe Asthma","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"modality","value":"Anti-Interleukin-5 Therapy","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"sample_size","value":"n=7161","value_numeric":7161},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"study_design","value":"Individual Participant Data Meta-Analysis","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"warning","value":"The additional translational cohorts (SA-OT, PRISMA, BOOST) were small and selected on data availability — findings from these subsets should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"warning","value":"The DREAM dataset used IV mepolizumab (not the approved SC formulation), which may limit direct translation to current clinical practice.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00150-5","tag_type":"warning","value":"The paper was published 2026-08-20 and indexed today (2026-08-27); full text was not available, so all extracted data derive from the abstract only.","value_numeric":null}],"summaries":{"what_studied":"This individual participant data meta-analysis evaluated whether ACQ-5 symptom burden predicts future severe asthma attacks and response to anti-inflammatory therapy, using data from 22 RCTs (ORACLE2, n=6,513 control-group participants) plus four additional translational/observational datasets (total 7,161 distinct participants).","key_result":"Each 0.5-point rise in baseline ACQ-5 added only a modest increase in attack risk (aRR 1.09, 95% CI 1.06–1.12; ΔR²=0.02). ACQ-5 did not predict benefit from IV mepolizumab, whereas patients with high blood eosinophils AND high FeNO had the greatest absolute risk reduction (2.81 vs 1.17 attacks; aRR 0.38, 95% CI 0.25–0.57). ACQ-5 was also unassociated with post-corticosteroid lung function change.","limitations":"- Control-group data from RCTs may not fully represent real-world asthma populations.\n- Additional translational datasets were small (n=53–74) and selected based on data availability, limiting generalisability.\n- ACQ-5 is a self-reported measure subject to recall and response bias, and unmeasured confounders (e.g., adherence, inhaler technique) were not accounted for.","practice_takeaway":"Symptom scores alone are poor guides for escalating anti-inflammatory therapy in asthma — type 2 biomarkers (blood eosinophils and FeNO) more reliably identify who is at high risk and who will benefit from biologic treatment. Clinicians should interpret ACQ-5 results in the context of objective biomarkers rather than using symptoms as the primary trigger for anti-inflammatory escalation."}},{"doi":"10.1016/s2213-2600(26)00197-9","pmid":"42612655","title":"Mepolizumab effectiveness for patients with severe, uncontrolled chronic rhinosinusitis with nasal polyps in Italy (MEPOREAL): a real-life, multicentre, phase 4 trial","journal_title":"The Lancet Respiratory Medicine","journal_issn":"2213-2600","published_at":"2026-08-18T00:00:00.000Z","url":"https://doi.org/10.1016/s2213-2600(26)00197-9","source_score":17,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-25T06:20:19.118Z","updated_at":"2026-08-25T06:20:19.118Z","tags":[{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"condition","value":"Chronic Rhinosinusitis With Nasal Polyps","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"condition","value":"NSAID-Exacerbated Respiratory Disease","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"sample_size","value":"n=621","value_numeric":621},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"study_design","value":"Phase 4 Real-World Evidence Study","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"warning","value":"'On the way to remission' is a surrogate endpoint defined by the authors and may not align with established remission definitions used in other trials.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"warning","value":"The phase 4 label refers to a post-marketing study; however, the lack of a comparator arm means it functions as a single-arm observational study rather than a traditional controlled trial.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00197-9","tag_type":"warning","value":"The study is ambispective (partly retrospective), so baseline data completeness may vary across centres. Denominators differ across outcomes (e.g., n=519 for disease control vs. n=621 enrolled), suggesting some missing follow-up data.","value_numeric":null}],"summaries":{"what_studied":"This real-life, multicentre, ambispective phase 4 study evaluated the effectiveness and safety of mepolizumab 100 mg every 4 weeks in 621 adults with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) across 25 Italian tertiary rhinology centres over 12 months.","key_result":"At 12 months, both nasal polyp score and SNOT-22 dropped significantly from baseline (p<0.0001); disease control was achieved in 42% (206/519) of patients, and 20% (104/519) were on the way to remission. However, 38% (186/495) of patients remained anosmic. Adverse events occurred in only 5% (29/621) of patients, mostly grade 1.","limitations":"- Ambispective design (partly retrospective) with no control arm limits causal inference.\n- Study limited to Italian tertiary centres, which may reduce generalisability to other settings or less-severe populations.\n- Only 12-month data are presented; remission requires a full 12-month sustained period, so true remission rates cannot yet be determined.","practice_takeaway":"Mepolizumab produces meaningful, progressive improvements in polyp burden and quality of life over 12 months in severe CRSwNP, with a good safety profile, but nearly 4 in 10 patients remain anosmic at one year. Patients with lower baseline nasal polyp scores are most likely to progress toward remission, which may help guide expectations when counselling patients."}},{"doi":"10.1111/all.70452","pmid":"42550682","title":"Simultaneous Dual Type 2 Biologic Therapy Improves Sinonasal Outcomes in Selected Patients With Chronic Rhinosinusitis With Nasal Polyps","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1111/all.70452","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-07T13:23:08.710Z","updated_at":"2026-08-07T13:23:08.710Z","tags":[{"paper_doi":"10.1111/all.70452","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"brand","value":"Tezspire","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"condition","value":"Chronic Rhinosinusitis With Nasal Polyps","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"condition","value":"Eosinophilic Granulomatous Polyangiitis","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"condition","value":"Hypereosinophilic Syndrome","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"modality","value":"Biologic Therapy","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"modality","value":"IgE Inhibitor","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"modality","value":"IL-4/IL-13 Inhibitor","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"modality","value":"IL-5 Inhibitor","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"modality","value":"TSLP Inhibitor","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"sample_size","value":"n=34","value_numeric":34},{"paper_doi":"10.1111/all.70452","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"warning","value":"Dual biologic therapy is off-label in some European countries; regulatory status may vary by region and specific drug combination.","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"warning","value":"No control arm or comparator group was included; improvement from baseline on single therapy to dual therapy may reflect disease trajectory or regression to the mean rather than a true treatment effect.","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"warning","value":"The five biologic combinations used were heterogeneous and sample sizes per combination were very small (as low as n=1), making combination-specific conclusions unreliable.","value_numeric":null},{"paper_doi":"10.1111/all.70452","tag_type":"warning","value":"The VAS overall disease severity improvement (−4.3) did not reach conventional statistical significance (p = 0.054), but is reported alongside significant outcomes — clinicians should interpret this measure cautiously.","value_numeric":null}],"summaries":{"what_studied":"This retrospective, multicentric study evaluated simultaneous dual type 2 biologic therapy in 34 adult patients with severe uncontrolled CRSwNP across six centers in Germany, the Netherlands, and Italy, comparing sinonasal outcomes at 6 months on dual therapy vs. baseline on single biologic therapy (median follow-up 25 months).","key_result":"Dual biologic therapy significantly improved all key sinonasal outcomes at 6 months: SNOT-22 improved by −32.8 (p < 0.0001), nasal polyp score by −3.2 (p < 0.0001), and smell by +3.4 (p = 0.003). Adverse reactions occurred in 4 of 34 patients (11.8%), including urticaria, erythema, GI symptoms, weight gain, and arthralgia (each n = 1).","limitations":"- Very small sample size (n = 34) limits generalizability.