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Daiana Stolz,1,2 Claudio Schuoler,3 Florian Charbonnier,4 Pierre-Olivier Bridevaux,4,5 Peter Jandus,6 Jörg D Leuppi,7 Nikolay Pavlov,8 Andreas Piecyk,9 Thomas Rothe10 1Pulmonology Clinic, University Hospital Basel, Basel, Switzerland; 2Clinic of Respiratory Medicine and Faculty of Medicine, University of Freiburg, Freiburg, Germany; 3Medical Department, AstraZeneca AG, Baar, Switzerland; 4Pulmonology Division, University Hospital Geneva, Geneva, Switzerland; 5Service de Pneumologie, Centre Hospitalier du Valais Romand, Sion, Switzerland; 6Immunology and Allergology Division, University Hospital Geneva, Geneva, Switzerland; 7University Centre of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland; 8Department for Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; 9Pulmonary Center Hirslanden, Zurich, Switzerland; 10Pulmonology Clinic, Cantonal Hospital Graubünden, Chur, SwitzerlandCorrespondence: Claudio Schuoler, AstraZeneca AG, Medical Department, Baar, Switzerland, Email claudio.schuoler@astrazeneca.comPurpose: Although studies have evaluated benralizumab, a monoclonal IL-5 receptor α antibody in severe eosinophilic asthma (SEA), in real-world settings, additional evidence is needed to further characterize its effectiveness in specific patient populations. Our study aimed to evaluate asthma control over 56 weeks in patients treated with benralizumab in Swiss real-world settings.Patients and Methods: Conducted across 13 centres, this prospective, observational, non-interventional study involved 73 adults with physician confirmed SEA. Benralizumab 30 mg was administered according to the Swiss label at baseline and up to week 56. Primary outcome was the change in Asthma Control Questionnaire (ACQ-5) scores at week 8 compared to baseline. Exacerbations, use of oral corticosteroids (OCS), and lung function were assessed descriptively.Results: At baseline, the mean ACQ-5 score was 2.76 (SD 1.26), with 82.2% of patients showing not well-controlled asthma (ACQ-5 > 1.5). At week 8, the mean change in ACQ-5 compared to baseline was − 0.95 (95% CI: − 1.25, − 0.66; p < 0.001). More than half of patients (59.1%) reached a clinically relevant improvement (MCID ≥ 0.5) at week 8, with 40.9% of patients doing so at week 1 and 87.2% at week 56. The annualized exacerbation rate (AER) of 3.65 (95% CI: 3.18, 4.18) at baseline was reduced to 0.68 (95% CI: 0.39, 1.19) at week 56. The relative reduction in AER from baseline to week 56 was 81.3%. Maintenance usage of OCS at baseline (median 25.0 mg/day) decreased over the study leading to a median change of 17.50 mg/day (95% CI: 10.0; 40.0) from baseline compared to week 56. The mean pre-bronchodilator FEV1 change from baseline to week 56 was 0.23 L (95% CI: 0.08; 0.38, p = 0.003).Conclusion: Benralizumab demonstrated significant, rapid improvements in asthma control within one week of treatment initiation, with sustained benefits over 56 weeks.Keywords: severe eosinophilic asthma, asthma symptom control, patient reported outcomes, exacerbation reduction

Michael Furian,1,* Deborah Flueck,1,* Tsogyal D Latshang,1 Philipp M Scheiwiller,1 Sebastian Daniel Segitz,1 Séverine Mueller-Mottet,1 Christian Murer,1 Adrian Steiner,1 Silvia Ulrich,1 Thomas Rothe,2 Malcolm Kohler,1 Konrad E Bloch1 1Department of Respiratory Medicine, University Hospital of Zurich, Zurich, Switzerland; 2Zuercher RehaZentrum Davos, Davos Clavadel, Switzerland *These authors contributed equally to this work Objective: To evaluate the effects of altitude travel on exercise performance and symptoms in lowlanders with COPD. Design: Randomized crossover trial. Setting: University Hospital Zurich (490 m), research facility in mountain villages, Davos Clavadel (1,650 m) and Davos Jakobshorn (2,590 m). Participants: Forty COPD patients, Global Initiative for Obstructive Lung Disease (GOLD) grade 2–3, living below 800 m, median (quartiles) age 67 y (60; 69), forced expiratory volume in 1 second 57% predicted (49; 70). Intervention: Two-day sojourns at 490 m, 1,650 m, and 2,590 m in randomized order. Outcome measures: Six-minute walk distance (6MWD), cardiopulmonary exercise tests, symptoms, and other health effects. Results: At 490 m, days 1 and 2, median (quartiles) 6MWD were 558 m (477; 587) and 577 m (531; 629). At 2,590 m, days 1 and 2, mean changes in 6MWD from corresponding day at 490 m were -41 m (95% CI -51 to -31) and -40 m (-53 to -27), n=40, P

