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Objective: Benralizumab is a promising drug for severe uncontrolled asthma. This study aimed to clarify the effectiveness of benralizumab in a real-life setting., Methods: Subjects included 24 patients with severe type 2 asthma who received benralizumab between April 2018 and July 2019. Changes in parameters, exacerbation frequency, and oral corticosteroid (OCS) use after 4 and 24 weeks of administration were examined. The parameters included the Global Evaluation of Treatment Effectiveness (GETE) scale, Asthma Control Questionnaire (ACQ), Asthma Control Test (ACT), blood eosinophils, fractional exhaled nitric oxide (FeNO), and spirometry. The response to treatment was defined as follows: for patients with exacerbations or OCS use before treatment initiation, a reduction of ≥50% in exacerbation frequency or OCS use; and for patients without exacerbations or OCS use, an improvement of ≥0.5 in ACQ scores and ≥3 in ACT scores, or of ≥10.38% in FEV1., Results: Twenty-one patients completed the treatment for 24 weeks. Excellent and good GETE scales and ACQ and ACT improvement were found in 67% of the patients at 4 weeks, and the effect continued until 24 weeks. The patients' rate with exacerbations was significantly reduced compared to the previous 24 weeks before administration. In 17 patients receiving OCS, the use could be reduced or quit in 14 patients. Overall, 16 patients (76.2%) met the responder definition and could be predicted by the baseline eosinophil count and FeNO levels with the best cutoff values of 100/μL and 40 ppb, respectively., Conclusions: Blood eosinophil and FeNO could predict benralizumab effectiveness.

The usefulness of the forced oscillation technique (FOT) for predicting the treatment outcomes in untreated asthmatic patients is unknown. We investigated whether FOT could predict an improvement in FEV1 following treatment. FOT, spirometry, and fractional exhaled nitric oxide were performed in 31 outpatients before and after undergoing a minimum of two months combination therapy of inhaled corticosteroids and long-acting β2-agonists. The patients were classified as responders or nonresponders to treatment based on the presence or absence of a 10% improvement in the FEV1. The responders to the treatment regimen exhibited lower FEV1, FEV1/FVC, FEF25-75%, and higher respiratory resistance at 5Hz (R5), as well as a difference between R5 and R20 (R5-R20) at baseline compared to the nonresponders. In the multivariate logistic regression analyses, a change in FEV1 greater than 10% was independently predicted by the R5 (adjusted odds ratio: 15.9). The ROC curve analyses revealed that the area under the curve for R5 (0.731) was larger than that of the other parameters. Thus, R5 is a forced oscillatory parameter and predicts an improvement in FEV1 following treatment., (Copyright © 2016 Elsevier B.V. All rights reserved.)

We present two cases of Pasteurella multocida (P. multocida) respiratory infection. The first case involves a 62‐year‐old female with abnormal chest shadows, a history of bronchial asthma, and colorectal cancer. Endobronchial ultrasound with a guide sheath (EBUS‐GS) revealed granulomatous changes, and P. multocida was cultured. The second case is a 64‐year‐old female presenting to the emergency department with progressively worsening chest pain and dyspnea, with P. multocida detected from her sputum culture. Treatment with penicillin antibiotics resulted in symptom improvement and normalization of CT findings. These cases indicate the importance of considering P. multocida in respiratory infections, given the patients' history of pet ownership and the nonspecific imaging findings and symptoms. This highlights the necessity for accurate diagnosis and appropriate antibiotic treatment, particularly in cases where animal traumatic exposure is not detected. [ABSTRACT FROM AUTHOR]

Sputum cell count is a noninvasive method to assess airway inflammation in patients with asthma and COPD. During the stable period, the sputum eosinophil count was significantly lower and the neutrophil count was higher in the COPD patients compared with the asthma and ACO patients (mean eosinophil and neutrophil counts: asthma, 17.4% and 78.8%; COPD, 1.8% and 95.6%; and ACO, 11.8% and 84.2%, respectively). The ROC curve analysis revealed that the blood eosinophil count predicted the sputum eosinophil count >= 3% during the stable period [AUC, 0.75 (95% CI, 0.66-0.84); cutoff, 235/ L; sensitivity 75.4%; and specificity 71.3%] and during the exacerbation period [AUC, 0.80 (95% CI, 0.66-0.94); cutoff, 351/ L; sensitivity 61.1%; and specificity 97.1%]. [Extracted from the article]