\n- Retrospective design with no control arm; no head-to-head comparison between dual-therapy combinations.\n- Long-term efficacy and safety remain unknown, with median follow-up only 25 months.","practice_takeaway":"For rare, complex CRSwNP cases with refractory type 2 comorbidities (e.g., EGPA, hypereosinophilic syndrome) that fail single biologic therapy, dual biologic therapy may offer meaningful symptom improvement — but it should only be considered after interdisciplinary consultation, given off-label status in some countries and high costs."}},{"doi":"10.1038/s41584-026-01406-1","pmid":"42552373","title":"Advances in the treatment of eosinophilic granulomatosis with polyangiitis","journal_title":"Nature Reviews Rheumatology","journal_issn":"1759-4790","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1038/s41584-026-01406-1","source_score":20,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-11T13:26:18.599Z","updated_at":"2026-08-11T13:26:18.599Z","tags":[{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"condition","value":"ANCA-Associated Vasculitis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"condition","value":"Eosinophilic Granulomatosis With Polyangiitis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"modality","value":"IL-4/IL-13 Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"modality","value":"IL-5 Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"modality","value":"TSLP Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"warning","value":"Full page text was not available in the provided source — only the abstract was parseable. Summary and tags are based solely on abstract content.","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"warning","value":"No sample size tag was applied as this is a narrative review without a primary study population.","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01406-1","tag_type":"warning","value":"Study design classified as 'Narrative Review'; the paper may include systematic elements not determinable from available text.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates the evolving treatment landscape for eosinophilic granulomatosis with polyangiitis (EGPA), including historical glucocorticoid-based regimens and emerging targeted therapies — particularly IL-5 pathway inhibitors (mepolizumab, benralizumab) and agents targeting IL-4, IL-13, and thymic stromal lymphopoietin (TSLP) — for newly diagnosed and relapsing disease.","key_result":"Clinical trial data support that targeting the IL-5 pathway with mepolizumab or benralizumab effectively controls persistent respiratory symptoms and reduces glucocorticoid dependence in EGPA; however, their role at diagnosis and in long-term management remains undefined. Retrospective data on IL-4/IL-13/TSLP-targeting agents suggest benefit for relapsing respiratory symptoms, but prospective evidence is limited and safety is not yet established.","limitations":"- Full text content was not extractable beyond the abstract, limiting granular data retrieval.\n- Most evidence for novel biologics beyond IL-5 inhibitors comes from retrospective studies only.\n- No prospective safety data yet exist for IL-4, IL-13, or TSLP-targeting agents in EGPA.","practice_takeaway":"For EGPA patients with persistent or relapsing respiratory disease, IL-5 pathway inhibitors (mepolizumab or benralizumab) offer a glucocorticoid-sparing option supported by trial data. Agents targeting IL-4, IL-13, or TSLP are promising for refractory respiratory symptoms but should be used cautiously given the absence of prospective safety evidence."}},{"doi":"10.1186/s13223-026-01055-9","pmid":"42464416","title":"Comparative effectiveness of mepolizumab and omalizumab in patients eligible for both: a retrospective cohort study","journal_title":"Allergy, Asthma & Clinical Immunology","journal_issn":"1710-1492","published_at":"2026-07-16T00:00:00.000Z","url":"https://doi.org/10.1186/s13223-026-01055-9","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-27T14:09:23.466Z","updated_at":"2026-07-27T14:09:23.466Z","tags":[{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"condition","value":"Severe Asthma","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"sample_size","value":"n=49","value_numeric":49},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"Age distribution and sex breakdown were not explicitly reported in the abstract; 'adult' age group and 'mixed' sex are assumed based on typical severe asthma trial populations.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"Sample size is very small (n=49), making subgroup findings (especially eosinophils ≥300 cells/μL) underpowered and potentially unreliable.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"Single-center retrospective design; unmeasured confounders (e.g., allergy phenotype severity, adherence) may affect estimates.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01055-9","tag_type":"warning","value":"The eosinophil eligibility threshold (≥150 or ≥300 cells/μL in the prior year) spans a wide range, which may introduce heterogeneity in the study population.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study compared real-world effectiveness of mepolizumab vs. omalizumab over 1 year in 49 severe asthma patients eligible for both biologics (blood eosinophils ≥150 cells/μL, total IgE ≥30 IU/mL, perennial allergen sensitization). Primary outcome was adjusted incidence rate ratio (IRR) for asthma exacerbations.","key_result":"Mepolizumab reduced asthma exacerbations significantly more than omalizumab (adjusted IRR 0.37; 95% CI 0.19–0.69). The benefit was significant in patients with baseline eosinophils <300 cells/μL (IRR 0.38; 95% CI 0.14–0.88) but not ≥300 cells/μL (IRR 0.47; 95% CI 0.15–1.35). ER visits, hospitalizations, and OCS dose reduction did not differ significantly between groups.","limitations":"- Very small sample (n=49 total), limiting statistical power, especially in subgroup analyses.\n- Single-center retrospective design introduces selection bias and unmeasured confounding.\n- Results require confirmation in larger, multicenter studies before broad generalization.","practice_takeaway":"When choosing between mepolizumab and omalizumab in patients eligible for both, mepolizumab may offer greater exacerbation reduction — particularly in those with baseline eosinophils <300 cells/μL. ER visits, hospitalizations, and OCS-sparing appear comparable, so exacerbation history should weigh heavily in biologic selection."