Norbert Meyer,1,2 Sarah Janine Nuss,1 Thomas Rothe,1 Alexander Siebenhüner,1 Cezmi A Akdis,2 Günter Menz11Hochgebirgsklinik Davos, Davos-Wolfgang, Switzerland; 2Swiss Institute of Allergy and Asthma Research (SIAF), Davos Platz, SwitzerlandBackground: Asthma is a heterogeneous disease characterized by different clinical phenotypes and the involvement of multiple inflammatory pathways. During airway inflammation, many cytokines and chemokines are released and some are detectable in the sera.Objective: Serum chemokines and cytokines, involved in airway inflammation in asthma patients, were investigated.Methods: A total of 191 asthma patients were classified by hierarchical cluster analysis, including the following parameters: forced expiratory volume in 1 second (FEV1), eosinophil cationic protein (ECP) serum levels, blood eosinophils, Junipers asthma symptom score, and the change in FEV1, ECP serum levels, and blood eosinophils after 3 weeks of asthma therapy. Serum proteins were measured by multiplex analysis. Receiver operating characteristic (ROC) curves were used to evaluate the validity of serum proteins for discriminating between asthma clusters.Results: Classification of asthma patients identified one cluster with high ECP serum levels, increased blood eosinophils, low FEV1 values, and good FEV1 improvement in response to asthma therapy (n=60) and one cluster with low ECP serum levels, low numbers of blood eosinophils, higher FEV1 values, and no FEV1 improvement in response to asthma therapy (n=131). Serum interleukin (IL)-8, eotaxin, vascular endothelial growth factor (VEGF), cutaneous T-cell-attracting chemokine (CTACK), growth-related oncogene (GRO)-α, and hepatocyte growth factor (HGF) were significantly different between the two clusters of asthma patients. ROC analysis for serum proteins calculated a sensitivity of 55.9% and specificity of 75.8% for discriminating between them.Conclusion: Serum cytokine and chemokine levels might be predictors for the severity of asthmatic inflammation, asthma control, and response to therapy, and therefore might be useful for treatment optimization.Keywords: asthma, cluster, phenotype, serum cytokines

Asthma is not a homogenous disease but a bundle of different phenotypes producing common symptoms due to swelling of bronchial mucosa and constriction of the airway smooth muscle. Beyond the treatment with a combination of topical steroids and long-acting beta agonists, new therapeutic options arise with the knowledge of different phenotypes. One option, specifically in allergic asthma, is the long known allergen immunotherapy. To identify the individual phenotype a diagnostic work up is warranted when asthma is diagnosed and whenever asthma control cannot be maintained. [ABSTRACT FROM AUTHOR]

According to the international guidelines of COPD (GOLD) and asthma (GINA) diagnosis and treatment of both diseases necessitate spirometry in the private practice as well as in hospital setting. However today, spirometry is not sufficiently used in Switzerland. This paper intends to give an easy overview how spirometry is performed and spirometric values can be interpreted. [ABSTRACT FROM AUTHOR]

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A 36 year old woman presented with mild recurrent haemoptysis and cough persisting over several months caused by a malignant haemangiopericytoma of the right lung. [ABSTRACT FROM PUBLISHER]

Proffered Papers: Proffered papers 4: CNS OC-0093: Hippocampus-avoidance whole-brain irradiation with dose escalation on multiple brain metastases I. Popp, S. Rau, M. Hintz, J. Schneider, A. Bilger, J.T. Fennell, D.H. Heiland, T. Rothe, K. Egger, C. Nieder, H. Urbach, A.L. Grosu. [Extracted from the article]