Raed Joundi, MD, is an assistant professor in the department of medicine at McMaster University, a scientist in the Brain Health research program at the Population Health Research Institute (PHRI), and the Anne Marie Brune/PHRI Chair in Vascular Dementia at McMaster and PHRI.

 recurrence without increasing major bleeding, irrespective of the baseline infarct pattern based on magnetic resonance imaging (MRI), according to a substudy of the OCEANIC-STROKE trial.

Asundexian Reduces Ischemic Stroke Without Increasing Bleeding Regardless of Infarct Pattern

 in Seoul, South Korea, by Raed Joundi, MD, assistant professor in the department of medicine at McMaster University, scientist in the Brain Health research program at the Population Health Research Institute (PHRI), and Anne Marie Brune/PHRI Chair in Vascular Dementia at McMaster and PHRI.

“OCEANIC-STROKE was a really remarkable finding, with the benefit in stroke reduction not having that increased bleeding typical of antithrombotics,” Joundi told 

 in an exclusive interview. “We did this substudy as part of the OCEANIC trial to better phenotype patients with respect to their baseline imaging, infarct pattern, and other markers to see whether any of that information impacts the effect of the treatment.”

OCEANIC-STROKE was a phase 3 double-blind trial evaluating the efficacy of asundexian in addition to antiplatelet therapy in patients with noncardioembolic ischemic stroke or transient ischemic attack (TIA) at risk of recurrent stroke. Patients were eligible for inclusion if they had a nonlacunar infarct on imaging, a history of atherosclerosis, or evidence of atherosclerotic plaque at any location in cerebrovascular imaging. The primary endpoints were time to first ischemic stroke occurrence and first major bleeding occurrence, both recorded ≤31 months.

A total of 12,327 patients were enrolled in OCEANIC-STROKE, with 6162 randomized to the asundexian arm and 6165 to placebo. Over 19 months of follow-up, ischemic stroke incidence was lower among those receiving asundexian than placebo (6.2% vs 8.4%; cause-specific HR [csHR], 0.74; 95% CI, 0.65-0.84; 

 <.001). Major bleeding incidence was similar in both groups (1.9% and 1.7%, respectively; csHR, 1.1; 95% CI, 0.85-1.44), establishing that bleeding risk was not increased with treatment, unlike standard antiplatelet therapy.

In the present study, Joundi and colleagues enrolled consecutive patients with non-cardioembolic stroke, obtaining standardized MRI scans within 5 days of the index event. Infarct patterns were categorized based on number, location, and size of diffusion restricting (DWI+) lesions. The team calculated csHRs to determine whether asundexian’s effects on recurrent ischemic stroke and major bleeding were contingent on baseline infarct pattern.

A total of 1126 evaluable MRI scans were included in the study, of which 1076 (95.6%) had DWI+ lesions consistent with acute infarcts. Single small subcortical infarcts, defined as ≤15 mm, occurred in 297 patients, multiple infarcts in 565 patients, ≥1 large infarct, defined as >15 mm, in 512 patients, and ≥1 cortical infarct in 544 patients. The team found that asundexian treatment was associated with a reduction in ischemic stroke (8.2% vs 12.1%; csHR, 0.67; 95% CI, 0.46-0.98), with no statistically significant interaction with infarct pattern. Joundi and colleagues also noted that only 2 intracerebral hemorrhages occurred per group, and no significant increase in major bleeding with asundexian was found.

Ultimately, Joundi and colleagues determined that asundexian’s effects had no interaction with infarct patterns. Ischemic stroke was substantially reduced and major bleeding was not increased irrespective of baseline infarct patterns based on MRI scans.

“We had a population in this substudy that was at high risk of bleeding, but the risk for intracranial bleeding was very low, not different between the arms,” Joundi said. “I think the safety signal in the main trial is really bolstered by the MRI substudy in this case.”

Editors’ Note: Joundi reports no relevant disclosures.

Joundi R. Effect of Factor XIa Inhibitor Asundexian on Ischemic Stroke Recurrence According to Baseline Infarct Pattern: MRI Substudy of OCEANIC-STROKE Trial. Presented at the World Stroke Congress (WSC) 2026 in Seoul, South Korea. October 21-23, 2026.

