Pulmonology

Biomass versus cigarette COPD: distinct phenotype and mixed exposure worsens exacerbations

In 4,436 real‑world patients, BS‑COPD had less emphysema but thicker airway walls and more mucus plugs than CS‑COPD. Adjusted analyses showed BS‑COPD had lower risk of moderate‑to‑severe exacerbations than CS‑COPD, with similar mortality. Patients with combined cigarette and biomass exposure (CS+BS‑COPD) had higher incidence of moderate‑to‑severe exacerbations than either single‑exposure group. Across groups, combination inhaled therapy (LABA+LAMA or ICS+LABA+LAMA) associated with lower exacerbation risk than LAMA alone. 1

UCSD‑SOBQ is reliable, responsive, and prognostic in fibrotic hypersensitivity pneumonitis

The UCSD‑SOBQ showed very high internal consistency (Cronbach’s alpha 0.97) and correlated with FVC% and DLCO%. A within‑person worsening threshold of 12 points represents meaningful deterioration at 95% confidence. Each 1‑point higher baseline UCSD score associated with HR 1.02 for death or transplant, supporting prognostic relevance. 2

Quantitative CT DTA extent outperforms visual patterns for PFS in fibrotic HP

Baseline DTA fibrosis extent, 12‑month DTA, and 12‑month change were associated with progression‑free survival. Visual CT patterns and MIL‑UIP classification did not predict PFS after adjusting for DTA extent. A 12‑month change in DTA carried HR 1.07 for worse PFS, and DTA at 12 months had HR 1.03 per unit increase. 3