}},{"doi":"10.1183/16000617.0076-2026","pmid":"42419778","title":"Fibrotic chronic eosinophilic pneumonia: from inflammation to fibrosis and therapeutic implications","journal_title":"European Respiratory Review","journal_issn":"0905-9180","published_at":"2026-07-08T00:00:00.000Z","url":"https://doi.org/10.1183/16000617.0076-2026","source_score":12,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-14T13:24:19.771Z","updated_at":"2026-07-14T13:24:19.771Z","tags":[{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"condition","value":"Chronic Eosinophilic Pneumonia","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"condition","value":"Fibrotic Interstitial Lung Disease","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"condition","value":"Hypereosinophilic Syndrome","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"generic","value":"nerandomilast","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"generic","value":"nintedanib","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"generic","value":"pirfenidone","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"generic","value":"reslizumab","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"modality","value":"Antifibrotic Agent","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"modality","value":"Anti-IL-5Rα Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"modality","value":"PDE-4B Inhibitor","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"modality","value":"Tyrosine Kinase Inhibitor","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"warning","value":"No sample_size tag was assigned for the review overall, as it synthesises data across heterogeneous sources with varying N; the Mayo Clinic cohort (n=62) is the largest single cited dataset.","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"warning","value":"Pirfenidone has been associated with rare cases of eosinophilic pneumonia, a specific safety concern flagged for diseases already driven by eosinophilic inflammation.","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"warning","value":"The paper includes two congress abstracts (not peer-reviewed publications) as key clinical evidence for antifibrotic use in eosinophilic fibrotic lung disease — findings from these should be interpreted with extra caution.","value_numeric":null},{"paper_doi":"10.1183/16000617.0076-2026","tag_type":"warning","value":"The study design is a narrative review with no formal quality assessment or meta-analysis; conclusions on therapeutic efficacy are based on extrapolation and expert opinion.","value_numeric":null}],"summaries":{"what_studied":"This narrative review evaluated the evidence for anti-IL-5/IL-5Rα monoclonal antibodies (mepolizumab, benralizumab, reslizumab) as glucocorticoid-sparing agents in chronic eosinophilic pneumonia (CEP), examined the emerging fibrotic CEP phenotype, and explored mechanistic links between eosinophilic inflammation and pulmonary fibrosis. It also assessed the potential role of antifibrotic agents (nintedanib, pirfenidone, nerandomilast) in progressive fibrotic CEP.","key_result":"A Mayo Clinic retrospective cohort (n=62) found fibrotic changes in 37% of CEP patients, with ~78% of fibrosis cases appearing within 2 years of diagnosis; 70% had non-UIP patterns. Anti-IL-5/IL-5Rα biologicals consistently reduced relapses and enabled glucocorticoid tapering in case series (largest n=10), but no study has specifically evaluated these agents in established fibrotic CEP. Only one published case of fibrotic CEP treated with mepolizumab showed disease stabilisation rather than fibrosis regression.","limitations":"- All evidence for anti-IL-5/IL-5Rα use in CEP comes from case reports and small series (max n=10 in a single study, 63 total reported cases in a 2024 scoping review), with likely publication bias toward positive outcomes.\n- No prospective or randomised trials exist for any therapy specifically in fibrotic CEP; antifibrotic trial data (INBUILD, FIBRONEER-ILD) included at most one CEP patient.\n- Mechanistic evidence linking eosinophils to lung fibrosis is largely from in vitro models and inference from asthma/IPF; direct causal evidence in human eosinophilic ILD is lacking.","practice_takeaway":"CEP should not be considered fully reversible — screen patients with worsening symptoms, declining lung function, or persistent HRCT changes for a fibrotic phenotype. In relapsing or glucocorticoid-dependent CEP, anti-IL-5/IL-5Rα biologicals are a reasonable steroid-sparing option; if progressive fibrosis develops, nintedanib may be added, though evidence remains limited to case reports."}},{"doi":"10.1016/j.chest.2026.02.017","pmid":"42419852","title":"Hypereosinophilia With Pseudomonas aeruginosa Infection in Patients With Asthma on Anti-Interleukin-5 Biologics","journal_title":"CHEST","journal_issn":"0012-3692","published_at":"2026-07-08T00:00:00.000Z","url":"https://doi.org/10.1016/j.chest.2026.02.017","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-17T13:24:11.519Z","updated_at":"2026-07-17T13:24:11.519Z","tags":[{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"condition","value":"Asthma-COPD Overlap","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"condition","value":"Hypereosinophilia","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"condition","value":"Pseudomonas aeruginosa Infection","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"condition","value":"Severe Eosinophilic Asthma","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"modality","value":"Anti-IL-5 Biologic","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"sample_size","value":"n=2","value_numeric":2},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"study_design","value":"Case Series","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"warning","value":"Both patients were female, limiting sex generalizability.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"warning","value":"Case series of only 2 patients — findings are hypothesis-generating, not confirmatory.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"warning","value":"Full text was not available; some methodological details (e.g., timing of cultures, antibiotic regimens) could not be verified.","value_numeric":null},{"paper_doi":"10.1016/j.chest.2026.02.017","tag_type":"warning","value":"One patient had asthma-COPD overlap, which may independently influence eosinophil dynamics and response to biologics.","value_numeric":null}],"summaries":{"what_studied":"Two patients with severe eosinophilic asthma on anti-IL-5 biologics (mepolizumab and benralizumab) who developed unexpected hypereosinophilia during *Pseudomonas aeruginosa* airway infection, evaluated to explore whether bacterial infection can drive eosinophil rebound independent of IL-5 pathway blockade.","key_result":"Both patients showed marked eosinophil rebound (1,400 and 1,690 cells/μL, respectively) coinciding with *P. aeruginosa* infection, which resolved after targeted antipseudomonal antibiotic therapy — suggesting IL-5-independent mechanisms of eosinophil elevation.","limitations":"Case series of only 2 patients limits generalizability; causal mechanism linking *P. aeruginosa* to IL-5-independent eosinophilia is proposed but not experimentally confirmed; full text not available to assess additional confounders.","practice_takeaway":"In patients on anti-IL-5 or IL-5R biologics who develop breakthrough hypereosinophilia during an exacerbation, send sputum cultures to rule out *P. aeruginosa* infection before assuming biologic failure. Antipseudomonal treatment may resolve eosinophilia without changing the biologic regimen."}},{"doi":"10.1002/ppul.71727","pmid":"42411189","title":"Efficacy and Safety of Biologic Therapies for Uncontrolled Asthma: An Overview of Systematic Reviews","journal_title":"Pediatric Pulmonology","journal_issn":"8755-6863","published_at":"2026-07-07T00:00:00.000Z","url":"https://doi.org/10.1002/ppul.71727","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-17T13:24:05.540Z","updated_at":"2026-07-17T13:24:05.540Z","tags":[{"paper_doi":"10.1002/ppul.71727","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Cinqair","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Tezspire","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"condition","value":"Eosinophilic Asthma","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"condition","value":"Oral Corticosteroid-Dependent Asthma","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"condition","value":"Severe Uncontrolled Asthma","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"reslizumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-IL-4/IL-13 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"modality","value":"Anti-TSLP Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"sample_size","value":"n=17","value_numeric":17},{"paper_doi":"10.1002/ppul.71727","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"study_design","value":"Overview of Systematic Reviews","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"12 of 17 included systematic reviews were rated critically low quality by AMSTAR 2—results should be interpreted with substantial caution.