Asthma symptoms predicted attacks weakly while eosinophils and FeNO picked responders, and rehabilitation raised weaning success after 80

The edition in brief

In a patient-level meta-analysis of 7,161 people with asthma, symptom burden on the ACQ-5 bore little relation to lung function or inflammation and only modestly predicted severe attacks (rate ratio 1.09 per 0.5 points); patients with both high blood eosinophils and high FeNO had the largest reduction in attacks with mepolizumab (rate ratio 0.38), and ACQ-5 did not modify treatment response. In a single-centre randomised trial of 150 patients aged 80 or over on prolonged mechanical ventilation, multicomponent pulmonary rehabilitation achieved successful weaning in 45.3% against 12.0% with standard rehabilitation (adjusted HR 5.11), with less ventilator-associated pneumonia at 60 and 90 days. In 8,991 current or former smokers in COPDGene, self-reported occupational exposure to both dust and fumes was associated with more respiratory exacerbations (rate ratio 1.38), cardiovascular disease (OR 1.35) and pneumonia (OR 1.39) over up to 15 years. The FDA recorded a supplemental approval for a Micro Labs generic triamcinolone acetonide on 8 September; the record does not give the formulation or what changed. The rehabilitation trial is randomised but single-centre; the occupational finding is observational.