Thorax Podcast

Previous trials on triple therapy inhaler use (ETHOS and IMPACT) were understood to show a reduction in mortality in COPD patients. However, a reanalysis published in Thorax shows that this benefit may have been misattributed. Host Dr. Kate Diomede is joined by the paper's authors, pharmacist Kari Leung¹ and physician Prof. Aroon Hingorani², both members of the ​North Central London Joint Formulary committee. Read the paper: Inhaled corticosteroid withdrawal and mortality rate in trials of triple therapy inhalers for COPD Further reading: Withdrawal of fluticasone propionate from combined salmeterol/fluticasone treatment in patients with COPD causes immediate and sustained disease deterioration: a randomised controlled trial 1. UCL Hospitals NHS Foundation Trust, London, UK 2. University College London, London, UK Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

In this episode, Thorax social media editor Dr. Kate Diomede speaks to Dr. Susan Muiser¹, author of a research paper based on the NOVELTY study that included over 12,000 patients globally with asthma, COPD, or asthma plus COPD. The research sought to find potential biomarkers that could link to exacerbations in these patients, giving consideration to blood eosinophils and fractional exhaled nitric oxide as possible candidates which could give insight into disease progression and treatment response.   Read the paper: Association of blood eosinophils and exhaled nitric oxide with exacerbations in patients with asthma, COPD and asthma+COPD: the NOVELTY study 1. Department of Pulmonology, University Medical Centre Groningen, Groningen, Netherlands   Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Last year the British Thoracic Society published the results of their 2024 survey of trainees. Since then, a number of commentary pieces have been published in Thorax, and two authors join the podcast this episode. Dr. Abigail MacKintosh¹ a respiratory medicine trainee, and Dr. Daniel Smith², consultant and chair of the BTS workforce committee, join host Dr. Kate Diomede to discuss some of the issues identified  and some potential solutions. Links: British Thoracic Society trainee survey 2024: what are the trainees saying and how will this impact the future workforce? Commentary on the 2024 British Thoracic Society Specialty Trainee Survey report  The British Thoracic Society Trainee Survey Report 2024 (1) Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK (2)  Sherwood Forest Hospitals NHS Foundation Trust, Nottinghamshire, UK Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

This journal club episode is guest-hosted by Dr. David Furfaro and Dr. Kristina Montemayor of the PulmPEEPs, in conversation with Thorax education editor Dr. Christopher Turnbull, and Dr. George Doumat, author of a recent journal club article focussing on the theme of bronchiectasis. These papers highlight the exciting progress that is being seen in the treatment of this condition, and the challenges that remain ahead. Links: Journal club Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis Cathepsin C (dipeptidyl peptidase 1) inhibition in adults with bronchiectasis: AIRLEAF, a phase II randomised, double-blind, placebo-controlled, dose-finding study Five-Year Outcomes among U.S. Bronchiectasis and NTM Research Registry Patients Anxiety, depression, physical disease parameters and health-related quality of life in the BronchUK national bronchiectasis cohort   For more from the PulmPEEPs, visit their podcast's website. You can find them Twitter (@PulmPEEPs) and Instagram (pulmpeeps), and hear past episodes on Apple Podcasts and Spotify. To submit a journal club article of your own, you can contact Chris directly - [email protected] Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Prophylactic use of azithromycin is common in the management of COPD patients with frequent acute exacerbations. But its application is conservative due to concerns around adverse events, interactions with other drugs, and bacterial resistance. Given these concerns, it is important to identify patients who are likely to be responders or non-responders. According to the NICE guidance in the UK, you should consider azithromycin if the patient: Doesn't smoke. Has already accounted for non-drug treatments, inhaled therapies and vaccines. And has one or more of the following kinds of exacerbations: Frequent exacerbations, more than four times a year, with high sputum production Prolonged exacerbations with high sputum production. Exacerbations causing hospitalisation. In this episode, Thorax social media editor Dr. Kate Diomede speaks to Prof. Wim Janssens¹, author of a study proposing five parameters to predict the individual treatment effect of azithromycin. These parameters were developed using a machine learning model trained using the MACRO and COLUMBUS datasets. This led to the creation of an online calculator, serving as an aid in decision making.   Read the paper: Identifying azithromycin responders with an individual treatment effect model in COPD   1. Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium   Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.