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"All comparative findings are based on indirect (network) comparisons; no direct head-to-head RCTs were available, limiting certainty of conclusions.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"Level of evidence assigned as '3' reflects the overview-of-reviews design drawing on network meta-analyses; the underlying primary evidence quality is lower due to predominantly critically low-rated source reviews.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"Population in the PICOT framework is ≥12 years, but the journal is Pediatric Pulmonology—clinicians should note that most included trial data likely skews toward adults; pediatric-specific subgroup data are not reported separately.","value_numeric":null},{"paper_doi":"10.1002/ppul.71727","tag_type":"warning","value":"The overview did not perform a formal corrected covered area (CCA) analysis, so the degree of primary study overlap across included reviews is unknown and may inflate the apparent weight of evidence.","value_numeric":null}],"summaries":{"what_studied":"This overview of 17 systematic reviews (including network meta-analyses) synthesized indirect comparative evidence on the efficacy and safety of six biologic agents—omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab—for uncontrolled moderate-to-severe asthma in patients aged ≥12 years, across outcomes including annualized exacerbation rate (AER), FEV1, ACQ, AQLQ, oral corticosteroid (OCS) reduction, and serious adverse events (SAEs).","key_result":"In indirect comparisons, dupilumab outperformed benralizumab (RR=0.46), mepolizumab (RR=0.72), and reslizumab (RR=0.62) on AER in the general severe asthma population; tezepelumab was favored over benralizumab (RR=0.73). In eosinophilic subgroups, dupilumab and tezepelumab were consistently favorable at ≥150 and ≥300 cells/μL, while tezepelumab outperformed dupilumab at <150 cells/μL. Dupilumab showed the greatest FEV1 improvement; mepolizumab was favored for ACQ control; omalizumab (general) and tezepelumab (eosinophilic ≥150 cells/μL) were favored for AQLQ. For OCS reduction, benralizumab and dupilumab outperformed reslizumab and tezepelumab. One indirect comparison suggested fewer SAEs with mepolizumab vs. dupilumab (OR=0.65). However, 12 of 17 included reviews were rated critically low quality by AMSTAR 2.","limitations":"- Nearly all findings are from indirect (network) comparisons; no head-to-head RCTs were available.\n- 12 of 17 included systematic reviews were rated critically low methodological quality (AMSTAR 2), mainly due to absent protocol registration, incomplete search strategies, and no duplicate data extraction.\n- Potential overlap of primary trials across included reviews was not formally quantified (no corrected covered area analysis), risking duplication of evidence.","practice_takeaway":"Biomarker-guided biologic selection remains key: dupilumab and tezepelumab appear broadly favorable for exacerbation reduction and lung function, while mepolizumab may offer better symptom control and a safer SAE profile in specific eosinophilic subgroups—but these are indirect comparisons from mostly low-quality reviews and should not be used to establish definitive treatment rankings. Clinicians should individualize biologic choice based on eosinophil count, OCS dependence, and patient profile while awaiting direct head-to-head trial data."}},{"doi":"10.1093/rheumatology/keag268","pmid":"42391608","title":"Mechanisms, clinical manifestations and management of cardiovascular diseases in ANCA-associated vasculitis","journal_title":"Rheumatology","journal_issn":"1462-0324","published_at":"2026-07-02T00:00:00.000Z","url":"https://doi.org/10.1093/rheumatology/keag268","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:42.011Z","updated_at":"2026-07-05T13:38:42.011Z","tags":[{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"brand","value":"Tavneos","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"ANCA-Associated Vasculitis","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"Eosinophilic Granulomatosis with Polyangiitis","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"Granulomatosis with Polyangiitis","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"Ischaemic Stroke","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"Microscopic Polyangiitis","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"Myocardial Infarction","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"condition","value":"Venous Thromboembolism","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"generic","value":"avacopan","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"generic","value":"cyclophosphamide","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"generic","value":"rituximab","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"generic","value":"rosuvastatin","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"modality","value":"Anti-CD20 Therapy","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"modality","value":"Anti-IL-5 Therapy","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"modality","value":"Complement Inhibitor","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"modality","value":"Statin","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"warning","value":"EGPA-specific standardized incidence ratios for stroke, DVT, and PE were not reported in the cited Swedish registry cohort, limiting phenotype-specific risk quantification for that subtype.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"warning","value":"Sample size tag was omitted as no single study population is the subject of this review; cited cohorts range from ~85 to ~22 million individuals across referenced studies.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the integrative framework proposed for bimodal CV risk management, not a single pivotal trial finding.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag268","tag_type":"warning","value":"This is a narrative (not systematic) review; conclusions on management are largely extrapolated from non-AAV trials and observational data, with no AAV-specific randomized CV prevention trials available.","value_numeric":null}],"summaries":{"what_studied":"This narrative review synthesizes evidence on the pathogenesis, clinical manifestations, and management of cardiovascular (CV) disease across the three main ANCA-associated vasculitis (AAV) subtypes—GPA, MPA, and EGPA—highlighting a time-dependent, bimodal CV risk trajectory from diagnosis through long-term follow-up.","key_result":"AAV carries up to a ~3-fold excess CV risk vs the general population; VTE affects ~18% of patients, with nearly 30-fold increased DVT risk and 10-fold increased PE risk. Post-diagnosis, MI occurs in ~11% and stroke in ~8% of patients. CV causes account for ~26% of deaths beyond the first year, with CV-specific mortality ~2.3-fold higher than in the general population. EGPA has the highest direct cardiac burden (~35% at diagnosis). Early inflammatory activity is the dominant driver of early events; glucocorticoid toxicity and traditional risk factors dominate later risk.","limitations":"No randomized trials have evaluated CV prevention strategies specifically in AAV; most estimates derive from observational cohorts with heterogeneous designs, and phenotype-specific CV data (especially for EGPA) remain sparse.","practice_takeaway":"Clinicians should assess CV risk at AAV diagnosis and at each disease phase—prioritizing rapid inflammation control early, then actively managing traditional risk factors (hypertension, dyslipidaemia, CKD) during remission. Glucocorticoid-sparing regimens (avacopan, anti-IL-5 agents in EGPA) should be used where available to reduce cumulative CV toxicity."