The Pulm PEEPs podcast will be providing regular episodes delving into the world of pulmonary and critical care medicine. Our mission with this platform is to provide learners of all levels multiple formats to engage in pulmonary and critical care education that you can access anytime, anywhere. We will be bringing you case reports of classic teaching cases that we have encountered accompanied by infographics on high-yield points from each case, roundtable chats with experts and leaders in the field of PCCM, and series of Top ICU and Top Pulmonary consults.
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The Pulm PEEPs podcast will be providing regular episodes delving into the world of pulmonary and critical care medicine. Our mission with this platform is to provide learners of all levels multiple formats to engage in pulmonary and critical care education that you can access anytime, anywhere. We will be bringing you case reports of classic teaching cases that we have encountered accompanied by infographics on high-yield points from each case, roundtable chats with experts and leaders in the field of PCCM, and series of Top ICU and Top Pulmonary consults.
109. Guidelines Series: GINA Guidelines – Special Considerations in Asthma Care
PulmPEEPs
1 week ago
109. Guidelines Series: GINA Guidelines – Special Considerations in Asthma Care
In this episode, we’re concluding our review of the Global Initiative for Asthma (GINA) guidelines on asthma today with a cased based episode on special considerations in asthma care. We’ve covered asthma diagnosis and phenotyping, the approach to therapy inhaler and oral medical therapy, and biologic therapy. On today’s episode we’re talking about complex cases that are at the edges of the guidelines, or may be in future guidelines. To help us with this exciting topic we’re joined by an expert in the field. Enjoy!
Meet Our Guest
Dr. Meredith McCormack is a Professor of Medicine at Johns Hopkins, where she leads multiple NIH funded endeavors at understanding lung health and disease. She is the Division Director for Pulmonary and Critical Care Medicine, while also directing the Asthma Precision Medicine Center of Excellence, and the BREATHE Center, which focuses on understanding the effects of the environment on lung health and disease through research and community engagement. She is an internationally recognized expert in asthma management and is a dedicated member of the faculty who is committed to the trainees.
Meet Our Co-Hosts
Rupali Sood grew up in Las Vegas, Nevada and made her way over to Baltimore for medical school at Johns Hopkins. She then completed her internal medicine residency training at Massachusetts General Hospital before returning back to Johns Hopkins, where she is currently a second year pulmonary and critical care medicine fellow alongside Tom. Rupali’s interests include interstitial lung disease, particularly as related to oncologic drugs. And she also loves bedside medical education.
Tom Di Vitantonio is originally from New Jersey and attended medical school at Rutgers, New Jersey Medical School in Newark. He then completed his internal medicine residency at Weill Cornell, where he also served as a chief resident. He currently is a second year pulmonary and critical care medicine fellow at Johns Hopkins, and he’s passionate about caring for critically ill patients, how we approach the management of pulmonary embolism, and also about medical education of trainees to help them be more confident and patient centered in the care they have going forward.
Key Learning Points
Episode themes* Built on GINA 2024: final capstone focusing on evolving topics + case-based application.* Three focal areas: (1) obesity/metabolic health (GLP-1s, metformin), (2) dual biologics vs switching, (3) de-escalating inhalers while on biologics.* Emphasis throughout on personalized care, shared decision-making, and multidisciplinary collaboration.Obesity & metabolic health in asthma* Obesity affects mechanics, inflammation, and treatment response; tackling metabolic dysfunction can improve asthma control.* GLP-1 receptor agonists may provide additive benefit beyond weight loss for some patients (early clinical signals; trials ongoing).* Metformin is being studied as a potential adjunct targeting metabolic-inflammatory pathways.* Practical approach: screen/counsel on weight, activity, and metabolic disease; partner with primary care/endocrine/sleep clinics; consider GLP-1/other agents when indicated for comorbidities, with potential asthma “bonus.”Biologics: switching vs dual therapy* Consider switching/adding when control is not achieved or sustained on a biologic despite adherence.* Upstream vs downstream targets:* Upstream: anti-TSLP (e.g., tezepelumab) may help when multiple pathways/biomarkers (e.g., high IgE + eos) suggest broader blockade.Downstream: IL-5/IL-4/13/IgE agents selected to match phenotype/endotypes.* Comorbidities can drive choice:* Nasal polyps or upper airway syndromes: there are biologic options that improve upper airway symptoms in addition to asthmaAtopic...
PulmPEEPs
The Pulm PEEPs podcast will be providing regular episodes delving into the world of pulmonary and critical care medicine. Our mission with this platform is to provide learners of all levels multiple formats to engage in pulmonary and critical care education that you can access anytime, anywhere. We will be bringing you case reports of classic teaching cases that we have encountered accompanied by infographics on high-yield points from each case, roundtable chats with experts and leaders in the field of PCCM, and series of Top ICU and Top Pulmonary consults.
