Special Reports

Eosinophilic disorders, such as eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES), often necessitate the use of corticosteroids due to diverse signs and symptoms. However, long-term corticosteroid use is associated with various complications. Patients with poor response to corticosteroids may experience disease recurrence. At an industry-sponsored symposium jointly organized by the Hong Kong Society of Rheumatology and the Hong Kong Thoracic Society, experts shared insights on multidisciplinary team management of eosinophilic disorders and discussed clinical evidence supporting the use of add-on medications, such as mepolizumab, in EGPA and HES.

Budesonide 160 mcg, glycopyrronium 7.2 mcg, formoterol fumarate dihydrate 5 mcg inhalation suspension

Eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is a subtype of chronic rhinosinusitis (CRS) characterized by local eosinophilic inflammation. Patients with CRSwNP often require multiple nasal surgeries despite repeated use of antibiotics and systemic corticosteroids and long-term use of intranasal corticosteroids with saline nasal rinse. At a symposium organized by the Hong Kong College of Otorhinolaryngologists, Dr Narinder Singh of the Otolaryngology, Head and Neck Surgery Department of the University of Sydney, Australia, discussed the pathogenesis of CRSwNP and the use of mepolizumab in improving outcomes in CRSwNP. Dr A B John, Specialist in Otorhinolaryngology in private practice in Singapore, shared clinical experience and insights in CRSwNP treatment with mepolizumab.

At a symposium hosted by AstraZeneca on 20 April 2023, a panel of distinguished experts discussed the latest developments in the management of early-stage epidermal growth factor receptor (EGFR)–mutated (EGFRm) non–small–cell lung cancer (NSCLC). Speakers included Dr Vincent Ng, who highlighted the advances in surgical interventions, and Professor Masahiro Tsuboi, who addressed unmet clinical needs in early-stage EGFRm NSCLC and potential solutions such as osimertinib as an adjuvant treatment. The symposium featured a lively debate on the utility of disease-free survival (DFS) as a surrogate endpoint and concluded with an informative panel discussion.

A 64-year-old Chinese woman with hyperlipidaemia was diagnosed with non-small-cell lung cancer (NSCLC) in June 2020. She had a 2.2 cm lesion in the right lower lobe of the lung.

Patients hospitalized for acute heart failure (HF) have high risks of readmission and mortality in the first few months after discharge. At Advances in Medicine (AIM) 2023, Professor Christiane Angermann of Comprehensive Heart Failure Centre, University Hospital of Würzburg, Würzburg, Germany, discussed recent evidence supporting in-hospital initiation of guideline-directed medical therapies (GDMT) in patients hospitalized for acute HF, focusing on clinical benefits of a sodium-glucose cotransporter 2 (SGLT2) inhibitor, empagliflozin, demonstrated in the EMPULSE trial.

An 83-year-old female (body weight, 50 kg) presented in December 2022 with dyspnoea and increasing lower-limb oedema for several weeks. These symptoms rendered her homebound and unable to go out for dim sum, which she previously enjoyed every morning. Otherwise, the patient walked with a normal gait at a slightly slow pace, and managed activities of daily living independently.

A 73-year-old male presented to the Accident & Emergency Department on 8 March 2022 (day 1) with fever (38°C), sore throat, cough, sputum and shortness of breath (SOB). Upon arrival, his blood pressure was 159/59 mm Hg, heart rate was 90 beats/minute, and oxygen saturation was 85 percent on room air, which improved to 96 percent with 3 L/min of supplemental oxygen. He was a hepatitis B virus carrier not receiving antivirals and had diabetes mellitus, which was well controlled with diet. He was not vaccinated against SARS-CoV-2 and had no prior exposure to COVID-19 oral antivirals.

Monoclonal antibodies (mAbs) have emerged as an attractive option for both COVID-19 immunoprophylaxis and treatment, especially since their efficacy vs SARS-CoV-2 is irrespective of patients’ immune system status. MIMS Doctor interviewed Dr Wilson Lam, Specialist in Infectious Disease in private practice in Hong Kong, who shared his experience with tixagevimab/cilgavimab, a combination of two long-acting mAbs, in providing protection against COVID-19 infection as well as evidence supporting its use as early treatment for adolescents and adults with COVID-19 who are at increased risk of progressing to severe disease.