Sharma M, Dong Q, Hirano T, et al. Asundexian for Secondary Stroke Prevention. New England Journal of Medicine. 2026;394(15):1467-1479. 

Bayer. A Study to Test Asundexian for Preventing a Stroke Caused by a Clot in Participants After an Acute Ischemic Stroke or After a High-risk Transient Ischemic Attack, a So-called Mini Stroke (OCEANIC-STROKE). ClinicalTrials.gov Identifier: NCT05686070. Updated November 12, 2025. Accessed November 3, 2026. 

https://clinicaltrials.gov/study/NCT05686070

Videos

Raed Joundi, MD, discusses his substudy of the OCEANIC-STROKE trial, demonstrating the safety of Bayer’s investigational FXIa inhibitor across the spectrum of infarct patterns.

News

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Stroke

On the HCPLive stroke page, resources on the topics of medical news and expert insight into CVA can be found. Content includes articles, interviews, videos, podcasts, and breaking news on stroke medicine, and more.

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 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for 

. He is also the executive producer of two podcasts: 

. 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.

KT-621 is an investigational, first-in-class, once-daily oral small molecule developed by Kymera Therapeutics. It degrades STAT6, a protein downstream of IL-4 and IL-13 signaling.

What did the phase 1b trial of KT-621 show?


Among 22 adults with moderate to severe atopic dermatitis, 4 weeks of KT-621 reduced mean EASI by 62.6%. 76.2% of patients reached EASI-50, and the drug was well tolerated.


Yes. The phase 2b BROADEN2 trial has completed enrollment, and topline results are expected by the end of 2026.

KT-621, an investigational oral STAT6 degrader, nearly eliminated STAT6 protein in blood and lesional skin and reduced disease severity by a mean of 62.6% after 4 weeks in adults with moderate to severe 

. The phase 1b results were presented at the 

2026 Fall Clinical Dermatology Conference

 in Las Vegas, Nevada.¹ No treatment-related adverse events were reported.

Signal transducer and activator of transcription 6 (STAT6) sits downstream of both interleukin (IL)-4 and IL-13, the cytokines targeted by current injectable biologics for atopic dermatitis. KT-621, developed by Kymera Therapeutics, is a first-in-class, once-daily small molecule designed to degrade STAT6 rather than inhibit it.¹

The poster was presented by Jared Gollob, MD, of Kymera Therapeutics. His co-authors included investigators from Red River Research Partners, Clinical Science Institute, and Cahaba Dermatology & Skin Health Center.¹

How Was KT-621 Studied in Atopic Dermatitis?

The single-arm, open-label phase 1b trial enrolled adults with a Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) score of 3 or higher and an Eczema Area and Severity Index (EASI) score of at least 16.¹ Participants received KT-621 100 mg (n = 10) or 200 mg (n = 12) once daily for 28 days, followed by 14 days of follow-up.

The 22 treated patients had a mean baseline EASI score of 24.9, and 45.5% had severe disease (vIGA-AD of 4).¹ End points at week 4 included STAT6 degradation in blood and skin, Type 2 inflammatory biomarkers, clinical activity and safety.

Both doses produced comparable degradation, with median STAT6 reductions of 97.5% in blood and 93.6% in lesional skin.¹ Across doses, median reductions in blood biomarkers were 47.9% to 54.8% for thymus and activation-regulated chemokine (TARC), 62.0% to 72.9% for eotaxin-3 and 54.1% to 56.0% for IL-31. Immunoglobulin E declined more modestly, by 5.3% to 14.2%.

What Clinical Activity Did KT-621 Show at 4 Weeks?

Across doses, mean EASI improved by 62.6%; 76.2% of patients reached EASI-50, and 28.6% reached EASI-75.¹ vIGA-AD 0/1 was achieved by 19.0%, and mean affected body surface area fell by 49.0%.

Patient-reported outcomes moved in the same direction. Mean Peak Pruritus Numerical Rating Scale scores improved by 40.2%, and 72.7% of patients had a clinically meaningful improvement of at least 4 points on the Patient-Oriented Eczema Measure.¹

KT-621 was shown to be well tolerated, with investigators finding no serious or severe adverse events (AEs) and no clinically relevant changes in laboratory values or electrocardiograms.¹ With no placebo arm, a 4-week treatment window, and 22 patients, the open-label study wasn’t designed to establish efficacy.