}},{"doi":"10.1186/s12890-026-04427-4","pmid":"42324522","title":"Mepolizumab initiation by day 30 and glucocorticoid exposure in newly diagnosed EGPA: a single-center 30-day landmark cohort study","journal_title":"BMC Pulmonary Medicine","journal_issn":"1471-2466","published_at":"2026-06-22T00:00:00.000Z","url":"https://doi.org/10.1186/s12890-026-04427-4","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-29T13:22:49.024Z","updated_at":"2026-06-29T13:22:49.024Z","tags":[{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"condition","value":"Eosinophilic Granulomatosis With Polyangiitis","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"generic","value":"methylprednisolone","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"generic","value":"prednisolone","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"sample_size","value":"n=27","value_numeric":27},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"warning","value":"Calendar-time confounding is a particular concern as mepolizumab became more widely available over time, which the authors acknowledge but cannot fully adjust for.","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"warning","value":"Sex distribution is not explicitly reported in the abstract; 'mixed' is assumed based on typical EGPA cohort composition.","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"warning","value":"The landmark cohort includes only 6 patients in the early mepolizumab group, making all effect estimates highly imprecise and potentially unreliable.","value_numeric":null},{"paper_doi":"10.1186/s12890-026-04427-4","tag_type":"warning","value":"The study is described as a pre-publication unedited manuscript; final content may differ after editorial revision.","value_numeric":null}],"summaries":{"what_studied":"This single-center pilot retrospective cohort study examined whether starting mepolizumab within 30 days of glucocorticoid initiation (vs. later or never) reduces oral prednisolone exposure in 27 newly diagnosed EGPA patients, followed to 12 months using a landmark cohort design.","key_result":"Cumulative oral prednisolone exposure (day 30–12 months) was markedly lower in the early mepolizumab group vs. the delayed/no-mepolizumab group (24.7 vs. 68.6 mg/kg); similar reductions were seen at 6 months (17.6 vs. 43.6 mg/kg). Disease activity (BVAS = 0) was achieved by 3 months in all evaluable patients in both groups.","limitations":"- Very small groups (n=6 early mepolizumab vs. n=21 comparator) severely limit statistical power and precision.\n- Nonrandomized design with unmeasured confounding from calendar time, treatment indication, and concomitant therapies.\n- Between-group differences were attenuated when IV methylprednisolone pulse exposure was included, suggesting oral prednisolone alone may not fully capture total steroid burden.","practice_takeaway":"Early mepolizumab (within 30 days) was associated with roughly 60% less cumulative oral prednisolone at 12 months, but this is hypothesis-generating only—confounding cannot be ruled out in this small pilot study. Larger prospective studies are needed before changing practice."}},{"doi":"10.1186/s13223-026-01038-w","pmid":"42323698","title":"Mepolizumab reduces healthcare resource utilization in patients with chronic rhinosinusitis with nasal polyps: a linked EMR and claims-based pre-post study","journal_title":"Allergy, Asthma & Clinical Immunology","journal_issn":"1710-1492","published_at":"2026-06-21T00:00:00.000Z","url":"https://doi.org/10.1186/s13223-026-01038-w","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-22T13:37:57.532Z","updated_at":"2026-07-22T13:37:57.532Z","tags":[{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"condition","value":"Chronic Rhinosinusitis With Nasal Polyps","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"sample_size","value":"n=245","value_numeric":245},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"study_design","value":"Pre-Post Observational Study","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"warning","value":"No control group: the pre-post design cannot rule out natural disease fluctuation, regression to the mean, or concurrent treatment effects as contributors to observed improvements.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"warning","value":"Sex breakdown was not reported in the abstract; the 'mixed' sex tag is assumed based on adult CRSwNP population norms.","value_numeric":null},{"paper_doi":"10.1186/s13223-026-01038-w","tag_type":"warning","value":"Study was funded or data sourced from OM1 Real-World Data Cloud; potential industry affiliation or selection bias in clinician network data was not assessable from the abstract alone.","value_numeric":null}],"summaries":{"what_studied":"This real-world pre-post study evaluated whether mepolizumab initiation (on/after July 29, 2021) reduced CRSwNP-related healthcare resource utilization (HCRU), concomitant medication use, and clinical symptoms in 245 US adults with CRSwNP, comparing 6-month post-initiation outcomes to ≥12 months pre-initiation data from linked EMR and claims records.","key_result":"At 6 months post-mepolizumab, outpatient visits dropped by a mean of 0.82 (95% CI: −1.10 to −0.53, p<0.0001), oral corticosteroid use fell from 36% to 27%, and oral antibiotic use fell from 38% to 23%; symptom burden also decreased, with anosmia down 53%, facial pain/pressure down 35%, nasal discharge down 32%, and nasal obstruction down 29%.","limitations":"Single-arm pre-post design with no control group limits causal inference; follow-up was only 6 months post-initiation; symptom data were clinician-recorded from EMR and may be incomplete or inconsistently documented.","practice_takeaway":"In real-world US practice, starting mepolizumab in CRSwNP patients was linked to fewer specialist visits and reduced reliance on oral corticosteroids and antibiotics within 6 months — clinicians can expect measurable HCRU and symptom benefits relatively early after initiation."}},{"doi":"10.1111/pai.70407","pmid":"42324659","title":"Bridging Rare to Common Diseases: Precision Medicine and the Transforming Landscape of Pediatric Allergy and Immunology","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-06-21T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70407","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-24T13:21:44.323Z","updated_at":"2026-06-24T13:21:44.323Z","tags":[{"paper_doi":"10.1111/pai.70407","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Adbry","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Cibinqo","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Ebglyss","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Niktimvo","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Olumiant","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Tezspire","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Activated PI3K-Delta Syndrome","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Atopic Dermatitis","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Common Variable Immunodeficiency","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Eosinophilic Esophagitis","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Hyper-IgE Syndrome","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Inborn Errors of Immunity","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"IPEX Syndrome","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"condition","value":"Primary Atopic Disorders","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"abatacept","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"abrocitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"lebrikizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"leniolisib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"ruxolitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"tralokinumab","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Allergen Immunotherapy","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-IgE Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-IL-4/IL-13 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Anti-TSLP Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"Multi-Omics","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"modality","value":"PI3K-Delta Inhibitor","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"Sample size tag was omitted as this is a review article with no primary study population.","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"Several biologic uses in primary atopic disorders (PAD) described in Table 1 are based on case reports or small series, not controlled trials—evidence levels vary widely across listed