Gerard Criner, MD, is chair and professor of thoracic medicine and surgery at Lewis Katz School of Medicine at Temple University and director of the Temple Lung Center.

Mepolizumab Reduced COPD Exacerbations, With Gerard Criner, MD

Mepolizumab reduced exacerbations requiring emergency department visits or hospitalization among patients with eosinophilic 

chronic obstructive pulmonary disease (COPD)

 receiving inhaled triple therapy, according to pooled phase 3 findings presented at the 

2026 American Thoracic Society (ATS) International Conference

In an interview at ATS 2026, Gerard Criner, MD, from the Lewis Katz School of Medicine at Temple University, said the integrated analysis demonstrated clinically meaningful benefit across a broader range of eosinophilic COPD phenotypes than many clinicians may currently recognize. Patients with blood eosinophil counts ≥ 150 can have clinical benefit from mepolizumab.

The pooled analysis combined results from the phase 3 METREX, METREO, and MATINEE trials, evaluating mepolizumab 100 mg added to inhaled triple therapy in patients with COPD and eosinophilic inflammation.

 Across the studies, investigators analyzed outcomes among patients with blood eosinophil counts (BEC) ≥ 150 cells/µL at screening and/or ≥ 300 cells/µL in the prior year.

Among 1713 patients meeting eosinophilic criteria, mepolizumab significantly reduced the annualized rate of exacerbations requiring emergency department visits and/or hospitalization by 23% versus placebo (rate ratio, 0.77; 95% CI, 0.60-0.99; 

 =.044). The therapy also reduced the hazard of a first such exacerbation by 22% through week 104 (hazard ratio, 0.78; 95% CI, 0.62-0.97; 

 = .029). Investigators additionally observed a trend toward reduced severe exacerbations requiring hospitalization or resulting in death.

Criner emphasized that the findings reinforce the importance of recognizing type 2 inflammation in COPD and suggest that clinically relevant benefit may extend to patients with eosinophil counts beginning at 150 cells/µL.

“It shows the range of patients that have type 2 inflammation can exist at 150 and greater,” Criner said. “It means clinicians… should measure the blood eosinophil count more than once to identify a patient that… might benefit from mepolizumab.”

He noted that while some patients may not perceive substantial symptomatic improvement, prevention of hospitalization and exacerbation burden may still provide meaningful clinical benefit. Criner also highlighted the safety findings from the pooled analysis, particularly given the advanced age and comorbidity burden common in COPD populations.

Criner said decisions regarding biologic initiation in COPD should involve individualized assessment and shared decision-making discussions between clinicians and patients.

“You’re going to have to really assess the patient… and know why you’re using a biologic for them,” he said. “Is it exacerbation reduction alone? Is it trying to improve quality of life? Or is it both?”

Editor’s note: Relevant disclosures for Criner include Pulmonx Corporation, GENZYME CORPORATION, GlaxoSmithKline, Olympus Corporation of the Americas, F. Hoffmann-La Roche AG, and AstraZeneca Pharmaceuticals.

) Mepolizumab Reduces the Burden of Chronic Obstructive Pulmonary Disease Exacerbations in a Wide Spectrum of Patients: Pooled Results From Phase III Randomized Controlled Trials. Poster presented at ATS 2026 in Orlando, Florida, on May 17.

Johnson V. Mepolizumab Reduces Type 2 COPD Exacerbations Across Variable BEC Levels. HCPLive. Published on February 28, 2026. Accessed May 19, 2026. 

https://www.hcplive.com/view/mepolizumab-reduces-type-2-copd-exacerbations-across-variable-bec-levels

Videos

At ATS 2026, pooled phase 3 data showed mepolizumab reduced COPD exacerbations and hospitalizations in patients with blood eosinophil counts starting at 150 cells/µL.

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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.

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.

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.

Incretins, Glucose Monitors, and Insulin Titration at ADA 2026

On June 5, 2026, the American Diabetes Association (ADA) Scientific Sessions will begin in New Orleans, Louisiana. Hundreds of presentations and trial readouts have already been announced, with many more on the way before the conference begins. Clinicians and companies will be sharing updates on everything from emerging incretin-based therapies, diabetes technology, and standards of care.

