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Non-malignant pleural effusion
This UK prospective study (Walker et al. Chest 2017;151:1099–105) assessed the mortality risk and associated prognostic factors for patients with non-malignant pleural effusions (NMPE). A total of 782 patients were included, of whom 356 (46%) were diagnosed with NMPE. Effusions secondary to organ dysfunction were reported by the authors to have an ‘extremely high’ 1 year mortality. Pleural effusions secondary to cardiac, renal and hepatic failure had a reported 1 year mortality of 50%, 46% and 25%, respectively. The presence of bilateral effusions (HR 3.55; 95% CI 2.22 to 5.68) or a transudative effusion (HR 2.78; 95% CI 1.81 to 4.28) was found to be associated with a worse prognosis, with an increased 1 year mortality rate of 57% and 43%, respectively. NMPE is common and can cause significant morbidity and mortality. The authors conclude that clinicians should be aware of the poor prognostic features in NMPE and guide management accordingly.
Mepolizumab and refractory eosinophilic granulomatosis with polyangiitis
In this phase 3, randomised, placebo controlled, double blind, multicentre study (Wechsler et al. N Engl J Med 2017;376:1921–32), mepolizumab, an anti-interleukin 5 monoclonal antibody, was shown to …
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Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.