Kymera has completed enrollment in BROADEN2 (NCT07217015), its phase 2b trial of KT-621 in those with moderate to severe atopic dermatitis, nearly 6 months ahead of its original timeline.² In a release, the company noted its move of topline results up to the end of 2026. They plan to start phase 3 trials in atopic dermatitis by mid-2027, pending regulatory discussions.²

Editor's Note: This summary has been edited for grammar and clarity using artificial intelligence tools.

Gollob J, Blankinship M, Yamauchi P, et al. Clinical activity and safety of KT-621, an oral STAT6 degrader, in moderate-to-severe atopic dermatitis: phase 1b trial results. Presented at: 2026 Fall Clinical Dermatology Conference; Las Vegas, NV. 

Kymera Therapeutics. Kymera Therapeutics announces second quarter 2026 financial results and provides a business update. Published August 5, 2026. Accessed November 3, 2026. 

https://investors.kymeratx.com/news-releases/news-release-details/kymera-therapeutics-announces-second-quarter-2026-financial

Articles

KT-621, an oral STAT6 degrader, cut mean EASI by 62.6% after 4 weeks with no treatment-related adverse events in a phase 1b atopic dermatitis study.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

Oral STAT6 Degrader KT-621 Reduces EASI by 62.6% in Atopic Dermatitis

Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

 news in October 2026 included an accelerated approval from the 

, along with phase 3 data for 4 additional IgAN therapies presented at the

On October 21, 2026, the FDA granted accelerated approval to ravulizumab (Ultomiris), a C5 complement inhibitor, to reduce proteinuria in adults with primary IgAN at risk of disease progression.

🎧 Catch Up on Kidney Compass: October 2026

Recorded on the floor at ASN Kidney Week 2026, cohosts Brendon Neuen, MBBS, PhD, and Shikha Wadhwani, MD, MS, talk with the investigators behind the meeting’s biggest trials.

Why Did ORIGIN 3 Move Its eGFR End Point to 1 Year? →

Jonathan Barratt, PhD, FRCP, walks through the final atacicept data and how clinicians might choose among the newer IgAN therapies.

2 Years of TELIGAN: What Telitacicept Showed in IgA Nephropathy →

Jicheng Lv, MD, discusses the final eGFR and proteinuria results.

What’s New From FIND-CKD? Finerenone Beyond Diabetes →

Katherine Tuttle, MD, breaks down the new FIND-CKD analyses presented at Kidney Week.

Can SGLT2 Inhibitors Help in Rapidly Progressing ADPKD? →

Stephen Seliger, MD, and Michel Chonchol, MD, share early findings from a pilot trial of empagliflozin.

At Kidney Week, the final ORIGIN 3 analysis of atacicept (Trutakna) and 2-year TELIGAN results for telitacicept reported estimated glomerular filtration rate (eGFR) outcomes versus placebo. Interim analyses of povetacicept in RAINIER and sefaxersen in IMAgINATION reported proteinuria reductions, with eGFR data from both trials still pending. The FDA target action date for povetacicept is November 30, 2026.

Additional October coverage included the ATTACK trial of aspirin for primary cardiovascular prevention in 

 study of pregnancy outcomes after living kidney donation, and an interview on the phase 2 TRANSPIRE trial of felzartamab for isolated microvascular inflammation (MVI) in kidney transplant recipients.

The 8 stories below are grouped into regulatory news, IgAN trial data, CKD and cardiovascular prevention, and expert perspective on kidney donation and transplantation. For full meeting coverage, see HCPLive’s 

FDA Grants Accelerated Approval to Ravulizumab (Ultomiris) for IgA Nephropathy

On October 21, 2026, the FDA granted accelerated approval to AstraZeneca’s ravulizumab to reduce proteinuria in adults with primary IgAN at risk of disease progression. Ravulizumab is a long-acting C5 complement inhibitor given intravenously every 8 weeks after a loading dose. It is the first C5 inhibitor indicated in IgAN.

The approval is based on a prespecified week-34 interim analysis of the phase 3 

. In that analysis, 24-hour urine protein-to-creatinine ratio (UPCR) fell 46.6% with ravulizumab and 5.6% with placebo, a 43.4% placebo-adjusted reduction.

