Ian D Pavord’s research while affiliated with University of Oxford and other places

... As a precision medicine strategy, TTs provide a structured framework for aligning therapeutic goals with personalized interventions. TT-based individualized medicine could enhance disease control, slow disease progression, improve quality of life and reduce healthcare utilization [10][11][12][13]. Assessing and managing TTs in a holistic manner could be useful for patients with chronic airway diseases, particularly those with complex conditions such as hospitalized AECOPD patients [14,15]. ...

Reference:

Treatable traits identified in Chinese patients hospitalized with AECOPD: A Multicenter Cohort Study

... However, some observational studies with a small number of patients showed promising results without significant adverse events [45]. Also, giving azithromycin to patients with asthma taking biologics and experiencing chronic bronchitis and/or frequent purulent exacerbations may result in reduced annual rates of exacerbations and improved symptom scores [46]. Combining biologics (particularly omalizumab and tezepelumab) and allergen-specific immunotherapy has promising prospects in the clinical treatment of allergic rhinitis and asthma due to the improvements in both clinical efficacy and safety [47]. ...

Reference:

Biologic Therapies for Severe Asthma: Current Insights and Future Directions

... Various cell types, including airway structural cells (e.g., airway epithelial cells) and innate immune cells (e.g., type 2 innate lymphoid cells [ILC2s] and dendritic cells), play critical roles in mediating IgE-independent airway inflammation in both allergic and non-allergic asthma [60][61][62][63]. ILC2s, in particular, are highly potent producers of Th2 cytokines, including IL-4, IL-5, and IL-13, in response to allergens like HDM as well as epithelial-derived cytokines (e.g., IL-25, IL-33, and thymic stromal lymphopoietin [TSLP]) released during allergen challenges to the airway epithelium [64][65][66]. Notably, the activation of ILC2s is recognized as an early event in initiating eosinophilic inflammation, even in the absence of IgE [64]. These findings underscore the importance of IgE-independent mechanisms in asthma pathogenesis and highlights diverse cellular players contributing to airway inflammation across different asthma endotypes. ...

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YAP as a potential therapeutic target for myofibroblast formation in asthma

... While tezepelumab has been primarily studied for severe asthma, its beneficial effect on CRSwNP has already been evidenced in a clinical trial (phase III WAYPOINT trial), with significantly greater reductions in the size of nasal polyps, the severity of nasal congestion and sinonasal symptoms, as well as the need for surgery or glucocorticoids [61]. For COPD, a phase IIb trial (COURSE trial) showed a 17% reduction in COPD exacerbations with tezepelumab compared to those of a placebo, with a greater effect on those with higher eosinophil counts, but no phase III trials have been registered yet [62]. ...

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Biologic Therapies for Severe Asthma: Current Insights and Future Directions

... Large cohort studies have demonstrated that although pre-bronchodilator spirometry and post-bronchodilator spirometry give the same diagnostic results in the majority of individuals, post-bronchodilator values can result in up to 36% fewer diagnoses due to a "flow" response characterised by an increase in FEV 1 that pushes FEV 1 /FVC > 0.7. (2) However, administration of a bronchodilator can reduce gas trapping ("volume" response). This improves FVC, thereby reducing the FEV 1 /FVC ratio; there are a small number of "volume" responders who move from > 0.7 to < 0.7 after bronchodilator administration. ...

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What’s new in the 2025 GOLD report

... Our results are supported by a recently published post hoc analysis from two studies in which FeNO levels (determined at weeks 2, 12 and 52) stayed stable throughout the 52 week study period for both children aged 6-11 years (VOYAGE study, n = 135) and adolescents ≥12 years and adult patients (QUEST study, n = 638), regardless of exacerbation events. 13 What lag time to choose between exposure and the outcome is an interesting question in epidemiological studies, so prior to conducting our study, we reviewed the main systematic reviews and meta-analysis of time series studies on airborne exposure and asthma emergency room visits or hospital admissions 12,14 as well as primary studies with personal samplers focusing on asthma with FeNO as outcome. 6 No specific lag time clearly stands out, making it unclear whether today's high PM exposure causes emergency department visits or hospital admissions in asthmatic patients on the same day, the next day, or two or more days after high PM exposures. ...

Reference:

FeNO Stability in Repeated Measurements in Asthma Patients During Three Consecutive Days

... The ABRA trial tested benralizumab (anti-IL5Rα) during active eosinophilic exacerbations of asthma/COPD and evidenced a reduced failure rate (against prednisolone) and reduced hospital readmissions [67]. This is the first trial demonstrating acute biologic efficacy during exacerbations rather than prevention. ...

Reference:

Biologic Therapies for Severe Asthma: Current Insights and Future Directions

... Dupilumab is also preferred for children with comorbid atopic skin conditions. Mepolizumab use is independent of FeNO levels, and mepolizumab should be used if there is evidence of a clear eosinophilic phenotype without significant atopy, a history of multiple eosinophilic exacerbations (particularly if associated with viral triggers and high eosinophil levels), or a history of conjunctivitis/ocular disease (which is more common with dupilumab) [55]. ...

Reference:

Biologic Therapies for Severe Asthma: Current Insights and Future Directions

... The pooled NAVIGATOR and DESTINATION remission analysis has also noted that those with higher baseline T2 biomarkers are more likely to achieve clinical remission with tezepelumab [12]. It is also of note that these rates are broadly similar to the absolute clinical remission rates reported with other biologics targeting T2 inflammation, including dupilumab (QUEST clinical remission rate of 33.6% in patients on high-dose ICS at 1 year) [13], and mepolizumab (30% in REDES) [14] Still, based on the baseline exacerbation frequency and mOCS use, our cohort appears more severe. However, caution must be applied to any indirect treatment comparison given key differences in the patient populations recruited to these studies. ...

Reference:

Clinical and Biological Remission With Tezepelumab: The Real‐World Response in Severe Uncontrolled Asthma

... It is interesting to note that despite a more severe asthma cohort than that recruited to the phase 3 NAVIGATOR study (with higher baseline exacerbation rates, higher dependence on maintenance OCS and a large proportion of patients who had failed eosinophil-directed therapy with an anti-IL5/5R biologic), the clinical remission rate of 35.6% we observed was higher than the 28.5% reported in the NAVIGATOR subjects [12]. The pooled NAVIGATOR and DESTINATION remission analysis has also noted that those with higher baseline T2 biomarkers are more likely to achieve clinical remission with tezepelumab [12]. ...

Reference:

Clinical and Biological Remission With Tezepelumab: The Real‐World Response in Severe Uncontrolled Asthma