indications.","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"Some brand-name mappings (e.g., Niktimvo for leniolisib) reflect recent approvals; clinicians should verify current regulatory status in their jurisdiction.","value_numeric":null},{"paper_doi":"10.1111/pai.70407","tag_type":"warning","value":"This is a narrative expert review funded by the Clemens von Pirquet Foundation; it does not follow systematic review methodology, so selection bias in cited evidence cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examines how precision medicine tools—including multi-omics, biomarkers, and AI—can bridge rare monogenic inborn errors of immunity (IEI) and primary atopic disorders (PAD) with common polygenic allergic diseases (asthma, atopic dermatitis, food allergy, allergic rhinitis) in pediatric patients, with a focus on shared pathogenic mechanisms and targeted therapies.","key_result":"The review maps a 'rare-to-common' translational pipeline showing that monogenic IEI (e.g., STAT6-GOF, DOCK8 deficiency, IPEX, APDS) share T2 inflammatory pathways with common allergic diseases; targeted biologics (dupilumab, omalizumab, mepolizumab) and small molecules (JAK inhibitors, leniolisib, abatacept) are increasingly repurposed across this spectrum, with leniolisib the first purpose-built targeted therapy approved for a monogenic IEI (APDS) following a landmark RCT.","limitations":"- This is a narrative expert review (funded seminar), not a systematic review or meta-analysis, limiting reproducibility and risk of bias assessment.\n- No original datasets were generated; evidence strength for many biologic uses in PAD rests on case series and small cohorts.\n- Clinical translation of omics biomarkers remains constrained by pre-analytical variability, small heterogeneous cohorts, and lack of prospective validation trials.","practice_takeaway":"Clinicians should consider PAD when children present with very early-onset severe atopic disease, treatment resistance, or multiorgan involvement—early genetic and immunologic workup can unlock targeted therapies (biologics, JAK inhibitors) that go beyond conventional management.\nAllergen immunotherapy guided by component-resolved diagnostics and molecular profiling remains the only disease-modifying option for IgE-mediated allergy, and its precision-medicine framework can serve as a template for broader pediatric allergy care."}},{"doi":"10.1111/cea.70349","pmid":"42178280","title":"Impact of Biologics on Oscillometry Defined Small Airway Dysfunction in Uncontrolled Asthma","journal_title":"Clinical & Experimental Allergy","journal_issn":"0954-7894","published_at":"2026-05-24T00:00:00.000Z","url":"https://doi.org/10.1111/cea.70349","source_score":3,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:35:11.004Z","updated_at":"2026-05-26T13:35:11.004Z","tags":[{"paper_doi":"10.1111/cea.70349","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"brand","value":"Fasenra","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"brand","value":"Tezspire","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"condition","value":"Severe Asthma","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"condition","value":"Small Airway Dysfunction","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"modality","value":"Anti-IL-4/IL-13","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"modality","value":"Anti-IL-5","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"modality","value":"Anti-IL-5 Receptor","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"modality","value":"Anti-TSLP","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"modality","value":"Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"warning","value":"No direct randomized head-to-head trial data are reported; comparisons between biologics are indirect and matched, which limits confidence in ranked efficacy claims.","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"warning","value":"Sample sizes and specific patient populations from the underlying clinical trials are not reported in the abstract, so a sample_size tag could not be assigned.","value_numeric":null},{"paper_doi":"10.1111/cea.70349","tag_type":"warning","value":"Study design is a narrative review; level of evidence (5) is an estimate based on review methodology described.","value_numeric":null}],"summaries":{"what_studied":"This review evaluated the impact of biologic therapies (mepolizumab, dupilumab, tezepelumab, benralizumab) on small airway dysfunction (SAD) in uncontrolled/severe asthma, as measured by forced oscillometry technique (FOT).","key_result":"Mepolizumab, dupilumab, and tezepelumab each produced significant and clinically meaningful improvements in oscillometry-defined SAD; benralizumab did not. In indirect matched head-to-head comparisons, dupilumab showed greater improvements than either benralizumab or tezepelumab.","limitations":"Findings rely on indirect matched comparisons rather than direct head-to-head randomized trials, limiting certainty about relative efficacy. Oscillometry-defined SAD is not yet a standard outcome in pivotal clinical trials, so data availability varies across biologics.","practice_takeaway":"When treating severe asthma with a prominent small airway dysfunction phenotype, dupilumab, mepolizumab, and tezepelumab appear preferable to benralizumab based on oscillometry data. Consider incorporating FOT assessment when selecting or monitoring biologic therapy in patients with suspected SAD."}},{"doi":"10.1080/02770903.2026.2666088","pmid":"42152594","title":"Eosinophilic vasculitis of aortic valve in EGPA: a life-threatening onset of disease","journal_title":"Journal of Asthma","journal_issn":"0277-0903","published_at":"2026-05-21T00:00:00.000Z","url":"https://doi.org/10.1080/02770903.2026.2666088","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-06T13:22:51.250Z","updated_at":"2026-06-06T13:22:51.250Z","tags":[{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"brand","value":"Nucala","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"condition","value":"Aortic Regurgitation","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"condition","value":"Chronic Rhinosinusitis with Nasal Polyps","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"condition","value":"Eosinophilic Granulomatosis with Polyangiitis","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"condition","value":"Severe Eosinophilic Asthma","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"generic","value":"mycophenolate mofetil","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"modality","value":"Immunosuppressant","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"warning","value":"ANCA status was initially negative and turned positive during disease course — clinicians should consider repeat testing in suspected EGPA even if initial ANCA is negative.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"warning","value":"Blood eosinophil count was near-normal (220 cells/mm³) due to mepolizumab, masking typical diagnostic markers of EGPA; peripheral eosinophilia should not be relied upon as a sole indicator of disease activity in patients on anti-IL-5 therapy.","value_numeric":null},{"paper_doi":"10.1080/02770903.2026.2666088","tag_type":"warning","value":"This is a single case report (n=1); findings and management approach cannot be generalized.","value_numeric":null}],"summaries":{"what_studied":"A 51-year-old man on mepolizumab 100 mg q4wk for severe eosinophilic asthma and CRSwNP who presented with cardiac arrest from acute severe aortic regurgitation, leading to histopathology-confirmed eosinophilic vasculitis of the aortic valve and a new EGPA diagnosis.","key_result":"Pathology showed fibrinoid necrosis, eosinophilic infiltrates, angioplasia, and vasculitis on the native aortic valve — the first reported case of this kind. Anti-MPO ANCA turned positive despite low blood eosinophils (220 cells/mm³). After aortic valve replacement plus escalation to mepolizumab 300 mg q4wk and mycophenolate mofetil 2000 mg/day, the patient had full clinical recovery at 3 months (ACT 23/25, EF 54%) and no myocardial LGE at 1-year cardiac MRI.","limitations":"Single case report; cannot generalize the management approach. The exact contribution of low-dose mepolizumab (100 mg) to disease progression vs. IL-5-independent pathogenic mechanisms cannot be determined. Long-term outcomes beyond 1 year are not reported.","practice_takeaway":"In EGPA patients on mepolizumab 100 mg who develop systemic symptoms or cardiac signs, aortic valve evaluation is essential — active vasculitis can occur even with near-normal blood eosinophil counts. When EGPA is confirmed with high disease burden (FFS ≥2), escalating to the approved EGPA dose of mepolizumab 300 mg q4wk plus an immunosuppressant should be considered promptly."