Christian Cardillo, MD, from Lewis Katz School of Medicine at Temple University Hospital.

Periconception Eosinophil Counts Predict Asthma Exacerbations in Pregnancy

Periconception eosinophil counts were independently associated with increased 

exacerbation frequency during pregnancy, according to late-breaking findings presented at the 

2026 American Thoracic Society (ATS) International Conference 

in Orlando, Florida. The findings suggest that a routinely available biomarker obtained at or near conception may help identify higher-risk patients earlier in gestation.

In an interview at ATS 2026, Christian Cardillo, MD, from Temple University Hospital, said asthma control during pregnancy remains highly variable, creating challenges for clinicians trying to anticipate which patients will deteriorate.

“We should all be aware that the physiologic changes during pregnancy in relation to asthma change from patient to patient, and it’s somewhat unpredictable,” Cardillo said.

Asthma exacerbations during pregnancy are associated with significant maternal and fetal risks, including acute respiratory failure, hospitalization, prolonged hospital stays, fetal growth restriction, and small for gestational age outcomes. Cardillo emphasized that identifying higher-risk patients earlier in pregnancy could help guide closer monitoring and coordination with subspecialists.

The late-breaking study included 31 pregnant patients with physician-diagnosed asthma treated at a single academic center. Investigators found that higher periconception absolute eosinophil counts were independently associated with increased exacerbation frequency during pregnancy.

Each 100 cells/µL increase in eosinophil count was associated with 0.20 additional exacerbations during pregnancy (adjusted β = 0.20; 95% CI, 0.12-0.28; 

 <.001) after adjusting for age, BMI, smoking status, controller therapy use, and prior exacerbation history. Cardillo noted that eosinophils are already part of routine clinical testing, making them a potentially scalable tool for risk assessment.

The analysis also suggested that greater eosinophil counts, particularly around 300 cells/µL, may better identify patients with type 2 inflammatory asthma phenotypes at higher risk for exacerbations during pregnancy. This threshold was consistent with prior retrospective data presented in 2025.

Cardillo said the findings remain exploratory but could eventually support earlier intervention strategies if validated in larger prospective studies. Future work will focus on more diverse cohorts and incorporation of objective pulmonary measures such as spirometry to strengthen risk prediction models.

“Most patients will obtain a CBC somewhere around 8 to 12 weeks,” he said. “While I don't think it's practice-changing at this very point in time, if we perform…more prospective studies…[it may become] a reflex cutoff where the patient will get hooked up with either [pulmonologists] or MFM [specialists] to have their asthma either taken a closer look at in terms of management or potentially get them started on new medications that can help them prevent exacerbations.”

Editor’s note: Relevant disclosures for Cardillo include AstraZeneca Pharmaceuticals and GlaxoSmithKline.

Cardillo C, Shenoy K, Karanam A, et al. (

) Periconception Eosinophil Count Is Independently Associated With Asthma Exacerbations During Pregnancy. Late-breaking poster presented at ATS 2026 in Orlando, Florida, on May 17.

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Periconception eosinophils may serve as a biomarker to identify asthma risk in gestation, according to Christian Cardillo, MD, who presented late-breaking data at ATS 2026.

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Kathryn Celeste Durham, MD, is a board-certified dermatologist practicing in Fort Worth, Texas, at U.S. Dermatology Partners.

How Online-Informed Patients Are Changing Dermatology Visits

In recent years, the rise of the “online-informed” patient has transformed visits to 

 practices, with clinicians increasingly encountering patients who greet them armed with TikTok skincare advice, Reddit-informed treatment data, AI-generated differential diagnoses, and screenshots from ChatGPT inquiries. In this feature, interviews between 4 leaders in dermatology and 

highlight this trend as being simultaneously empowering to patients and potentially hazardous.

David Cotter, MD, PhD, assistant clinical professor at the University of Nevada, spoke with 

 in 1 such interview, describing the phenomenon as a double-edged sword. Cotter noted digitally informed individuals often arrive more prepared to discuss disease states and treatment options. He described access to online tools as encouraging earlier intervention, particularly for conditions such as skin cancer or acne, where delays in care may hurt patient outcomes. Cotter pointed to teledermatology and online educational content as especially valuable among those without access to specialists.

