Pulmonology

Music‑facilitated, app‑based home PR improved ISWT distance and symptoms versus usual care in COPD

In a 3‑arm multicenter RCT of 70 Chinese adults with COPD, a 12‑week music‑facilitated multicomponent app PR (MT) increased ISWT distance versus usual care (MD 56.35 m; P=.03). MT also reduced dyspnea (mMRC MD -0.44), COPD impact (CAT MD -3.23), anxiety, and improved inspiratory capacity versus usual care. Rhythm‑guided walking alone produced no significant benefit versus usual care. These results support offering home, app‑delivered multicomponent PR for motivated patients unable to attend center programs. 1

Nerandomilast slowed FVC decline and lowered composite respiratory event risk in autoimmune PPF

Among 325 patients with autoimmune ILD and progressive fibrosis, nerandomilast 9 mg and 18 mg twice daily reduced 52‑week FVC decline versus placebo (placebo -107.1 mL; nerandomilast -61.2 and -64.9 mL). Over mean 15.8 months, the 18 mg dose reduced time to first acute ILD event, respiratory hospitalization, or death (HR 0.56). Mortality HRs favored nerandomilast (0.40 for 9 mg; 0.28 for 18 mg), and discontinuation rates were similar across groups. Consider nerandomilast for autoimmune PPF where available, but note subgroup data and longer‑term safety require further confirmation. 2

Primary‑care private‑practice PR is feasible, safe, and yields clinically meaningful gains

In a randomized feasibility trial of adults with chronic respiratory disease, twice‑weekly 8‑week PR in private practices had a 72% completion rate. Participants who completed PR improved ISWT by a mean 53.7 m, 1‑minute sit‑to‑stand by 4.7 repetitions, and HRQoL beyond minimal important differences. Only one minor study‑related adverse event occurred, supporting the safety of delivering PR in private primary‑care settings. Implementing PR in community practices can expand access, but program fidelity and referral pathways should be ensured. 3