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss a few of the presentations and trial results they’re most looking forward to at this year’s ADA Scientific Sessions.

Check out the full episode on recent GLP-1 trials and results 

In this segment, Isaacs and Bellini highlight growing excitement around next-generation GLP-1, GIP, and glucagon receptor agonists, emphasizing the expanding therapeutic landscape beyond traditional GLP-1 monotherapy. They discuss upcoming readouts for novel agents, including triple agonists such as retatrutide, noting the substantial weight-loss efficacy observed in patients with type 2 diabetes (T2D) and the possibility that triple agonism may address the attenuated weight-loss response typically seen in diabetes populations compared with obesity trials alone.

The hosts also discuss their enthusiasm surrounding Orforglipron, particularly its oral administration, ease of use, and comparatively lower cost profile. The speakers reflect on how affordability and convenience may improve patient uptake and adherence, drawing parallels to the adoption of continuous glucose monitoring (CGM) technologies among highly motivated patients. They suggest that reduced-cost incretin therapies could meaningfully broaden access and shift treatment priorities for many individuals with diabetes.

A major portion of the discussion focuses on advances in diabetes technology and the expanding role of CGM in T2D management. The speakers review growing evidence supporting CGM use beyond insulin-treated populations and discuss new ADA guideline language endorsing CGM for any patient likely to benefit. Particular attention is given to Dexcom’s Smart Basal feature, which integrates CGM data with automated basal insulin titration recommendations for individuals with T2D using long-acting insulin. The group highlights the potential of this tool to reduce therapeutic inertia, improve insulin adjustment, and lessen the burden on clinical staff through automated dose guidance.

The discussion then shifts to emerging ketone-monitoring technology, including anticipated dual glucose-ketone sensors expected later this year. The speakers debate how continuous ketone monitoring may parallel the early evolution of CGM adoption, ultimately becoming routine for many patients, particularly those with type 1 diabetes at risk for diabetic ketoacidosis (DKA). They underscore the practical limitations of traditional ketone testing, noting that many patients do not consistently carry or replace ketone strips despite repeated education and prescriptions. Continuous ketone monitoring is framed as a potentially transformative safety tool capable of providing passive, real-time surveillance for impending DKA risk.

The segment concludes with a broader overview of advancements in automated insulin delivery (AID) systems and connected insulin technologies. The speakers express excitement about ongoing efforts toward fully closed-loop systems, including studies evaluating meal-unannounced insulin delivery in T2D with Omnipod 5. Additional attention is given to new insulin pump developments from Medtronic, including updates to the MiniMed platform and integration of the InPen with the MiniMed Go app and sensor ecosystem. The speakers emphasize the importance of maintaining advanced therapeutic options for patients who prefer injections over pumps, while preserving real-time safety features, insulin tracking, and decision support capabilities that can improve diabetes self-management across a broad range of patient populations.

Editor’s 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.

Diabetes Dialogue cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the presentations that they’re looking forward to at ADA 2026.

Endocrinology

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. 


Type 2 Diabetes

Type 1 Diabetes

Obesity Management

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Podcasts

podcasts page features a feed of medical news and interview podcast series, including DocTalk, Lungcast, Derm Discussions, and Heart Trials.

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

Patrick J. Strollo, MD, from the University of Pittsburgh Medical Center

AD109 Shows Promise as Oral Agent for Obstructive Sleep Apnea, With Patrick John Strollo, MD

A once-nightly oral pill called AD109 demonstrated statistically significant and clinically meaningful 

 improvements in the largest pharmacotherapy clinical development program ever conducted for the condition.

, drawn from a pooled analysis of two phase 3 trials, SynAIRgy and LunAIRo, were presented at the 2026 American Thoracic Society (ATS) International Conference.

 Patrick John Strollo, MD, study author and a sleep medicine physician at the University of Pittsburgh Medical Center, spoke about AD109 and its efficacy.