IgA Nephropathy Trial Data at Kidney Week 2026

ORIGIN 3: Final Data Show Atacicept (Trutakna) Slows eGFR Decline in IgA Nephropathy

The phase 3 ORIGIN 3 trial randomized 431 adults with biopsy-proven IgAN to weekly subcutaneous atacicept 150 mg or placebo. Atacicept is a dual B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) inhibitor. At week 52, eGFR changed by −0.11 mL/min/1.73 m² with atacicept and −5.69 mL/min/1.73 m² with placebo. Proteinuria decreased 53% with atacicept and 5% with placebo. Kidney disease progression occurred in 5.1% and 17.8% of patients, respectively (HR, 0.24).

. On a Kidney Compass episode recorded at Kidney Week, Jonathan Barratt, PhD, FRCP, of the University of Leicester discussed why the eGFR end point was moved from 2 years to week 52 and how APRIL-selective inhibitors compare with dual BAFF/APRIL inhibitors.

RAINIER: Povetacicept Reduces Proteinuria and Gd-IgA1 in IgA Nephropathy

An interim analysis of the phase 3 RAINIER trial, published in the 

, included 199 adults with IgAN. At week 36, 24-hour UPCR decreased 52.0% with povetacicept, an investigational dual BAFF/APRIL inhibitor from Vertex, and 4.3% with placebo. Galactose-deficient IgA1 (Gd-IgA1) decreased 77.4% with povetacicept and increased 9.1% with placebo.

, 42.2% of patients receiving povetacicept and 6.2% of those receiving placebo reached a UPCR below 0.5 g/g, the target aligned with Kidney Disease: Improving Global Outcomes (KDIGO) guidance. The FDA target action date for povetacicept is November 30, 2026.

TELIGAN: Telitacicept Preserves eGFR Through 2 Years in IgA Nephropathy

Final 2-year results from the phase 3 TELIGAN trial included 318 adults with IgAN. Annualized eGFR change was −0.6 mL/min/1.73 m² per year with telitacicept, a dual BAFF/APRIL inhibitor, and −5.7 mL/min/1.73 m² per year with placebo. Confirmed 30% eGFR decline occurred in 2.5% and 16.4% of patients, respectively (HR, 0.11). Placebo-adjusted UPCR decreased 60.7% at week 104.

Investigator Jicheng Lv, MD, discussed the results on 

IMAgINATION: Sefaxersen Meets Phase 3 Proteinuria End Point in IgA Nephropathy

In an interim analysis of the phase 3 IMAgINATION trial, sefaxersen reduced 24-hour UPCR by 43.1% versus placebo at week 37 in 438 patients. Sefaxersen is an investigational once-monthly antisense oligonucleotide from Roche that targets complement factor B.

The trial remains blinded, and 2-year eGFR results are pending.

ATTACK Trial: Aspirin for Primary Cardiovascular Prevention in CKD

The pragmatic, open-label ATTACK trial randomized 4,633 adults with CKD stages G1 to G4 and no history of cardiovascular disease, in UK primary care, to aspirin 75 mg daily or no aspirin. Major cardiovascular events occurred in 2.4% of the aspirin group and 3.3% of the control group, a difference that was not statistically significant (SHR, 0.73; 95% CI, 0.52–1.03). Major bleeding occurred in 29 and 19 patients, respectively.

Enrollment reached 4,633 of a planned 25,000 participants after a pause during the COVID-19 pandemic. Hugh Gallagher, MBBS, PhD, told HCPLive the investigators do not recommend aspirin for primary prevention in CKD based on these results.

Expert Perspective: Kidney Donation and Transplantation

Pregnancy Outcomes After Living Kidney Donation, With Amit X. Garg, MD, PhD

Amit X. Garg, MD, PhD, of Western University discussed a matched cohort study published in 

. It compared 385 pregnancies after living kidney donation with 1,540 matched nondonor pregnancies in 3 Canadian provinces. Hypertensive disorders of pregnancy occurred in 11.9% of donor pregnancies and 8.3% of nondonor pregnancies.

Garg said a desire for future pregnancy does not preclude donation. He also 

 on the possible increased risk of gestational hypertension or preeclampsia.

Felzartamab for Isolated Microvascular Inflammation in Kidney Transplant, With Yasir Qazi, MD

Yasir Qazi, MD, a transplant nephrologist at Providence St. Joseph Hospital and an investigator on Biogen’s phase 2 TRANSPIRE trial, discussed isolated MVI in kidney transplant recipients. Isolated MVI occurs without detectable donor-specific antibodies or C4d staining, and no therapy is approved specifically for it.

