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Medical News
26th Nov, 2025
phys.org
When Cop30 convened in Belém, deep inside the Amazon, the world's attention turned once again to negotiations, emissions pledges and political maneuvering. The global stage was set against one of Earth's most biodiverse landscapes and some of its most vulnerable communities, yet the conversation still leaned heavily toward geopolitics rather than people.
Respiratory Medicine
2nd Dec, 2025
The Lancet
Identifying safe and effective therapies that target the underlying cause of cystic fibrosis remains a key priority for the cystic fibrosis community. CFTR modulators are first-in-class, regulatory-approved therapies that improve the function of the protein encoded by the CFTR gene and are associated with dramatic and sustained clinical benefits. Although approximately 90% of the population with cystic fibrosis could benefit from these therapies based on genetic eligibility, a crucial unmet need remains: developing CFTR-directed therapies for the ultra-rare population with cystic fibrosis who are not candidates for CFTR modulators due to either ineligibility or intolerance.
Projections indicate that obstructive sleep apnoea will affect 76·6 million adults aged 30–69 years across the USA in 2050, with a disproportionate growth among females compared with males. These findings highlight the urgent need for targeted public health strategies and revised access to diagnosis and follow-up pathways to address the growing prevalence of obstructive sleep apnoea, particularly among females.
Dupilumab was superior to omalizumab in patients with severe CRSwNP and coexisting asthma. These findings support the efficacy of dupilumab in patients with type 2 respiratory diseases versus an active biologic comparator, the known safety profiles of dupilumab and omalizumab, and could enable better treatment targeting for patients with CRSwNP and asthma in clinical practice.
For decades, chronic respiratory diseases (CRDs) such as asthma and chronic obstructive pulmonary disease (COPD) have been treated as a “Cinderella” issue in global health—a silent epidemic that affects around half a billion adults and children and causes 4 million deaths each year, yet it remains overlooked and underfunded. Patients in low-income countries often face an impossible choice, sometimes asked to pay a month's wages for just one week's supply of life-saving inhalers.
Previous non-experimental studies suggest an association between paracetamol exposure in the first year of life and subsequent asthma and eczema developing in childhood; however, randomised trials are needed to establish whether a causal link truly exists. Stuart R Dalziel (University of Auckland, Auckland, New Zealand) presented 1-year results from the PIPPA Tamariki randomised study comparing the use of paracetamol versus ibuprofen in early life. The study included 3908 infants in New Zealand aged less than 8 weeks.
US vaccine policy is in disarray. Amid unprecedented turmoil at the US Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP), some state governments and medical societies are parting ways with federal immunisation schedules that they see as politicised and at odds with scientific evidence.
We thank Jingyuan Ning and colleagues for their comments and agree with their assessment of the Evaluating Treatment Responses of Dupilumab vs Omalizumab in patients with type 2 inflammatory disease (EVEREST) trial results and the importance of dupilumab's comprehensive inhibition of type 2 inflammatory pathways.1 Although blood eosinophils were transiently elevated in the dupilumab group, we did not observe a correlation between baseline eosinophil levels and nasal polyp outcomes. Transient elevations in blood eosinophils have previously been observed in dupilumab studies for asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), consistent with the intrinsic pharmacodynamic mechanism of the drug.
The most thought-provoking finding in the Evaluating Treatment Responses Of Dupilumab Versus Omalizumab (EVEREST) trial is not dupilumab's superiority, but its eosinophil paradox—transient eosinophil elevation after treatment correlating with significantly better efficacy than omalizumab's sustained suppression.1 This occurrence challenges our traditional understanding of type 2 inflammation, suggesting that eosinophils might participate in tissue repair rather than simply acting as pathogenic mediators.
Stephanie A Christenson and colleagues' post-hoc analysis of the BOREAS trial provides valuable data in The Lancet Respiratory Medicine: they show that blocking the shared interleukin (IL)-4 and IL-13 receptor with dupilumab reduces chronic obstructive pulmonary disease (COPD) exacerbations and that the treatment effect increases with higher baseline blood eosinophil counts and fractional exhaled nitric oxide (FeNO).1
Refractory chronic cough (RCC), defined as a persistent cough for more than 8 weeks despite adequate treatment of underlying comorbidities, is increasingly acknowledged as a standalone clinical disease with a neuropathic aetiology.1 For clinicians, decades of therapeutic nihilism have been replaced with hope for the future, given the advances in therapeutics. The first targeted medication, gefapixant, has been licensed in the EU, UK, Switzerland, and Japan and has proven efficacy, with indications of sustained improvement even after discontinuation.
In the past decade, the treatment landscape for non-oncogene-addicted non-small-cell lung cancer (NSCLC) has changed substantially. Immune checkpoint inhibitors, either alone or combined with chemotherapy (the latter especially in tumours with PD-L1 expression of less than 50%), are recommended by clinical guidelines as first-line treatment regimens.1 These recommendations are supported by multiple phase 3, randomised clinical trials that show both the efficacy and the safety of immune checkpoint inhibitor-based treatment regimens.
The main goal of current ventilatory strategies in acute respiratory failure is to keep spontaneous breathing whenever clinically appropriate. This approach aims to enhance gas exchange, promote physiological lung aeration, and maintain respiratory muscle function.1 Diaphragm atrophy and atelectasis are frequent complications of respiratory muscle inactivity.2 Changes in respiratory muscle strength and respiratory system mechanics can uncouple respiratory drive from effort, creating a dual risk in which elevated drive might mask harmful effort; conversely, effort alone might hide the severity suggested by excessive drive.
Obstructive sleep apnoea increases risk of all-cause mortality.1 In 2019, the global burden of obstructive sleep apnoea was estimated at nearly 1 billion adults.2 However, guidance regarding the future burden of the condition, important to developing policy and public health strategies, is scarce. An innovative modelling study by Elroy Boers and colleagues3 in The Lancet Respiratory Medicine now provides robust data regarding the inferred 30-year burden of obstructive sleep apnoea in the USA. A major strength of their analysis is the probabilistic simulation model, accounting for risk factors such as age, sex, and BMI.
The addition of immune checkpoint inhibitors (ICI) to first-line platinum-doublet chemotherapy has substantially improved long-term outcomes in a subset of patients with extensive-stage small-cell lung cancer (SCLC), with 3-year survival rates reaching 16–18%, compared with approximately 6% with chemotherapy alone, as shown in phase 3 studies such as the CASPIAN and IMpower133 trials.1,2 However, these trials were highly selective, excluding patients with poor Eastern Cooperative Oncology Group performance status (ie, ≥2) and impaired organ function, raising concerns about the generalisability of their outcomes to real-world settings, in which 33–88% of patients would not have met eligibility criteria.
15th Jan, 2026
Medical Journal
Wiley