However, Cotter also warned against inaccurate online information, noting its ability to lead patients astray, particularly when individuals rely on unverified influencers or AI tools lacking training. He described seeing patients delay appropriate care following treating autoimmune skin disease as fungal infections based on online recommendations. Cotter also raised concerns over increasingly aggressive self-treatment trends, ranging from excessive tween skincare routines involving multiple active ingredients to do-it-yourself cosmetic filler injections promoted on social media platforms and Reddit forums. In Cotter’s view, dermatologists must lean into the digital era by understanding the online content patients consume.

Raj Chovatiya, MD, PhD, clinical associate professor of medicine at Rosalind Franklin University Chicago Medical School and founder and director of the Center for Medical Dermatology + Immunology Research in Chicago, Illinois, similarly highlighted online self-education as an inevitable development, noting the widespread availability of search engines and large language models (LLMs) making patient self-research a permanent fixture. Chovatiya noted these tools may help patients recognize symptoms and connect with appropriate specialists, but only when they understand their limitations.

Chovatiya described dermatology’s visual nature as amplifying the impact of social media, especially for stigmatized diseases such as hidradenitis suppurativa (HS). He did acknowledge online communities can reduce shame and encourage earlier care-seeking, though they may also expose patients primarily to severe disease presentations that generate unnecessary fear. Chovatiya recalled a patient of his who extensively self-treated what she believed were refractory warts after consulting AI tools, only to later discover she had chronic inflammatory eczema. By the time she presented to clinic, her skin barrier had been significantly damaged by chemical peels and other at-home interventions.

Kathryn Celeste Durham, MD, a board-certified dermatologist practicing in Fort Worth, Texas, at US Dermatology Partners, echoed that ambivalence. With 20 years of clinical experience, Durham said patient self-education is broadly positive, as she values patients feeling empowered and informed about their conditions, but described mounting frustration when AI tools generate diagnoses that contradict her own clinical assessment.

Durham identified skin cancer as the area of greatest concern, explaining that diagnosing lesions involves far more than visual pattern recognition. Texture, feel, history, and chronology all factor into clinical judgment in ways that images and symptom checkers cannot replicate. She described seborrheic keratoses as a frequent driver of patient anxiety amplified by online searches, where broad symptom matching commonly steers individuals toward worst-case conclusions. She also described some patients’ resistance to standard surgical treatment for confirmed cancers in favor of holistic alternatives discovered online.

Durham pointed to perioficial dermatitis as a case study in how well-intentioned self-research can worsen outcomes. Because the condition can resemble both acne and eczema at different stages, patients frequently self-treat with topical steroids sourced from prior prescriptions or online recommendations, an approach potentially exacerbating the condition and complicating clinical management.

On the positive end, Durham described a significant rise in numbers of patients with acne who arrive already familiar with such products as retinoids and tretinoin, a development she attributed largely to online skincare communities. Durham also said targeted digital advertising has meaningfully expanded awareness of biologic treatments for psoriasis and other conditions, particularly among younger patients who do not engage with traditional broadcast media. She noted that growing disease awareness has translated into more patients actively seeking diagnoses and treatment.

When patients arrive with social media screenshots or online forum discussions, Durham urged acknowledgment over dismissal, suggesting the need for clinicians to validate patients’ attempts to engage with their own care before gently redirecting toward a more accurate diagnosis or treatment plan.

Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, described the current AI era as a significant acceleration of the patient self-research trend that began with widespread internet access. While he acknowledged AI systems can produce misinformation and occasionally dangerous confabulations, Lio noted his own cautious optimism as that patients are arriving more educated and engaged.

Lio additionally argued against clinicians feeling threatened by informed patients, framing education in this or any manner as central to medical care rather than a challenge to clinical authority. In his practice, he welcomes patients who bring in influencer videos, research papers, or chatbot outputs, as these materials allow for higher-level conversations earlier in the treatment process. He cautioned, however, that oversimplified online narratives can create unrealistic expectations.

Durham expressed cautious optimism about the trajectory of AI-assisted patient research, noting tools like ChatGPT, when implemented appropriately, can provide a useful on-ramp to professional care. On the inquiry of whether cliniciasns should build their own digital presence to counter unverified health content, Durham acknowledged the growing necessity while flagging its issues. She framed the challenge as a matter of balance: dermatologists need a presence in the digital space where their patients are increasingly turning for health information, but the profession’s primary obligation remains availability and care in the clinic.

