American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Feb 2021
Randomized Controlled Trial Comparative StudyCPAP Did Not Improve Nonalcoholic Fatty Liver Disease in Patients with Obstructive Sleep Apnea: A Randomized Clinical Trial.
Rationale: Obstructive sleep apnea (OSA) is associated with development of nonalcoholic fatty liver disease (NAFLD). The effects of continuous positive airway pressure (CPAP) on NAFLD in patients with concomitant OSA are unknown. Objectives: To investigate the effects of autoadjusting CPAP versus subtherapeutic CPAP treatment over 6 months on NAFLD activities. ⋯ Regression analysis showed that weight change over 6 months correlated with changes in both intrahepatic triglyceride and CAP (P < 0.001). Conclusions: Despite significant correlations between hepatic steatosis and markers of severity of OSA, CPAP alone did not improve hepatic steatosis and fibrosis. However, the additional role of weight reduction through lifestyle modification deserves further investigation.
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Am. J. Respir. Crit. Care Med. · Feb 2021
Letter Randomized Controlled TrialPulmonary Arterial Hypertension Caused by AhR Signal Activation Protecting Against Colitis.
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Am. J. Respir. Crit. Care Med. · Feb 2021
Randomized Controlled TrialA Phase 2a, Double-Blind, Placebo-Controlled Randomized Trial of Inhaled TLR9 Agonist AZD1419 in Asthma.
Rationale: To examine the potential of TLR9 (Toll-like receptor 9) activation to modulate the type 2 immune response in asthma. Objectives: To evaluate efficacy and safety of AZD1419, an inhaled TLR9 agonist, in a phase 2a, randomized, double-blind trial. Methods: Adult patients with asthma with a history of elevated eosinophils (>250 cells/μl) were randomized 1:1 to receive 13 once-weekly doses of inhaled AZD1419 (1, 4, or 8 mg; n = 40) or placebo (n = 41). ⋯ Adverse events were balanced across groups, with no deaths or serious adverse events judged as causally related to AZD1419. Conclusions: AZD1419 was safe and well tolerated but did not lead to improved asthma control, despite reducing markers of type 2 inflammation. Results suggest that a novel accelerated step-down approach based on FeNO is possible for patients with well-controlled asthma.