TRANSPIRE compares felzartamab, an investigational anti-CD38 monoclonal antibody, with placebo for 24 weeks in adults with late isolated MVI. The primary end point is biopsy-proven resolution of MVI, and results are expected in 2028.

Nephrology in October 2026: FDA approves ravulizumab for IgAN, plus ORIGIN 3, RAINIER, TELIGAN, and ATTACK data from Kidney Week.

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.

FDA News

Chronic Kidney Disease

IgA Nephropathy

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

8 Nephrology Headlines You Missed in October 2026

In the latest installment of the Month in Review series, the 

 editorial team highlights notable dermatology stories covered in October 2026. The series is designed to round up significant news from the previous month in a summary of top headlines in the skin health space.

2026 European Academy of Dermatology and Venereology (EADV) Congress

 in Las Vegas, Nevada. The month’s coverage included long-term extension data, phase 3 readouts, and expert interviews on hidradenitis suppurativa (HS), psoriasis, atopic dermatitis, cutaneous lupus, and alopecia areata.

The following list summarizes some of the most notable headlines from October 2026:

Lutikizumab Improves HS Pain, Flares in Phase 3 INTREPID Study

AbbVie reported topline results from the phase 3 INTREPID trial, which randomly assigned about 1,400 adults and adolescents with moderate to severe HS to subcutaneous lutikizumab or placebo. At week 16, 31.4% of lutikizumab recipients achieved HiSCR75, compared with 23.4% of those receiving placebo. Fewer patients on lutikizumab had flares (18.4% vs 28.1%).

Pain responses separated early: 36.0% of lutikizumab recipients reached NRS30 at week 8, compared with 22.8% receiving placebo. Rates of adverse events and serious adverse events were similar between groups.

ICONIC-LEAD: Icotrokinra Sustains Psoriasis Skin Clearance at 2 Years

New ICONIC-LEAD data presented at Fall Clinical showed that the oral IL-23 receptor antagonist icotrokinra maintained high levels of skin clearance through 2 years in patients aged 12 years and older with moderate to severe plaque psoriasis. Between weeks 64 and 112, at least 72% of patients achieved PASI 90, and at least 44% achieved PASI 100.

Among PASI 90 responders who stopped treatment at week 24, 85% regained PASI 90 within 24 weeks of restarting it. Mark Lebwohl, MD, of the Icahn School of Medicine at Mount Sinai, discussed the findings with 

Ixekizumab, Tirzepatide Broaden Biomarker Effects in Psoriasis, Obesity

An exploratory analysis of the phase 3b TOGETHER-PsO study, also presented at Fall Clinical, looked at molecular changes in 274 adult patients living with psoriasis and either obesity or overweight. At week 36, ixekizumab plus tirzepatide altered the expression of 482 proteins and 467 genes, compared with 140 proteins and 16 genes with ixekizumab alone.

Investigators found that changes in a subset of neutrophil-associated markers explained part of the added PASI response with the combination. James G. Krueger, MD, PhD, of The Rockefeller University, commented on the results.

Nemolizumab Sustains AD Response at 3 Years, With Matthias Augustin, MD

At EADV, Matthias Augustin, MD, of University Medical Center Hamburg-Eppendorf, reviewed 3-year results from the open-label ARCADIA long-term extension of nemolizumab. Through week 152, up to 91% of patients reached EASI-75, up to 75% reached EASI-90 and up to 73% were itch-free or nearly itch-free.

“The findings that we present at EADV have a profound impact for practice,” Augustin said.

3-Year Nemolizumab Data in Atopic Dermatitis, With Sarina Elmariah, MD, PhD

A related post hoc analysis presented at Fall Clinical focused on 295 patients who responded to nemolizumab by week 16 and stayed on treatment. By week 152, about 80% reached EASI-90, half had fully clear skin and about 80% were itch-free or nearly itch-free.

Sarina Berger Elmariah, MD, PhD, MPH, of UCSF, explained that IL-31 blockade often relieves itch first, while skin clearance keeps improving over time.

