Target Audience:

Faculty, residents, fellows, and community physicians in General Internal Medicine and subspecialties.

Abstract This Department of Medicine Grand Rounds presentation is another installment of our "Year in Review" Series. This series highlights practice-changing updates in various medical fields, and in this session we will hear from some of our experts in Pulmonary, Allergy and Critical Care Medicine.

Updates in Asthma
Marc Gauthier, MD
Assistant Professor of Medicine

Update on COPD
Corrine Kliment, MD, PhD
Assistant Professor of Medicine

Interstitial Lung Diseases
Eleanor Valenzi, MD
Assistant Professor of Medicine

Educational Objectives:

Upon completion of this activity, participants should be able to:

• Review inhaled Treprostinil in pulmonary hypertension due to ILD
• Describe ATS 2022 Guidelines for progressive pulmonary fibrosis
• Explain COPD Pathogenesis
• Review new GOLD 2023 guidelines and advances in COPD diagnosis and exacerbations
• Incorporate new COPD evidence-based guidelines into clinical practice
• Evaluate increasing evidence for the use of PRN inhaled corticosteroids (ICS) with PRN albuterol in the treatment of asthma
• Review the approval of a new biologic for asthma: Tezepelumab

Suggested Additional Reading & Joint Accreditation Statement - Note: This Accreditation Statement Supersedes All Other Statements:

Suggested Additional Reading

1. Bateman ED, Reddel HK, O'Byrne PM, et al. As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. N Engl J Med 2018; 378:1877-87.
2. O'Byrne PM, FitzGerald JM, Bateman ED, et al. Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma. N Engl J Med 2018; 378:1865-76.
3. Hardy J, Baggott C, Fingleton J, et al. Budesonide-formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild to moderate asthma (PRACTICAL): a 52-week, open-label, multicentre, superiority, randomised controlled trial. Lancet 2019; 394:919-28.
4. Israel E, Cardet J-C, Carroll JK, et al. Reliever-Triggered Inhaled Glucocorticoid in Black and Latinx Adults with Asthma. N Eng J Med 2022.
5. Papi A, Chipps BE, Beasley R, et al. Albuterol–Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma. N Engl J Med 2022; 386:2071-83.
6. Menzies-Gow A, Corren J, Bourdin A, et al. Tezepelumab in Adults and Adolescents with Severe, Uncontrolled Asthma. N Engl J Med 2021; 384:1800-9.
7. Wechsler ME, Menzies-Gow A, Brightling CE, et al. Evaluation of the oral corticosteroid-sparing effect of Tezepelumab in adults with oral corticosteroid-dependent asthma (SOURCE): a randomized, placebo-controlled, phase 3 study. Lancet Respir Med 2022; 10:650-60.
8. Nathan SD et al. Lancet Respir Med 2021;11:1266-1274
9. A Waxman et al. N Engl J Med 2021;384:325-334
10. Barnes, PJ. et al. (2015) Nat. Rev. Dis. Primers doi:10.1038/nrdp.2015.76
11. Celli BR, et al. An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal. Am J Respir Crit Care Med 2021; 204: 1251-1258.
12. Siddharthan T, Investigators GES, et al. Discriminative Accuracy of Chronic Obstructive Pulmonary Disease Screening Instruments in 3 Low- and Middle-Income Country Settings. JAMA 2022; 327: 151-160
13. Stefan MS, et al. Association between Initiation of Pulmonary Rehabilitation and Rehospitalizations in Patients Hospitalized with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2021; 204: 1015-1023

Joint Accreditation Statement:

In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME) and the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

The University of Pittsburgh School of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit[s]™. Physicians should only claim credit commensurate with the extent of their participation in the activity. This educational activity is approved for 1.0 contact hours.

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.