Simon Couillard, MD-MSc

Episode 1 : Setting up camp | The Odyssey: Navigating the Early Career Clinician-Researcher Journey Simon Couillard and Sanjay Ramakrishnan discuss their paths from medical school to becoming assistant professors in different parts of the world, the challenges they faced in securing academic positio...

Pleased to share the first episode of my new podcast The Odyssey: Navigating the Early Career Clinician-Researcher Journey
Episode 1 : setting up camp
odysseyresearch.podbean.com/e/navigating...

bmjopen.bmj.com/content/15/7... Non-invasive neuromodulation for alleviating dyspnoea: protocol for a feasibility sham-controlled randomised trial | BMJ Open

Great response to our correspondence to Clarice Leung and John Fahy on the association between FeNO and baseline membrane thickness in SARP-3. This seems like a good marker of type-2 inflammation, and more specifically IL-13 activity, in #asthma.

www.atsjournals.org/doi/abs/10.1...

📰 For #WorldAsthmaDay check out this #OpenAccess meta-analysis on inflammatory and clinical risk factors for #asthma attacks (ORACLE2)

Findings support incorporation of blood eosinophils and FeNO into clinical risk stratification

🔗 tinyurl.com/93ar3am3

@simcouillard.bsky.social

Mepolizumab to Prevent Exacerbations of COPD with an Eosinophilic Phenotype | NEJM Mepolizumab is a humanized monoclonal antibody that targets interleukin-5, a cytokine that plays a central role in eosinophilic inflammation, which is present in 20 to 40% of patients with chronic ...

"Mepolizumab to Prevent Exacerbations of COPD with an Eosinophilic Phenotype."
Publié ce jour dans le @nejm.org.
#MedSky @simcouillard.bsky.social
www.nejm.org/doi/full/10....

🚨 Funded Clinical Research Fellowship
Asthma/COPD focus | MSc/PhD req | 2–3 yrs | 80% research, 20% clinic | Sherbrooke, QC 🇨🇦
French is a must (95% francophone patients).
📩 S.Couillard@USherbrooke.ca
🌐 DM for details!

www.usherbrooke.ca/dep-medecine...

The wait is over! 🤩

“Blood eosinophil count, FeNO, asthma attack history, disease severity, low lung function (low FEV1%), and symptoms (ACQ-5 score) are key predictors of asthma attacks”
Huge congrats to the team on this important work 🫁 @simcouillard.bsky.social
@sanjayresp.bsky.social
#asthma

Study identifies direct link between inflammation and asthma attacks | NIHR Oxford Biomedical Research Centre

A major study led by @simcouillard.bsky.social has highlighted the key role of inflammation in #asthma and proposes a new approach to predict and prevent these attacks oxfordbrc.nihr.ac.uk/study-identi... @usherbrooke.bsky.social www.ndm.ox.ac.uk @unileiden.bsky.social @nihr.bsky.social

Research in context panel explaining: This work quantifies the value of measurable inflammatory and clinical prognostic factors to identify patients at highest risk of asthma attacks. Unlike a predictor such as previous history of asthma attacks, tools such as the type 2 inflammatory biomarkers anticipate risk and provide opportunities to intervene preventively. In our large IPD meta-analysis, elevations in blood eosinophil count and FeNO were associated with an excess risk of asthma attacks. Considering the mechanistic, prognostic (ie, predicting adverse outcomes), and theragnostic (ie, predicting treatment responsiveness) values of type 2 inflammatory biomarkers, we speculate that individualised clinical decision making in asthma would be improved by a framework that includes these modifiable prognostic factors in clinical prediction models.

📰 New Article available #OpenAccess

Inflammatory and clinical risk factors for #asthma attacks (ORACLE2): a patient-level meta-analysis

These findings support incorporation of blood eosinophils and FeNO into clinical risk stratification

🔗 tinyurl.com/93ar3am3

@simcouillard.bsky.social

🚨 New paper in @lancetrespirmed.bsky.social !
ORACLE2: we pooled data from 6,500+ asthma patients x22 RCTs.

🧪 Blood eosinophils + FeNO = powerful predictors of asthma attacks (esp. together)
💨 Surprise: more lung reversibility = lower risk?

Open access 👉 doi.org/10.1016/S221...

Global collab 💪

🚀 Exciting News! 🚀 Thrilled to share that our paper, Phenotyping the Responses to Systemic Corticosteroids in the Management of Asthma Attacks (PRISMA), has been accepted for publication in the European Respiratory Society ERJ journal! 🎉 Congratulations to 1st author @pulmonology101.bsky.social

Home - together.partners We create sustainable ideas real movement colourful content strong stories lasting concepts enduring values emotional highlights beautiful memories powerful networks smart entertainment together.partn...