5-Year ADlong Data on Lebrikizumab for Eczema, With Stephan Weidinger, MD, PhD

Late-breaking ADlong results presented at EADV followed 174 patients with up to 5 years of cumulative lebrikizumab exposure. At week 108 of the extension, 92.9% had achieved EASI-75, 73.8% had reached EASI-90 and 66.7% had clear or almost clear skin. No new safety signals emerged.

“For me, the main message is the consistency of the data over time,” said Stephan Weidinger, MD, PhD, of University Hospital Schleswig-Holstein.

AMETHYST: Litifilimab Sustains CLE Gains at 52 Weeks, With Victoria Werth, MD

Victoria Werth, MD, of the University of Pennsylvania, discussed 52-week data from Part A of the phase 2/3 AMETHYST study of litifilimab in 93 adults with active cutaneous lupus erythematosus. Among patients who started litifilimab at baseline, the CLASI-50 response rate rose from 40.8% at week 24 to 46.0% at week 52. No serious viral infections were reported.

Rezpegaldesleukin Hair Regrowth Climbs Through 1 Year in AA: David Rosmarin, MD

In the phase 2b REZOLVE-AA trial presented at EADV, hair regrowth with rezpegaldesleukin kept improving after the 36-week treatment period in patients with severe to very severe alopecia areata. In the 24 µg/kg group, the share of patients with a SALT score of 20 or lower rose from 15.6% at week 36 to 27.6% at week 52, compared with 6.7% with placebo.

David Rosmarin, MD, of Indiana University School of Medicine, noted that a phase 3 program is expected to begin at the end of 2026.

HCPLive recaps October 2026 dermatology highlights, including data in hidradenitis suppurativa, atopic dermatitis, psoriasis, lupus, and alopecia areata.

Plaque Psoriasis

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.

8 Dermatology Headlines You Missed in October 2026

pediatric pulmonologist and sleep medicine physician at University Hospitals (UH) Rainbow Babies and Children’s Hospital.

 warrants screening into adulthood, and children on home tracheostomy ventilation require awake, trained supervision, according to Moshe Prero, MD, pediatric pulmonologist and sleep medicine physician at University Hospitals Rainbow Babies and Children's Hospital.¹

A 2024 review conservatively estimated 1,000,000 survivors of BPD in the US and described the literature on adult survivors as “scant.”² At the 

 in Phoenix, Prero addressed BPD and chronic mechanical ventilation in his session, "Updates in Pediatric Pulmonology: Year in Review."¹ He discussed these topics with HCPLive in the second part of an interview, following a 

"It might look like asthma, but there might be underlying causes," said Prero, describing adults with a history of BPD who present with respiratory symptoms. He said these causes can track back to the neonatal course.

Bronchopulmonary Dysplasia Follow-Up, With Moshe Prero, MD

Bronchopulmonary Dysplasia Follow-Up, With Moshe Prero

Bronchopulmonary Dysplasia Follow-Up From Childhood to Adulthood

Prero said BPD severity varies widely, from supplemental oxygen to invasive mechanical ventilation through a tracheostomy, and each child's course can differ through adulthood. Patients have an elevated incidence of obstructive lung disease, according to Prero, although the full extent of long-term risk remains unknown.

Early imaging does not reliably predict later disease. Some children with severe CT findings in infancy do not have severe lung disease when older, and some with subtle early findings develop more severe disease with age.

Prero advised clinicians to treat prematurity as a permanent part of the medical history, noting records may not follow children who move between states or health care systems. He recommended screening for swallowing dysfunction, aspiration risk, and sleep-disordered breathing, each of which can affect lung disease.

Shortness of breath should prompt a diagnostic evaluation extending beyond the lungs, Prero said. He cited pulmonary hypertension and larger airway involvement as examples, adding unaddressed tracheomalacia in childhood can predispose patients to recurrent infections.

Home Safety for Children With Tracheostomies and Chronic Ventilation

The 2025 American Thoracic Society (ATS) guideline strongly recommends an awake and alert trained caregiver always be present with children at risk of immediate decompensation from tracheostomy-related complications, based on very low certainty evidence.

 Prero described this requirement as a large burden for families and tied it directly to mortality risk.

"These children are at high risk for mortality if they have a tracheostomy and a ventilator at home," Prero said.