Overall, the experts painted a complicated picture of the benefits and drawbacks of the online-informed patient. The 4 leaders in the field made their views regarding better-informed questions and increased access clear, along with their opinions of the potential negative aspects of misinformation and delayed diagnoses. Their statements help to paint a picture of the cross-section of the clinician viewpoints surrounding the ubiquity of access to information through Internet and AI use.

As dermatology patients enter clinical visits with information from social media, online forums, and AI inquiries, clinicians face are juggling new concerns.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

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The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Diana Isaacs, PharmD, is an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic.

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

Diabetes Dialogue: ADA Scientific Sessions 2026 Preview

In this special in-studio episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, reflect on major themes and anticipated developments ahead of the upcoming American Diabetes Association (ADA) Scientific Sessions 2026.

The discussion opens with Bellini congratulating Isaacs on receiving the ADA Outstanding Educator in Diabetes Award, prompting a conversation centered on Isaacs’ forthcoming presentation, “Behind Every Number Is a Story: Transforming Diabetes Care and Education through Technology and Human Connection.” Isaacs reflects on the rapid evolution of diabetes technology over the last decade, from limited continuous glucose monitoring (CGM) access and the emergence of early automated insulin delivery (AID) systems to the integration of artificial intelligence into diabetes care, while emphasizing that successful care remains grounded in human connection and individualized patient experiences.

The hosts then preview several therapeutic areas expected to dominate discussion at ADA, particularly the expanding pipeline of incretin-based therapies. Bellini and Isaacs discuss growing excitement surrounding GLP-1, GIP, and glucagon receptor agonists, including anticipated data from triple agonist agents such as retatrutide and emerging oral therapies like orforglipron. They highlight the significance of improved weight-loss efficacy in people with 

, broader cardiometabolic applications, and the increasing importance of treatment accessibility and affordability. The conversation also explores the expanding role of these therapies in addressing cardiovascular disease, 

Technology advancements represent another major focus of the episode. Isaacs and Bellini discuss new CGM-driven insulin titration tools, including Dexcom’s Smart Basal feature, designed to address therapeutic inertia among people with T2D using basal insulin. They also examine the growing role of CGM in broader patient populations and discuss evolving ADA recommendations supporting CGM access for any individual likely to benefit from the technology. The hosts express particular enthusiasm for the anticipated arrival of continuous ketone monitoring, including dual glucose-ketone sensors, and consider how these devices may transform diabetic ketoacidosis prevention and patient education, particularly for individuals with 

The conversation also highlights continued innovation in insulin delivery systems and connected diabetes devices. Isaacs and Bellini discuss progress toward fully closed-loop AID systems, including ongoing studies evaluating meal-unannounced insulin delivery in T2D. They review emerging insulin pump technologies from Medtronic, including updates to the MiniMed platform and the integration of connected insulin pen systems with real-time CGM data through the MiniMed Go app. The hosts emphasize the importance of preserving therapeutic choice for people who prefer injections over pump therapy or who seek temporary alternatives to wearable devices.

Toward the conclusion of the episode, both hosts preview their own ADA presentations. Isaacs discusses an upcoming session on inhaled insulin that will use simulated patient scenarios to explore shared decision-making and individualized therapy selection. Bellini highlights her session focused on skin complications related to diabetes technologies, including allergic reactions and adhesive-related challenges that can interfere with sustained device use. Together, they underscore the importance of addressing practical barriers to technology adoption while continuing to expand therapeutic and technological options for people living with diabetes.

Editors’ Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

Podcasts

This episode covers key trial results and presentations to keep an eye on as ADA 2026 approaches.

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The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

This page also hosts content previously published by EndocrinologyNetwork. 


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Diabetes Dialogue

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives is a monthly podcast hosted by Diana Isaacs, PharmD, and Natalie Bellini, DNP, aimed at providing a regular roundup of the latest clinically applicable insights across diabetes and metabolic diseases, with a focus on leveraging technology to improve care.

Strategic Alliance Partnership

On IgA Nephropathy (IgAN) Awareness Day, HCPLive spoke with Edgar Lerma, MD, Clinical Professor of Medicine with the Section of Nephrology at the University of Illinois at Chicago, about the rapidly evolving treatment landscape, including the rise of targeted therapies, the emerging role of APRIL inhibition, and ongoing debates surrounding proteinuria as a surrogate endpoint in clinical trials.