“AD109, which is an investigational drug and which we studied in the SynAIRgy trial, offers another tool in the toolbox, and it's a first in class drug that is a neuromuscular modulator to address the problem with sleep apnea, which is airway obstruction,” Strollo explained.

AD109, he noted, combines 2 medications: aroxybutynin and atomoxetine. They are designed in this agent to work together to address the neuromuscular root causes of OSA, specifically the collapse of throat muscles during sleep that repeatedly obstructs the airway.

Strollo and his team’s 2 randomized, double-blind, placebo-controlled phase 3 trials assessed adults with mild-to-severe OSA who had failed or refused CPAP. They spanned a broad range of severity levels and body types. AD109 produced a model-estimated 39.3% reduction in the apnea-hypopnea index (AHI) from baseline in the pooled analysis, compared to 12.6% with placebo.

Additionally, Strollo et al found 28% of those given AD109 attained a 50% or greater AHI reduction. A significantly higher proportion reached complete disease control. AD109 also diminished patients’ hypoxic burden by 41.6% versus 9.9% with placebo, and those showing excessive daytime sleepiness reported meaningful improvements in fatigue and sleep impairment scores. Benefits were also shown by Strollo and coauthors to be consistent across severity levels and body types.

Apnimed has already submitted a New Drug Application to the US Food and Drug Administration (FDA), which has granted AD109 Fast Track designation. A potential PDUFA target action date is slated for the first quarter of 2027.

Patel S, Farkas R, Pho H, et al. (Poster Board # P194) Aroxybutynin and Atomoxetine (AD109) in Obstructive Sleep Apnea: A Pooled Analysis of the SynAIRgy and LunAIRo Phase 3 Trials. Poster presented at ATS 2026 on May 17.

Once-nightly pill treats causes of airway collapse to control OSA. American Thoracic Society. May 18, 2026. Accessed May 19, 2026. 

https://www.eurekalert.org/news-releases/1127768

This interview at ATS 2026 highlights notable findings on the once-nightly oral pill, AD109, in obstructive sleep apnea (OSA).

Obstructive Sleep Apnea

AD109 Effective as Oral Agent for Obstructive Sleep Apnea, With Patrick John Strollo, MD

Charles L. Daley, MD, from National Jewish Health. 

ALIS Improves Symptoms in Newly Diagnosed MAC Lung Disease, With Charles Daley, MD

Amikacin liposome inhalation suspension (ALIS) added to guideline-based therapy improved respiratory symptoms and produced high rates of sputum culture conversion in patients with newly diagnosed 

, according to findings from the phase 3b ENCORE trial presented at the 

2026 American Thoracic Society (ATS) International Conference 

In an on-site interview at ATS 2026, Charles Daley, MD, from the National Jewish Health, said the randomized, double-blind ENCORE study demonstrated both clinical and microbiologic benefit when ALIS was used earlier in the disease course rather than reserved for refractory disease.

MACLD remains the leading cause of nontuberculous mycobacterial lung disease and is associated with chronic respiratory symptoms, progressive lung damage, impaired quality of life, and 5-year mortality rates approaching 42%.

ALIS is currently approved for refractory MACLD, based largely on the phase 3 CONVERT trial, but ENCORE evaluated whether earlier initiation in newly diagnosed disease could improve outcomes before patients progress to more advanced illness.

 Daley said the rationale stemmed directly from prior refractory MACLD data showing meaningful efficacy despite treatment in highly difficult-to-manage populations.

“We said, ‘Well, this is an active drug. Why are we waiting for people to fail to give it to them?’” Daley said. “Why don’t we give it to them at the beginning and see what kind of impact we would have?”

The phase 3b ENCORE study randomized adults with newly diagnosed noncavitary MACLD to receive either ALIS plus azithromycin and ethambutol or an empty liposome control plus azithromycin and ethambutol for 12 months.

Participants had symptomatic MACLD with impaired respiratory quality-of-life scores and at least 2 positive sputum cultures (before enrollment and at screening).

The study’s primary endpoint evaluated change in patient-reported respiratory symptom score using a validated instrument derived from the Quality of Life-Bronchiectasis Respiratory Domain (QOL-B RD).