}},{"doi":"10.1016/j.jaci.2026.04.013","pmid":"42061467","title":"Group 2 innate lymphoid cells: Where are we 15 years out?","journal_title":"Journal of Allergy and Clinical Immunology","journal_issn":"0091-6749","published_at":"2026-04-29T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13198743/","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-09T13:35:54.240Z","updated_at":"2026-07-09T13:35:54.240Z","tags":[{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"brand","value":"Mepolizumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"brand","value":"Omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"brand","value":"Tezepelumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"condition","value":"Aspirin-Exacerbated Respiratory Disease","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"condition","value":"Chronic Rhinosinusitis With Nasal Polyps","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"generic","value":"liraglutide","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"modality","value":"Allergen Immunotherapy","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"modality","value":"Anti-IL-4 Receptor Alpha Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"modality","value":"Anti-IL-5 Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"modality","value":"Anti-TSLP Monoclonal Antibody","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"warning","value":"Author discloses consultant relationship and research support from Sanofi/Regeneron (dupilumab manufacturer), which may introduce bias in interpretation of biologic data.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"warning","value":"Brand tag 'Mepolizumab' does not have a standard proprietary trade name listed in the paper; included based on generic name context. Dupixent is correctly mapped to dupilumab.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"warning","value":"Several referenced findings are from mouse models only; human translation remains uncertain for many ILC2 neuro-endocrine and memory mechanisms.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the breadth of mechanistic insight rather than a single trial result; individual cited studies vary widely in design and quality.","value_numeric":null},{"paper_doi":"10.1016/j.jaci.2026.04.013","tag_type":"warning","value":"This is a narrative review without systematic search methodology; evidence grading and study selection are at author discretion.","value_numeric":null}],"summaries":{"what_studied":"This narrative review covers 15 years of ILC2 research, focusing on four domains: neural and endocrine modulation of ILC2s, memory/trained immunity, cellular plasticity (ILC2-to-ILC1/ILC3 transitions, IL-10+ and IL-17+ subsets), and ILC2 contributions to adaptive Th2 responses in asthma, CRSwNP, AERD, and allergic rhinitis.","key_result":"ILC2s are now established as central drivers of type 2 inflammation, modulated by a wide network of neuro-endocrine signals (e.g., NMU amplifies, β2-adrenergic and CGRP suppress), capable of memory-like epigenetic reprogramming (Bach2 repression, Fhl2 activation), and able to transdifferentiate into ILC1- or ILC3-like cells under IL-12, IL-18, or IL-1β+IL-23+TGFβ signaling; CD45RO+ ILC2s in nasal polyps and severe asthma correlate with corticosteroid resistance.","limitations":"Almost all mechanistic data come from mouse models, with limited validation in human tissue; ILC2-specific depletion tools in humans do not yet exist, making causal inference difficult; peripheral blood ILC2 findings may not reflect tissue ILC2 behavior.","practice_takeaway":"In severe or steroid-refractory type 2 airway disease (asthma, CRSwNP, AERD), ILC2 activation—especially CD45RO+ steroid-resistant subsets—may explain treatment failure, making upstream alarmin blockade (TSLP, IL-33) or JAK inhibition plausible adjuncts. GLP-1R agonists may reduce ILC2-driven airway inflammation in obese patients with mixed or T2-low asthma and merit further clinical investigation."}},{"doi":"10.1016/j.waojou.2026.101383","pmid":"42058161","title":"Clinical remission in allergy and clinical immunology practice: State of the art and World Allergy Organization (WAO) call to action","journal_title":"World Allergy Organization Journal","journal_issn":"1939-4551","published_at":"2026-04-20T00:00:00.000Z","url":"https://doi.org/10.1016/j.waojou.2026.101383","source_score":4,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:04.940Z","updated_at":"2026-05-07T22:50:04.940Z","tags":[{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"brand","value":"Dupixent","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Atopic Dermatitis","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Chronic Rhinosinusitis With Nasal Polyps","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Chronic Spontaneous Urticaria","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Eosinophilic Esophagitis","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"condition","value":"Mastocytosis","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"abrocitinib","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"lebrikizumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"tralokinumab","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"modality","value":"Allergen-Specific Immunotherapy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"modality","value":"Biologic Therapy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"study_design","value":"Narrative Review / Expert Consensus Framework","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"warning","value":"No sample size is applicable as this is a framework/consensus review, not an original clinical study.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"warning","value":"Remission rates cited for asthma (36–42% in trials; 61–67% in inflammometry-guided cohorts) are not directly comparable due to differing definitions across studies.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"warning","value":"The 3D-CR framework and ADReS scoring tool are proposed conceptual instruments without prospective validation; treat recommendations as expert consensus, not evidence-based guidelines.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101383","tag_type":"warning","value":"The paper discloses use of ChatGPT-5.2 Pro for linguistic refinement; scientific content was author-validated.","value_numeric":null}],"summaries":{"what_studied":"This WAO-commissioned narrative review proposes a unified framework for defining clinical remission (CR) across 8 immunoallergic diseases—asthma, allergic rhinitis, CRSwNP, chronic urticaria, atopic dermatitis, mastocytosis, food allergy, and eosinophilic esophagitis—in the context of emerging biologics, small molecules, and allergen immunotherapy.","key_result":"The authors introduce the **3D-CR model** (Clinical–Biological–Functional domains) and the **Allergic Disease Remission Score (ADReS)** (0–6 scale) to standardize remission characterization. Key disease-specific thresholds proposed include: asthma CR requiring no symptoms/exacerbations, no OCS, and FEV₁ ≥80% for ≥12 months; CSU CR defined as complete symptom resolution off all therapy for ≥6 months; and AD complete remission requiring EASI/SCORAD = 0, DLQI = 0, and no flares for ≥12 months. Biologic-achieved CR rates in severe asthma trials range from 36–42%, rising to 61–67% with inflammometry-guided strategies in selected cohorts.","limitations":"- The framework is expert-consensus based with no prospective validation of 3D-CR or ADReS in real-world cohorts.\n- Remission definitions remain heterogeneous across diseases, and no reliable biomarkers exist for several conditions (e.g., chronic urticaria, atopic dermatitis).