Once considered a disease with limited therapeutic options beyond supportive care and immunosuppression, IgA nephropathy treatment has entered what Lerma described as a “mechanism-first era,” with multiple newly approved and investigational agents now targeting distinct pathways across the pathogenic cascade. From sparsentan and targeted-release budesonide to complement inhibitors and APRIL-targeting biologics, clinicians are increasingly tasked with determining how to sequence therapy, identify high-risk patients, and communicate prognosis in a more individualized way.

Despite these advances, real-world uptake of newly approved IgAN therapies has remained relatively low through 2025, with barriers including REMS requirements, safety monitoring burdens, prior authorization hurdles, and continued uncertainty surrounding long-term renal outcomes. At the same time, ongoing development of APRIL and dual APRIL-BAFF inhibitors has intensified discussion around upstream immune modulation and whether newer biologics may eventually become foundational therapies in IgAN management.

HCPLive sat down with Lerma for a Q&A on treatment sequencing, proteinuria endpoints, APRIL inhibition, and how clinicians should approach prognosis discussions in the modern IgAN era.

HCPLive: With 5 approved agents now targeting distinct points on the pathogenic cascade, how do you approach treatment selection and sequencing in patients with IgAN?

Lerma: Even though we now have 5 or more targeted options emerging, most guideline-consistent practice still begins with risk stratification. Clinicians are not routinely “stacking” disease-modifying agents at this point. More commonly, treatment involves substituting agents or intensifying therapy within a pathway based on patient response and tolerability. Combination approaches, such as endothelin receptor antagonists plus complement inhibitors, remain more in the trial territory than standard practice.

In my own practice, I still take a stepwise approach. First, patients are started on optimized supportive therapy. That includes maximizing renin-angiotensin system (RAS) blockade as tolerated, adding an SGLT2 inhibitor—which is now essentially standard across CKD, including IgAN—and targeting blood pressure below 130/80 mmHg. We also aim for proteinuria reduction, ideally below .5 g/day if feasible, although older guidelines used <1 g/day as the benchmark.

Once supportive care is optimized, the next step is defining the patient’s risk trajectory. If proteinuria persists above .5 g/day despite optimal care, if eGFR is declining, or if histopathology suggests higher-risk disease—such as crescents or concerning MEST-C scores—then we begin considering the newer pathway-targeted therapies. These include agents targeting IgA production, endothelin pathway therapies with hemodynamic and antifibrotic effects, and complement inhibitors targeting downstream injury modulation.

Recent real-world data suggest fewer than 5% of eligible IgAN patients received newly approved therapies through 2025, with REMS requirements and black box warnings cited as barriers. What do you think is driving that gap?

Lerma: The gap is real, but it’s also not unexpected when new therapies enter practice. The reasons tend to fall into about 5 major categories.

First is regulatory and safety friction. Some agents require REMS programs, frequent laboratory monitoring, or carry black box warnings, all of which create administrative burdens. Those challenges can be particularly difficult in community nephrology settings.

Second is skepticism surrounding proteinuria as a surrogate endpoint. Most clinicians view proteinuria reduction positively, but many still question whether it truly translates into long-term prevention of end-stage kidney disease. As a result, uptake of therapies approved on surrogate endpoints tends to lag behind approvals themselves.

Third are infrastructure barriers, including specialty pharmacy routing, prior authorizations, and documentation requirements proving failure of optimized supportive care. Monitoring demands can also exceed what some practices can realistically support.

Fourth is the inherent heterogeneity of IgAN. The disease is often slowly progressive and highly variable at the individual level, so clinicians may defer immunomodulatory or pathway-targeted therapies unless the patient appears clearly high risk.

Finally, there is the physician familiarity curve. Many nephrologists trained before the era of targeted therapies in IgAN. Historically, adoption of new CKD therapies can lag evidence by several years, so some delay is expected.

HCPLive: For patients who have been on sparsentan or budesonide for a year or more, what role do APRIL inhibitors play? Are you using them as add-on therapy, replacement therapy, or something else entirely?

Lerma: When we talk about APRIL inhibitors—such as sibeprenlimab and other APRIL biologics currently in development—we’re discussing agents that target a different, upstream mechanism. These therapies decrease mucosal B-cell activation and reduce production of galactose-deficient IgA1, which is central to IgAN pathogenesis.

