Pulmonology Evidence Evolution
5 evidence evolution narratives tracing how landmark trials and guideline updates reshaped pulmonology practice.
Severe Asthma Biologics
Right biologic, right patient
High-dose ICS/OCS → omalizumab (INNOVATE) → mepolizumab (DREAM/MENSA) → dupilumab → tezepelumab (NAVIGATOR)
COPD Inhaler Strategy
The triple therapy revolution
Single bronchodilator → LAMA (UPLIFT) → LAMA/LABA → triple ICS/LAMA/LABA (ETHOS/IMPACT) → eosinophil-guided
IPF Antifibrotic Therapy
Two drugs end decades of futility
No treatment → pirfenidone (CAPACITY/ASCEND) → nintedanib (INPULSIS) → combination debates
Pulmonary Embolism Treatment
Beyond anticoagulation alone
AC-only → systemic thrombolysis (PEITHO) → catheter-directed (ULTIMA/SEATTLE II) → half-dose → PERT
High-Flow Nasal Cannula
Changing supplemental oxygen
Supplemental O2 → FLORALI (2015) → post-extubation → COVID expansion → immunocompromised