 Daley said the findings demonstrated clinically meaningful improvement in how patients felt over the course of therapy.

Investigators also reported high rates of microbiologic response, including culture conversion rates that exceeded those historically observed in MACLD studies.

“By 6 months, almost 88% of the participants [had] culture converted,” Daley said. “…that’s pretty dramatic.”

No unexpected safety findings emerged during the trial. Known adverse events associated with inhaled amikacin, including dysphonia and cough, occurred at rates similar to prior studies in refractory disease, although treatment discontinuation rates due to intolerance appeared lower in the newly diagnosed population. He suggested newly diagnosed patients may tolerate therapy better because they are less clinically advanced than refractory MACLD populations.

If the ENCORE data ultimately support the incorporation of ALIS into earlier-line MACLD treatment strategies, Daley said pulmonologists and infectious disease specialists may need to recalibrate treatment discussions with newly diagnosed patients. He said they should keep the higher culture conversion rates in mind, which may result in a shorter duration of therapy.

Daley also emphasized the rigor of the ENCORE trial design, highlighting extensive sputum culture collection and high protocol adherence across study sites.

“This study was really well conducted,” he said. “Over the course of a year, we got 95% of the expected sputum cultures. That’s unbelievable.”

Editor’s note: Relevant disclosures for Daley include Insmed, E.R. Squibb & Sons, Merck Sharp & Dohme, and Electromed.

) Amikacin Liposome Inhalation Suspension for Newly Diagnosed Mycobacterium Avium Complex Lung Disease: Efficacy and Safety From a Phase 3b Study (ENCORE). Latebreaker presented at ATS 2026 in Orlando, Florida, on May 17, 2026.

Morimoto K, Nonaka M, Yamazaki Y, et al. Amikacin liposome inhalation suspension for Mycobacterium avium complex pulmonary disease: A subgroup analysis of Japanese patients in the randomized, phase 3, CONVERT study. 

At ATS 2026, phase 3b ENCORE findings showed amikacin liposome inhalation suspension achieved high culture conversion rates in newly diagnosed MAC lung disease.


Kyle Staller, MD, MPH, is a gastroenterologist and the director of the Gastrointestinal Motility Laboratory at Mass General.

IBS-C Treatment Cycling Linked to Higher Healthcare Utilization

Irritable bowel syndrome with constipation (IBS-C)

 practice, and its management is complicated by a crowded therapeutic landscape and persistent patient dissatisfaction.

A new real-world analysis presented at Digestive Disease Week (DDW) 2026 in Chicago, IL, sheds light on a pattern that many clinicians recognize but rarely quantify: the cycle of stopping, restarting, and switching IBS-C medications, and the consequent downstream burden it places on both patients and providers.

“Our question was, with all of the different agents that are out there, what is the journey that patients go on in terms of switching from different agents, one agent to another, stopping or restarting an agent, and do those stops and starts correlate with increased healthcare resource utilization?” study author Kyle Staller, MD, MPH, Massachusetts General Hospital, told HCPLive.

The observational analysis drew on nationwide community gastroenterology practice data collected between January 2018 and February 2025, identifying 31,465 adults who had used ≥ 1 IBS-C medication and had a minimum of 365 days of follow-up. Treatment changes including starts, drops, swaps, and add-ons were tracked by medication type and dose. Regression analyses examined associations between patient characteristics, treatment change rates, GI-related healthcare resource utilization (HCRU), and patient portal activity.

Over a mean follow-up of 5.1 years, 41% of patients changed IBS-C treatments at least once. The mean number of treatment changes was approximately 1 per 5 years, but the nature of those changes was striking: roughly 60% were cycles, or patients returning to a previously used medication rather than switching to an agent with a different mechanism of action.

"Many patients are actually doing the same thing over and over again, hoping to get better results the second time," Staller said. "There is a real opportunity to consider alternative treatments when someone has failed one treatment for one reason or another."

“Many patients are actually doing the same thing over and over again, hitting their head against the same wall hoping to get better results, perhaps the second time they do it," Staller said. “I think there is a real opportunity here to consider alternative treatments when someone has failed one treatment for one reason or another.”