Mechanistically, APRIL inhibitors act earlier in the disease cascade than either budesonide or sparsentan. In practice, there are currently 3 conceptual roles being explored.

One is replacement therapy. If APRIL inhibition demonstrates strong and durable proteinuria reduction with a favorable safety profile, it could potentially replace steroid-based approaches.

The second is sequential escalation. In that model, clinicians would begin with optimized supportive care and hemodynamic modulation, then escalate to APRIL inhibition if progression persists despite treatment.

The third possibility is combination therapy. Biologically, combining upstream and downstream approaches makes sense, but concerns remain regarding overlapping immunosuppression and whether combination therapy provides meaningful additional benefit.

At this point in 2026, APRIL inhibition is not yet standard add-on therapy in routine practice. It’s better viewed as a potentially foundational future therapy whose role is still being defined.

HCPLive: Several pipeline agents target both APRIL and BAFF simultaneously. How do you assess the rationale for dual blockade compared with the more selective approaches already approved?

Lerma: Dual APRIL-BAFF blockade is mechanistically appealing, but it also represents a more aggressive immunosuppressive strategy. Some would argue that selective APRIL inhibition may ultimately fit better within a precision nephrology framework unless dual blockade clearly demonstrates superior efficacy.

The rationale behind dual inhibition is broader suppression of the pathogenic B-cell axis. BAFF inhibition suppresses B-cell survival, while APRIL inhibition reduces plasma cell differentiation and IgA production. In theory, this could produce greater reductions in pathogenic IgA.

However, there are trade-offs. BAFF plays an important role in long-term B-cell homeostasis, so suppressing it may increase infection risk, contribute to hypogammaglobulinemia, or blunt vaccine responses.

Because of that, some clinicians favor APRIL-only inhibition, which may more selectively target pathogenic IgA production while preserving broader immune competence. That creates a potentially cleaner safety profile in patients with CKD.

Right now, the jury is still out, and many practicing clinicians are closely watching how those risk-benefit questions evolve.

HCPLive: Proteinuria as a surrogate endpoint continues to generate debate in IgAN drug development. What are your thoughts on that discussion?

Lerma: Proteinuria remains the central methodological tension in IgAN drug development. For FDA approval, the earliest signal therapies can realistically demonstrate is proteinuria reduction, which is why so many trials use it as a surrogate endpoint.

The challenge is that reducing proteinuria does not automatically prove preservation of long-term kidney outcomes. What clinicians ultimately want to see is stabilization of eGFR over time.

The difficulty is that meaningful eGFR preservation takes years to demonstrate. You may not see those differences within 6 months or even the first year of treatment. Sometimes even 2 years may still be too short.

Ultimately, the field will likely judge these therapies based on whether they meaningfully preserve kidney function long term.

HCPLive: As the treatment landscape expands, what is the most important shift in how clinicians should communicate prognosis to patients?

Lerma: This is probably where practice is changing the most. The older model was largely passive monitoring of kidney function over time. The newer model is much more evidence-driven and trajectory-based.

Risk is no longer viewed as binary. Instead, clinicians are increasingly focusing on proteinuria trajectory, eGFR slope, histologic risk—including MEST-C scoring—and response to therapy within the first 6 to 12 months.

Treatment response itself is now becoming part of prognosis. We know CKD progression is modifiable, even if the disease is not universally curable. The goal is increasingly about altering the slope of progression rather than promising cure.

At the same time, clinicians need to communicate uncertainty carefully. We should avoid overpromising kidney preservation based solely on surrogate endpoints while also acknowledging that individual responses can vary considerably.

Compared with several years ago, our understanding of IgAN pathogenesis has improved substantially, particularly with the development of the 4-hit hypothesis framework. There is still uncertainty, but it is narrower than it once was.

HCPLive: Is there anything else you’d like to highlight?

Lerma: I think the key point is that we are now in a mechanism-first era of IgAN, but not yet in a sequencing-consensus era. Uptake of therapies is being shaped not only by efficacy, but also by system-level barriers, monitoring requirements, and lingering skepticism around surrogate endpoints.

APRIL inhibition may ultimately become a foundational upstream therapy rather than simply an add-on option, while dual APRIL-BAFF blockade raises important questions about balancing broader efficacy with potential safety risks.

