Observational studyMolecular medicine (Cambridge, Mass.)2026
Metabolic effects following initiation of single-inhaler triple therapy in COPD: a prospective observational study.
Observational study in Molecular medicine (Cambridge, Mass.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05458934 (Analysis of Exhaled Breath From Patients With Lung-/Airway Diseases), which is not on this map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Analysis of Exhaled Breath From Patients With Lung-/Airway Diseases (BigExBrESs)
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic obstructive pulmonary disease (COPD) is characterized by airflow limitation, airway inflammation, and oxidative stress. Triple inhaled therapy improves lung function and reduces acute exacerbations, yet its underlying systemic effects remain poorly understood. Exhaled breath analysis offers a non-invasive approach to assessing treatment-related metabolic changes. The objective of this study was to characterize the metabolic changes associated with the initiation of single-inhaler triple therapy in COPD patients through real-time mass spectrometry of exhaled breath.
methodsIn this prospective observational study, patients with COPD were assessed before initiation and after at least 8 weeks of single-inhaler triple therapy. Clinical data, spirometry, symptom scores, and inflammatory markers were collected. Exhaled breath was collected and analyzed by secondary electrospray ionization high-resolution mass spectrometry, and changes in metabolic profiles were evaluated using paired statistics, dimensionality reduction, and pathway enrichment analysis.
resultsTwenty-four patients with COPD (mean (standard deviation) age 65 (7) years, 42% female, median (quartiles) forced expiratory volume in the first second (FEV1) 41 (30, 57) % predicted) completed both visits. Breath analysis revealed significantly altered breath features after initiation of single-inhaler triple therapy, with a total of 40 breath features showing both a relevant effect size (|log2 fold change|≥ 1) and statistical evidence (q < 0.22) for within-subject change. Pathway enrichment analysis suggested predominant changes in lipid peroxidation and β-oxidation associated pathways, consistent with altered lipid catabolism and increased oxidative processes. Additionally, breath signatures strongly correlated with fractional exhaled nitric oxide (r = –0.8) and high-sensitivity C-reactive protein (r = –0.93).
conclusionPredominant molecular changes following initiation of single-inhaler triple therapy were associated with coordinated shifts in breath metabolites consistent with modulation of inflammatory- and oxidative stress-related pathways, suggesting a potential trade-off between anti-inflammatory effects and oxidative processes.
trial registrationClinicalTrials.gov (NCT05458934).
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