Pulse steroids showed no survival gain in acute IPF exacerbation

The edition in brief

The SAFER trial randomised 100 adults with acute exacerbation of idiopathic pulmonary fibrosis at eight Korean hospitals to pulse methylprednisolone, 10 mg/kg for three days, or 1 mg/kg for seven days, both followed by a taper. Mortality did not differ at 28 days (10.0% vs 14.6%) or 90 days (24.5% vs 29.8%), though the trial was small and the confidence intervals wide. A two-campus Chinese cohort of 2,251 inpatients with acute pulmonary embolism found the 2026 AHA/ACC clinical categories discriminated 30-day mortality better than the 2019 ESC scheme, with an area under the curve of 0.89 against 0.76, and picked out a group the ESC called intermediate-risk in which three-quarters died. A meta-analysis of six trials in moderate-to-severe obstructive sleep apnoea found liraglutide or tirzepatide reduced the apnoea-hypopnoea index by about 10 events an hour, with high heterogeneity; the authors say this does not replace CPAP. The FDA approved a supplement for an intravitreal dexamethasone implant, an ophthalmic product with no direct respiratory implication. The pearl covers when to repeat risk assessment in pulmonary embolism.