Proteinuria remains a necessary—but insufficient—surrogate for long-term renal survival. And importantly, communication with patients is shifting toward dynamic, response-based risk modeling rather than static CKD staging alone.

Articles

IgA nephropathy management is shifting from predominantly supportive care and nonspecific immunosuppression to mechanism-guided intervention across the pathogenic cascade. Current practice remains stepwise, anchored by optimized RAS blockade, SGLT2 inhibition, blood pressure control, and proteinuria targets, with targeted agents introduced for persistent proteinuria, eGFR decline, or high-risk histology. Adoption of newer therapies remains low due to REMS/monitoring burden, payer friction, and skepticism about proteinuria-based approvals. APRIL inhibition is positioned as an upstream, potentially foundational strategy, while dual APRIL-BAFF blockade raises safety trade-offs.

 An expert describes his perspective on sequencing, APRIL inhibition, proteinuria endpoints, and long-term kidney preservation in IgA nephropathy.



Nephrology

The HCPLive nephrology page is a resource for medical news and expert insights on kidney disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments in nephrology, and more.

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APRIL Inhibition, Dual Blockade, and Proteinuria Endpoints in IgAN, With Edward Lerma, MD

Andrew (Truong-An) Ho, MD, is a pulmonologist in Philadelphia, Pennsylvania and is affiliated with Temple University Hospital.

Heart Rate Metrics During 6-Minute Walk Test Linked to Hospital Use in COPD

Heart rate metrics captured during routine 6-minute walk testing may help identify patients with 

chronic obstructive pulmonary disease (COPD) 

at greater risk for hospital utilization and exacerbations, according to late-breaking findings presented at the 

2026 American Thoracic Society (ATS) International Conference

The ongoing phase 3 randomized controlled HiFlo trial evaluated associations between heart rate responses during 6-minute walk testing and prior hospital utilization among patients with moderate-to-severe COPD. In an interview at ATS 2026, Andrew Truong-An Ho, MD, from Temple University Hospital, said the findings represent an early effort to better characterize physiologic differences among patients enrolled in the study investigating high-flow nasal therapy (HFNT).

“This is just a starting point when we’re looking at the trial as a whole,” Ho said.

HiFlo is comparing HFNT plus usual care versus usual care alone over at least 1 year in patients with COPD. Investigators are assessing whether HFNT can reduce exacerbations through several physiologic mechanisms, including reducing gas trapping, improving ventilatory efficiency, and decreasing dynamic hyperinflation.

“There’s a few key mechanisms from high-flow nasal therapy that might help reduce COPD exacerbations,” Ho said. “There’s the ability to wash out the dead space, improve ventilatory efficiency for patients with COPD, small amounts of PEEP that are generated with high flow, and humidified air, which can help loosen mucus plugs and make it easier for patients to breathe.”

The current analysis focused on baseline 6-minute walk (6MW) heart rate parameters among 267 patients with COPD enrolled in the trial. Participants had a mean age of 67.9 years, a mean FEV

 of 41% predicted, and an average of 2.2 hospitalizations in the prior year.

Investigators evaluated resting heart rate, peak heart rate during exertion, and delta heart rate during the 6MW test. Small but statistically significant positive associations emerged between several heart rate metrics and both moderate exacerbations and hospitalizations in the prior year.

Delta heart rate and peak heart rate were associated with moderate exacerbations, while pre-walk resting heart rate and peak heart rate correlated with prior hospitalizations. Patients with emergency department visits in the previous year had greater baseline heart rates before the walk test, while patients with more than 1 hospitalization demonstrated greater exertional heart rate changes and higher peak heart rates.

Ho emphasized that COPD remains a highly heterogeneous disease, making physiologic stratification challenging.

“Sometimes it’s for dyspnea, sometimes it’s for phlegm production, other times it’s just exacerbations that lead to dynamic hyperinflation,” Ho said. “The heart rate can reflect [some of] these measures. It shows if there’s a higher burden or demand at baseline.”

Rather than focusing exclusively on walk distance, Ho suggested heart rate responses may provide additional insight into cardiopulmonary reserve and physiological stress during exertion.

“This gives a more functional way to see how the patient progresses, rather than just looking at distance,” he said.

Still, Ho cautioned clinicians against overinterpreting the findings at this stage. Correlations between heart rate metrics and outcomes were modest, with coefficients ranging approximately from 0.12 to 0.16. Ho emphasized that this is an exploratory analysis, and while it observed a trend, it does not display the full picture.