He pointed to 2 specific hazards. Small-diameter tubes can become obstructed by mucus, and active children can accidentally decannulate. In either event, Prero said, a trained and awake caregiver needs to be at the child's side and know how to respond.

The guideline also recommends a standardized discharge process with comprehensive family caregiver training for safe transitions from hospital to home, a conditional recommendation.

Multidisciplinary Tracheostomy Care Outside Tertiary Centers

A history of prematurity and BPD remains clinically relevant into adulthood, and symptoms resembling asthma may trace back to the neonatal course, according to Prero.

Early CT findings do not reliably predict later lung disease severity in patients with BPD.

The 2025 ATS guideline strongly recommends an awake, trained caregiver for children at risk of immediate decompensation from tracheostomy-related complications.

Prero described multidisciplinary care as ideal, although these teams are often concentrated in cities or areas with tertiary care centers. He said collaboration may take the form of a single clinic bringing together pulmonology, otolaryngology, palliative care, respiratory therapy, and speech therapy.

In other cases, specialists may practice at separate locations, requiring patients to travel or use another form of monitoring. Prero said communication among team members is necessary in either model.

He identified 2 areas for further research. The first is tracheostomy infection, since cultures from these patients often grow bacteria of uncertain significance. The second is perioperative care; Prero said better stratification of unplanned readmission risk could help clinicians determine who should recover in the ICU, in a step-down unit, or at home.

“If we could figure that out, we'd be able to make life easier for both the families and the patients,” he said.

Prero M. Updates in pediatric pulmonology: year in review. Presented at: CHEST 2026 Annual Meeting; October 21, 2026; Phoenix, AZ.

Wozniak PS, Makhoul L, Botros MM. Bronchopulmonary dysplasia in adults: exploring pathogenesis and phenotype. 

Respiratory monitoring after spinal muscular atrophy gene therapy. HCPLive. 

https://www.hcplive.com/view/respiratory-monitoring-spinal-muscular-atrophy-gene-therapy

. Published October 27, 2026. Accessed November 2, 2026.

Deciding Whether a Breathing Tube is Best for a Child. American Thoracic Society. Published October 22, 2025. Accessed November 2, 2026. 

https://site.thoracic.org/press-releases/deciding-whether-a-breathing-tube-is-best-for-a-child

Moshe Prero, MD, says bronchopulmonary dysplasia remains relevant into adulthood and details home safety priorities for children with tracheostomies.

Pulmonology

Infectious Disease condition center page is a comprehensive resource for clinical news and insights on respiratory health. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for asthma, COPD, interstitial lung disease, COVID-19, and more.

John Cleland, MD, PhD, is an emeritus professor at the University of Glasgow.

John Cleland, MD, PhD, discusses the results of the HF-TRACK study and the potential for the Heartfelt device to improve HF outcomes among monitored patients.

Heart Failure

The HCPLive heart failure page is a resource for medical news and expert insights on HF. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for heart disease, reduced and preserved ejection fraction, and more.

Heartfelt Edema Monitor Improves HF Outcomes, May Provide Durable Benefit

The FDA updated the risankizumab label to make pretreatment TB evaluation a matter of clinical judgment across all indications, including psoriasis.

FDA Label Change Drops Mandatory TB Screening for Risankizumab

Steven D. Nathan, MD, is the director of the Advanced Lung Disease Program and medical director of the lung transplant program at Inova Fairfax Hospital

Nathan explains why a TETON-2 post hoc analysis of recurrent events, 126 vs 161 with placebo, supports continuing inhaled treprostinil after progression.

Inhaled Treprostinil After IPF Progression, With Steven Nathan, MD

Phase 2 and 3 data show difamilast 1% ointment improved severity and itch within 1 week in adults and children with mild to moderate atopic dermatitis.

What Phase 2 and 3 Data Show for Topical Difamilast in Atopic Dermatitis

Final VALUE data show fewer drug changes with risankizumab vs other biologics over 37 months in patients with psoriasis and comorbid psoriatic arthritis.

Risankizumab Shows Higher 3-Year Drug Survival in Psoriasis With PsA

Domenico Santoro, MD, PhD is a full professor of nephrology and director of the Division of Nephrology and Dialysis at the University of Messina in Italy

In 101 Italian adults on stable RAS blockade, SGLT2 inhibitor add-on was tied to lower 12-month proteinuria but no eGFR slope change.

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