30-Second Takeaway
- Serum NOTCH3-ECD shows strong diagnostic and prognostic performance in idiopathic PAH.
- Tirzepatide improves cardiometabolic risk in obese OSA via weight loss and OSA improvement.
- High-flow nasal cannula clearly outperforms conventional oxygen during bronchoscopy, especially at ≥45 L/min.
- Macrolides and DPP-1 inhibitors reduce bronchiectasis exacerbations with acceptable safety.
- Noninvasive ventilation in severe asthma is increasingly used and associated with less intubation and lower adult mortality.
Week ending January 17, 2026
New tools reshaping pulmonary hypertension, bronchoscopy safety, and obstructive lung disease management
Serum NOTCH3-ECD as a high-performance biomarker for idiopathic PAH
Serum NOTCH3 extracellular domain (NOTCH3-ECD) was markedly higher in idiopathic PAH than in healthy controls across three geographically distinct cohorts. NOTCH3-ECD strongly correlated with hemodynamic severity, 6-minute walk distance, and NYHA class, linking biomarker levels to disease burden. Diagnostic performance was excellent, with an AUC of 0.96 and high sensitivity and specificity at a defined cutoff concentration. Each 3 ng/mL NOTCH3-ECD increase above the cutoff was associated with an 18% rise in 3-year mortality risk. Adding NOTCH3-ECD to REVEAL 2.0, REVEAL 2.0 Lite, and COMPERA 2.0 improved prognostic discrimination and tracked disease progression over six years.
Tirzepatide improves cardiometabolic risk in obese patients with OSA
In SURMOUNT-OSA, tirzepatide produced larger improvements in multiple cardiometabolic risk factors than placebo over 52 weeks in obese patients with moderate-to-severe OSA. Prespecified and post hoc analyses showed independent mediation effects of OSA metric improvements on hs-CRP, insulin resistance, and triglycerides. Weight loss and OSA improvements, alone and combined, significantly mediated reductions in systolic blood pressure, but not diastolic pressure. Mediation findings suggest that treating both obesity and sleep-disordered breathing is needed to maximize cardiometabolic benefits in this population.
High-flow nasal cannula reduces hypoxemia and interruptions during bronchoscopy
Across 17 RCTs including 3,116 adults, high-flow nasal cannula (HFNC) significantly reduced desaturation events compared with conventional oxygen during bronchoscopy. HFNC also lowered procedure interruptions, escalation of respiratory support, and need for airway interventions versus conventional oxygen therapy. Individual participant data analyses suggested greater relative benefit in patients with lower BMI and lower baseline respiratory and heart rates. Flows ≥45 L/min were associated with further desaturation risk reduction, informing practical HFNC settings in bronchoscopy suites. HFNC appears superior to conventional oxygen for bronchoscopic support, though additional data in higher-risk patients are needed.
Macrolides and DPP-1 inhibitors cut bronchiectasis exacerbations
This network meta-analysis of 31 RCTs (4,092 adults) evaluated eight anti-inflammatory agents in non–cystic fibrosis bronchiectasis. Compared with placebo, macrolides nearly halved overall exacerbation rates, while DPP-1 inhibitors produced a more modest but significant reduction. DPP-1 inhibitors also reduced severe exacerbations; macrolides showed a similar trend but with wide confidence intervals and low certainty. Adverse events and discontinuations were generally small or trivial across interventions, supporting acceptable safety. Among macrolides, azithromycin yielded the largest exacerbation reduction, and DPP-1 efficacy persisted regardless of background long-term macrolide use.
References
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Additional Reads
Optional additional studies from this edition.