Diarrhoea is the primary cause of nintedanib discontinuation in idiopathic pulmonary fibrosis. We investigated predictors in 100 prospective patients; 46% experienced diarrhoea, defined as common terminology criteria for adverse events V.5.0 grade ≥1. In a multivariable model (area under the curve 0.9056), lower standardised body surface area (adjusted OR 0.20, 95% CI 0.06 to 0.55, p=0.004) emerged as a significant independent predictor. A linear mixed model showed that dose adjustments managed symptoms without compromising 12-month forced vital capacity or diffusing capacity of the lungs for carbon monoxide trajectories (p>0.05). Small body size influences drug tolerability, suggesting that simple anthropometric measures can aid in baseline risk stratification to improve adherence.

Studying the associations between indoor mould contamination and blood inflammatory phenotypes may provide further insight into the mechanisms by which this environmental factor affects asthma.Among 1870 adults with current asthma from a population-based cohort, 29.6% reported visible mould in the dwelling. Paucigranulocytic (reference category), neutrophilic, eosinophilic and mixed phenotypes accounted for 58.8%, 3.8%, 34.5% and 2.9%, respectively. Visible mould was consistently associated with eosinophilic phenotype (OR 1.30 (95% CI 1.04 to 1.63)) whatever the analyses, with no heterogeneity by sex.Our findings suggest that mould contamination may contribute to type 2 inflammation, offering mechanistic insight into the effect of mould on asthma in adults.

The minimum important difference (MID) for the incremental shuttle walk test (ISWT) in individuals with long covid was estimated using anchor-based and distribution-based methods. 397 participants (56 ± 13 years; 63.7% male) with long covid completed a 6-week rehabilitation programme and rated perceived change using the Global Rating of Change Scale (GRCS). Change in ISWT distance differed across GCRS categories (p<0.05); participants reporting slight improvement increased ISWT distance by 60.7±85.9 m. Receiver operating characteristic analysis identified an optimal cut-off of 35 m (area under the curve 0.70, 95% CI 0.61 to 0.79; p<0.05). Distribution-based methods yielded MID estimates of 40.1 m and 52.5 m, supporting an MID range of 35-60.7 m.