Each treatment change was associated with a 9% increase in GI-related HCRU and an 11% increase in patient portal messaging, a finding Staller flagged as particularly relevant given the growing burden of inbox management on gastroenterologists. The top decile of HCRU utilizers averaged > 6 GI-related encounters per year.

Patients with psychiatric comorbidities, somatic pain disorders, and those covered by Medicaid were approximately 20% more likely to have higher treatment change rates. Of note, these same groups are among the highest healthcare utilizers in IBS more broadly.

Staller framed the findings as a call to action on two fronts. First, clinicians should be more deliberate about steering patients toward therapeutic alternatives rather than medication restarts when a treatment has already failed. Second, identifying high-risk patients early may allow for targeted interventions that reduce both treatment cycling and its associated resource burden.

"These are the patients that we need to think about targeting with alternative types of treatments," he said. "The reason for a break is probably because of lack of satisfaction with their current treatment options."

Editor's note: Staller reports disclosures with AbbVie, Ardelyx, Gemelli, Salix, and Takeda.

Scott L, Fossa A, Staller K, et al. Patient Factors Associated With Irritable Bowel Syndrome With Constipation (IBS-C) Treatment Changes. Presented at Digestive Disease Week (DDW) 2026; Chicago, IL; May 2–5, 2026.

Brooks A. Despite Advances, IBS Continues to Impact Patients' Daily Lives, Productivity. 

. August 8, 2025. Accessed May 19, 2026. 

https://www.hcplive.com/view/despite-advances-ibs-continues-to-impact-patients-daily-lives-productivity

Kyle Staller, MD, MPH, explains new real-world data showing 41% of IBS-C patients change treatments at least once, with each switch driving higher HCRU and provider portal burden.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

Irritable Bowel Syndrome

On the HCPLive irritable bowel syndrome page, resources on the topics of medical news and expert insight into IBS can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBS, IBD, and more.

Treatment Cycling in IBS-C Drives Greater Healthcare Resource Utilization

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.

Articles

This potential new treatment option shows potential for patients living with obstructive sleep apnea.

Once-Nightly AD109 Pill Effective for Patients with Obstructive Sleep Apnea (OSA)

Carel le Roux, PhD, MSC, is a director of the Metabolic Medicine Group at the University College of Dublin School of Medicine.

Carel le Roux, PhD, MSC, discusses the investigative dual GLP-1/glucagon agonist’s weight loss efficacy in patients with obesity and overweight without T2D.

SYNCHRONIZE-1: Survodutide Achieves Significant Weight Loss Versus Placebo

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 granted priority review to asundexian for secondary prevention after non-cardioembolic ischemic stroke or TIA.

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...

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.

FDA Grants Priority Review to Asundexian for Secondary Prevention After Ischemic Stroke

Freed discusses the evidence supporting treatment of iron deficiency before anemia develops, the symptom burden of non-anemic iron deficiency including fatigue, restless legs syndrome, and pica.

Treating Before Anemia — Non-Anemic Iron Deficiency, Symptom Recognition, and Completing the Diagnostic Picture

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

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.

Asthma

The HCPLive asthma page is a comprehensive resource for clinical news and insights on asthmatic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for allergic and severe asthma, and more.

Periconception Eosinophil Counts Predict Asthma Exacerbations in Pregnancy

As dermatology patients enter clinical visits with information from social media, online forums, and AI inquiries, clinicians 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.

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.

How Online-Informed Patients Are Changing Dermatology Visits

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

Diabetes Dialogue: ADA Scientific Sessions 2026 Preview

 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.

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.

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.

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.

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.

Latest News

Mepolizumab Reduced COPD Exacerbations, With Gerard Criner, MD

Incretins, Glucose Monitors, and Insulin Titration at ADA 2026

AD109 Effective as Oral Agent for Obstructive Sleep Apnea, With Patrick John Strollo, MD

ALIS Improves Symptoms in Newly Diagnosed MAC Lung Disease, With Charles Daley, MD

Treatment Cycling in IBS-C Drives Greater Healthcare Resource Utilization