\n- CR data in asthma derive predominantly from severe asthma biologic trials, limiting generalizability to milder disease.","practice_takeaway":"Clinicians can use the 3D-CR framework (Clinical mandatory + Biological + Functional) as a structured lens when assessing long-term treatment response across allergic diseases—complete remission requires all 3 domains, partial remission requires the clinical domain plus one other. The ADReS tool and disease-specific thresholds (e.g., CSU: symptom-free off therapy ≥6 months; asthma: no OCS/exacerbations + FEV₁ ≥80% for ≥12 months) offer a starting point for incorporating remission endpoints into routine follow-up and clinical trial design, though prospective validation is still needed."}},{"doi":"10.1016/j.anai.2026.02.009","pmid":"41771482","title":"Asthma in pregnancy: Optimizing treatment strategies and the emerging role of biologic therapies","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-02-28T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.02.009","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-23T13:24:42.109Z","updated_at":"2026-05-23T13:24:42.109Z","tags":[{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"brand","value":"Xolair","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"condition","value":"Asthma","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"condition","value":"Asthma in Pregnancy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"benralizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"budesonide","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"dupilumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"formoterol","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"mepolizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"omalizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"reslizumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"generic","value":"tezepelumab","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-IgE Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-IL-4/IL-13 Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-IL-5 Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Anti-TSLP Therapy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Inhaled Corticosteroid","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"modality","value":"Long-Acting Beta-2 Agonist","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"Aspirin-exacerbated respiratory disease discussion and low-dose aspirin use in pre-eclampsia are covered but peripheral to the main asthma management focus.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"One author (Rupani) discloses advisory board, speaker, and grant relationships with GSK, AstraZeneca, Sanofi, Chiesi, and Boehringer Ingelheim — relevant given the review covers biologics made by these companies.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied cautiously — the biologic recommendations are consensus-based (Delphi) rather than RCT-derived, and registry data are limited mostly to omalizumab.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.02.009","tag_type":"warning","value":"This is a narrative (non-systematic) review; evidence grading and study selection may reflect author judgment rather than a reproducible search strategy.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examines strategies to optimize asthma management during pregnancy, including objective monitoring tools (spirometry, FeNO), a four-pillar management framework, anti-inflammatory reliever strategies (AIR/MART), and the safety and use of biologic therapies in women with severe asthma.","key_result":"Pregnancy does not significantly alter FEV1, FVC, or FeNO, making these tools valid for diagnosis and monitoring. Over 65% of women with severe asthma experience exacerbations requiring treatment during pregnancy. FeNO-guided management reduced exacerbations by ~50% in one RCT (Managing Asthma in Pregnancy trial), though a larger multicenter trial (Breathing for Life) found no significant improvement in perinatal or exacerbation outcomes. An international Delphi consensus supports continuing or initiating biologics during pregnancy when clinically indicated, with omalizumab registry data showing no increased risk of preterm delivery or major congenital anomalies.","limitations":"- Pregnant women are excluded from pivotal biologic and AIR/MART clinical trials, so direct pregnancy-specific efficacy and safety data are lacking.\n- Biologic safety data rely on small case series, registries, and animal studies rather than RCTs.\n- FeNO-guided management showed conflicting results across trials, and the optimal delivery model remains undefined.","practice_takeaway":"Do not withhold standard asthma therapies (ICS, combination inhalers, systemic corticosteroids for exacerbations) during pregnancy — uncontrolled disease poses greater risk than medication exposure. For women with severe asthma on biologics, shared decision-making and multidisciplinary review should guide continuation or initiation during pregnancy, rather than routine discontinuation."}},{"doi":"10.1007/s11882-025-01242-5","pmid":"41405763","title":"Psychological and Related Factors Influencing Adherence to Biologic Therapies in Asthma: A Scoping Review","journal_title":"Current Allergy and Asthma Reports","journal_issn":"1529-7322","published_at":"2025-12-17T00:00:00.000Z","url":"https://doi.org/10.1007/s11882-025-01242-5","source_score":15,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-18","doi":"10.1007/s11882-025-01242-5","days":"30","issn":"1529-7322","rank":"4","field":"Clinical Medicine","score":"15","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1007/s11882-025-01242-5","title":"Psychological and Related Factors Influencing Adherence to Biologic Therapies in Asthma: A Scoping Review.","journal":"Current allergy and asthma reports","methods":"","results":"","abstract":"$30","keywords":["Adherence","Asthma","Biologic therapy","Scoping review"],"pubmed_id":"41405763","conclusions":"","publication_date":"2025-12-17T00:00:00"},"crossref":{"DOI":"10.1007/s11882-025-01242-5","URL":"https://doi.org/10.1007/s11882-025-01242-5","ISSN":["1529-7322","1534-6315"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1007/s11882-025-01242-5.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1007/s11882-025-01242-5/fulltext.html","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1007/s11882-025-01242-5.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Psychological and Related Factors Influencing Adherence to Biologic Therapies in Asthma: A Scoping Review"],"author":[{"given":"Valentina","family":"Poletti","sequence":"first","affiliation":[]},{"given":"Eleonora","family":"Volpato","sequence":"additional","affiliation":[]}],"funder":[{"id":[{"id":"10.13039/501100005743","id-type":"DOI","asserted-by":"crossref"}],"DOI":"10.13039/501100005743","name":"Università Cattolica del Sacro Cuore","doi-asserted-by":"crossref"}],"issued":{"date-parts":[[2025,12]]},"member":"297","prefix":"10.1007","source":"Crossref","volume":"25","created":{"date-time":"2025-12-17T09:36:47Z","timestamp":1765964207000,"date-parts":[[2025,12,17]]},"indexed":{"date-time":"2025-12-17T09:41:48Z","timestamp":1765964508573,"date-parts":[[2025,12,17]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000,"date-parts":[[2025,12,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000,"date-parts":[[2025,12,17]]},"delay-in-days":16,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1007/s11882-025-01242-5"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"26 July 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":2,"value":"2 December 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":3,"value":"17 December 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics, Consent to Participate, and Consent to Publish"},"order":2,"value":"Not applicable."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":3,"value":"The authors declare no competing interests.EV declares the winning of an ERS Long-Term Research Fellowship 2024 grant (ID Number: LTRF202404-01155), which is unrelated to this study. 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