Seemingly overnight, we Canadians have gone from America's greatest ally to a country labelled as drug smugglers needing to be waged a Trade War. There is nothing more painful than fighting a friend. 😔

Hopefully, research and healthcare are spared, so we can keep improving health together.

Apprenez en davantage sur notre projet Propulsion Santé 👉. Merci FMSQ pour le beau résumé et la visibilité. Merci AstraZeneca, Opération-Enfant-Soleil , et Association pulmonaire du Québec pour le financement ayant permis de partir un projet qui se déploie maintenant à vitesse grand V. 🚀

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. In a multicenter, non...

Among hospitalized patients with bloodstream infection, antibiotic treatment for 7 days was noninferior to treatment for 14 days. www.nejm.org/doi/full/10....

Among participants with obesity and knee osteoarthritis with moderate-to-severe pain, treatment with once-weekly injectable semaglutide resulted in significantly greater reductions in body weight and pain related to knee osteoarthritis than placebo.
www.nejm.org/doi/full/10....

Azithromycin to Reduce Mortality — An Adaptive Cluster-Randomized Trial | NEJM Twice-yearly mass distribution of azithromycin to children is a promising intervention to reduce childhood mortality in sub-Saharan Africa. The World Health Organization recommended restricting dis...

Azithromycin distributions to Nigerian children 1 to 59 months of age significantly reduced mortality and was more effective than treatment of infants 1 to 11 months of age. Antimicrobial resistance must be monitored.

www.nejm.org/doi/full/10....

Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity | NEJM Obesity increases the risk of heart failure with preserved ejection fraction. Tirzepatide, a long-acting agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor...

Truly an amazing class of drugs: Treatment with tirzepatide led to a lower risk of a composite of death from cardiovascular causes or worsening heart failure than placebo and improved health status in patients with HFpEF and obesity.

www.nejm.org/doi/abs/10.1...

Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial Benralizumab can be used as a treatment of acute eosinophilic exacerbations and achieves better outcomes than the current standard of care with prednisolone alone. These results offer a new way of treating eosinophilic endotypes of asthma and COPD exacerbations.

Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): first new therapy in 50 years for airway attacks.

www.thelancet.com/journals/lan...

Thoracentesis: an old story and some new sources Throughout history, thoracentesis has been the treatment of choice for fluid effusions. Several historians have investigated the antiquity and numerous variations of the procedure. Most descriptions recognise that the procedure can be dangerous and should be conducted only in the most dire of situations. Indeed, even today with the advantages of imaging, antiseptics, and antibiotics, the risks still include pain, bleeding, infection, laceration of the liver or spleen, pneumothorax, and re-expansion pulmonary oedema.

Two manuscripts from Paris in the 18th century shed new light on the grim history of Thoracentesis.

www.thelancet.com/journals/lan...

Efficacy and safety of tezepelumab versus placebo in adults with moderate to very severe chronic obstructive pulmonary disease (COURSE): a randomised, placebo-controlled, phase 2a trial A significant reduction was not observed in the annualised rate of moderate or severe COPD exacerbations with tezepelumab versus placebo. Further studies are required to evaluate the efficacy of tezepelumab in patients with moderate to very severe COPD, particularly in patients with a baseline BEC of 150 cells per μL or higher. Tezepelumab was well tolerated, with no safety concerns identified.

Tezepelumab 420mg sc monthly decreases COPD exacerbations in COPD with >=150 blood eosinophil count.

www.thelancet.com/journals/lan...

Type-2 inflammation is a strong predictor of remission with biologics--- as well as earlier use in the disease course. www.thelancet.com/journals/lan...

Cost-related non-adherence to medications among adults with asthma in the USA, 2011–2022 Background Uncontrolled asthma is possibly caused by medication non-adherence, and financial hardship can be a major contributor to non-adherence. Since economic conditions and asthma management have ...

Approximately every one in six adults with asthma was non-adherent to medications due to cost. thorax.bmj.com/content/earl...

Comparative estimate of glucose-lowering therapies on risk of incident pneumonia and severe sepsis: an analysis of real-world cohort data Background Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are treatments for type 2 diabetes (T2D). Beyond glucose-lowering and cardiorena...

SGLT2i and GLP-1 RAs are associated with a reduced risk of incident pneumonia and severe sepsis in patients with T2D.
thorax.bmj.com/content/earl...

Neuropsychiatric diagnoses after montelukast initiation in paediatric patients with asthma Background The evidence base on montelukast-associated adverse outcomes is inconclusive in children and young persons (CYP) with asthma. We aimed to investigate 1-year incidence of neuropsychiatric di...

Montelukast-associated Neuropsychiatric Absolute Risk Increase per 100 persons, 1.71 (95% CI 1.44 to 1.98); 1-year NNH, 58 patients (95% CI 51 to 69)).  thorax.bmj.com/content/earl...