Investigators ultimately hope baseline physiologic measures may help identify which patients are most likely to benefit from HFNT as additional data from the HiFlo trial become available.

“Depending on the results of the study, we want to see where high-flow nasal therapy fits in the picture of managing a patient’s COPD,” Ho said. “There’s other forms of ventilation that can be used, so it will be important to see where this fits in.”

) Association Between Hospital Utilization and 6mw Heart Rate Metrics From the Hiflo Study. Late-breaking poster presented at ATS 2026 in Orlando, Florida, on May 17.

In patients with COPD, heart rate measured during the 6-minute walk test were associated with greater hospital utilization, according to Andrew Truong-An Ho, MD, at ATS 2026.

COPD

COPD condition center page, resources on the topics of medical news and expert insight into chronic obstructive pulmonary disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on COPD research, treatment, and drug development.

Heart Rate Metrics During 6-Minute Walk Test Linked to Hospital Use in COPD 

Robert Wallis, MD, is the chief scientific officer at the Aurum Institute and adjunct professor in the department of medicine at Vanderbilt University Medical Center.

At ATS 2026, Robert Wallis, MD, shared preliminary phase 2c data showing a novel 4-month pan-TB regimen containing sutezolid and N-acetylcysteine improved lung function recovery.

Novel 4-Month Pan-TB Regimens Show Promise for Lung Function Recovery

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

Phase 2 LANTIC trial data show corabotase maintained glabellar line improvement in 60.8% of patients at week 24 versus 36.7% for Dysport.

Corabotase Phase 2 Data Show Sustained Glabellar Line Improvement Through 24 Weeks

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

FDA approved baxdrostat as add-on therapy for adults with hypertension not controlled on other medications.

FDA News

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

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The HCPLive hypertension page is a resource for medical news and expert insights on high blood pressure. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for hypertension, and more.

FDA Approves Baxdrostat for Uncontrolled Hypertension on Background Therapy

Bruce Strober, MD, PhD, details a principled approach to sequencing psoriasis therapies based on mechanism and response pattern.

Updates in PsO Sequencing and Future Research 

Alan D. Betensley, MD, is a board-certified pulmonologist and associate professor at the Feinberg School of Medicine in Northwestern Medicine.

Maintenance extracorporeal photopheresis was associated with improved survival in lung transplant recipients with bronchiolitis obliterans syndrome, according to Alan Betensley, MD.

Maintenance ECP Linked to Survival Benefit in BOS After Lung Transplant, With Alan Betensley, MD

Chelsie Derman is an associate editor for 

who covers allergy and  psychiatry. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

At ATS 2026, investigators reported that pediatric pulmonary rehabilitation improved exercise capacity and quality of life in chronic respiratory disease.

Pulmonary Rehabilitation Boosts QoL in Pediatric Chronic Respiratory Disease

Adults with difficult-to-treat psoriasis due to overweight or obesity saw notable benefits to both with concomitant ixekizumab and tirzepatide.

Ixekizumab + Tirzepatide Improves Psoriasis, Reduces Weight in Those with Obesity

A study presented at the ATS 2026 found the New York City Housing Authority’s Mold Busters program was associated with nearly 2800 fewer annual asthma-related ED visits.

NYC Public Housing Mold Program Linked to Fewer Asthma ED Visits

Patricia Fechner, MD, is the attending physician at Seattle Children’s Hospital and a professor of pediatrics at the University of Washington School of Medicine.

Fechner discusses the 2-year data from an open-label extension of the CAHtalyst Pediatric study, maintaining substantial glucocorticoid dose lowering.

Hormonal Disorders

Crinecerfont Maintains Improvements in Pediatric CAH at 2 Years, With Patricia Fechner, MD

Stay updated with the latest healthcare breakthroughs, including FDA submissions and new cardiology guidelines.

Latest News

Periconception Eosinophil Counts Predict Asthma Exacerbations in Pregnancy

How Online-Informed Patients Are Changing Dermatology Visits

Diabetes Dialogue: ADA Scientific Sessions 2026 Preview

APRIL Inhibition, Dual Blockade, and Proteinuria Endpoints in IgAN, With Edward Lerma, MD

Heart Rate Metrics During 6-Minute Walk Test Linked to Hospital Use in COPD