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Nicola Hanania, MD, MS

Articles by Nicola Hanania, MD, MS

Prioritizing Long-Term Control and Steroid Reduction in COPD

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the ongoing challenge of engaging patients, providers, and families in understanding the long-term risks of frequent oral corticosteroid use in chronic obstructive pulmonary disease (COPD), emphasizing the importance of clear communication about serious adverse effects—including mental health and cardiovascular risks—and the role of electronic medical records in early intervention; they note that patients often feel well between exacerbations and may undervalue steroid-sparing strategies, so personalized education focusing on preventing future harm is key, and express optimism that new biologics offer promising options to reduce exacerbations and steroid dependence, highlighting the evolving, hopeful landscape of COPD care.

Selecting a Biologic in COPD Management

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the introduction of 2 biologics for patients with chronic obstructive pulmonary disease (COPD) with high blood eosinophils and frequent exacerbations as a major advancement, highlighting their ability to reduce exacerbations and steroid use; they note differences in dosing schedules, inflammatory markers, and patient preferences that influence therapy choice, emphasize the role of shared decision-making amid cost and insurance challenges, and acknowledge that trial and error may be needed to personalize treatment while calling for more research to optimize biologic use.

Structuring Patient Visits to Ensure Timely COPD Management

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the importance of early identification of patients with chronic obstructive pulmonary disease (COPD) at risk for exacerbations through targeted clinical questioning about recent hospitalizations, emergency visits, and steroid or antibiotic use, noting that many patients underreport or misunderstand exacerbations; they emphasize patient education, improved communication across multiple providers, and the integration of electronic medical records and patient portals as key strategies to enhance monitoring, ensure timely treatment escalation, and ultimately reduce exacerbation frequency and severity.

Addressing Barriers to COPD Treatment Escalation and the Importance of Continuity of Care

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss common barriers to timely escalation of chronic obstructive pulmonary disease (COPD) treatment, including infrequent follow-up visits, fragmented care across multiple providers, and delayed communication of exacerbations or hospitalizations, as well as therapeutic inertia stemming from competing clinical priorities and insufficient patient education; they emphasize the need for integrated, proactive strategies such as shared electronic medical records, rapid posthospitalization follow-up, care coordination, and enhanced patient engagement to overcome these challenges and optimize treatment adjustments.

Approaches and Timing to Therapy Escalation in COPD Management

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the critical factors guiding therapy escalation in chronic obstructive pulmonary disease (COPD), emphasizing thorough evaluation of symptoms, exacerbation history, and medication adherence; they highlight the foundational role of standard inhaled therapies and nonpharmacologic interventions like pulmonary rehabilitation and smoking cessation, while noting that newer treatments, including biologics, are reserved for patients with persistent exacerbations despite optimized care, with decisions shaped by shared decision-making and personalized considerations such as inhaler technique and delivery method to improve outcomes and quality of life.

Exploring the Relationship Between COPD and Asthma

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the nuanced relationship between chronic obstructive pulmonary disease (COPD) and asthma through the lens of type 2 inflammation, emphasizing that while both diseases share inflammatory pathways and a treatable trait, they remain distinct conditions with differing manifestations and treatment responses; they highlight that asthma-COPD overlap affects 15% to 20% of patients, but type 2 inflammation is a separate COPD subtype rather than evidence of dual diagnosis, underscoring the importance of precise phenotyping to guide personalized treatment strategies that balance efficacy, safety, and patient-specific factors.

Prevalence and Clinical Features of Type 2 Inflammation in COPD

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the prevalence and complexity of type 2 inflammation in chronic obstructive pulmonary disease (COPD), noting that blood eosinophil counts—using thresholds of 150 to 300 cells/µL—identify roughly 30% to 50% of patients with this phenotype, while emphasizing that not all elevated eosinophil cases reflect true type 2 inflammation; they highlight additional markers like allergen sensitization and immunoglobulin E (IgE), the association of type 2 inflammation with increased symptoms and exacerbations, and the ongoing need for refined phenotyping and targeted therapies to address the heterogeneity of COPD inflammation.

The Role of Type 2 Inflammation of COPD

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the emerging recognition of type 2 inflammation in a subset of patients with chronic obstructive pulmonary disease (COPD) , highlighting differences from asthma in eosinophil thresholds and therapeutic responses, the roles of key cytokines IL-4, IL-13, and IL-5 in driving airway inflammation and remodeling, and the promise and challenges of targeting these pathways with biologics to improve outcomes while emphasizing the need for further research to understand the distinct inflammatory mechanisms in COPD.

Variabilities in Blood Eosinophils and Challenges in Interpretation in COPD

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the variability of blood eosinophil counts in chronic obstructive pulmonary disease (COPD), emphasizing the impact of factors such as corticosteroid use, infections, comorbidities, and smoking on their interpretation, and highlight the importance of considering these influences and monitoring trends over time to guide personalized treatment decisions effectively.

Implementation of Blood Eosinophil Testing Into Clinical Practice

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists highlight that while blood eosinophil counts are valuable for guiding chronic obstructive pulmonary disease (COPD) treatment, real-world challenges like fluctuating levels, incomplete symptom tracking, and fragmented care hinder their consistent use, underscoring the need for better data integration and clinician education.

The Utility of Blood Eosinophils and Other Emerging Biomarkers in COPD Management

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the growing role of blood eosinophils as a key biomarker in chronic obstructive pulmonary disease (COPD) management, highlighting their utility in guiding inhaled corticosteroid and biologic therapy decisions, the benefits of tracking longitudinal trends to improve accuracy, and the potential for integrating emerging biomarkers like FeNO to further personalize treatment despite current limitations.

Research Needs and the Future of COPD Treatment

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the future of chronic obstructive pulmonary disease (COPD) management, emphasizing the need for long-term data on newly approved therapies, the development of refined biomarkers like FeNO and imaging tools to guide precision treatment, and the potential for earlier intervention with biologics—all aimed at advancing personalized care and altering the disease trajectory in high-risk patients.

Managing Moderate to Severe COPD: Integrating New Therapies Into Practice

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the evolving role of newly approved chronic obstructive pulmonary disease (COPD) therapies—such as ensifentrine, mepolizumab, and dupilumab—in addressing persistent symptoms and frequent exacerbations despite standard care, highlighting their targeted use based on patient profiles, the practical challenges of integration into clinical practice, and the importance of education, shared decision-making, and personalized care to optimize outcomes in moderate to severe COPD.

New Horizons in COPD: Recent Approvals and GOLD Guideline Updates

ByJoseph Khabbaza, MD ,Diego J. Maselli Caceres, MD ,MeiLan K. Han, MD, MS,Nicola Hanania, MD, MS

Panelists discuss the impact of newly approved therapies for chronic obstructive pulmonary disease (COPD)—such as ensifentrine, mepolizumab, and dupilumab—highlighting their diverse mechanisms and potential to personalize treatment for patients with persistent symptoms or type 2 inflammation, while emphasizing the importance of guideline integration, clinician education, and collaboration across care teams to ensure timely and effective adoption in clinical practice.

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