Top 5 Inflammation Articles of 2025

This year’s top 5 inflammation articles on AJMC.com covered topics ranging from the first FDA-approved treatment for bronchiectasis to the impact of anti-inflammatory diets on Alzheimer disease-related death and beyond.

Here are the top 5 inflammation pieces of 2025; stay up-to-date with all the inflammation content from The American Journal of Managed Care® here.

This year's top inflammation article highlighted the first FDA-approved treatment for patients with bronchiectasis. | Image credit: cacaroot - stock.adobe.com

5. Anti-Inflammatory Diets May Reduce Risk of Alzheimer Disease-Related Death

This May article summarizes findings from an Experimental Gerontology study, which showed that higher dietary inflammatory index (DII) scores are significantly associated with an increased risk of Alzheimer disease-related death among American adults. Although several studies have linked higher DII scores with greater cognitive decline and an increased risk of developing dementia, few have investigated the relationship between DII and mortality outcomes in patients with Alzheimer disease; the researchers conducted a study to address this literature gap.

Cox proportional models determined higher DII scores to be associated with an increased risk for Alzheimer disease-related mortality when analyzed as a continuous variable. In the fully adjusted model, each 1-unit increment in DII corresponded to a 9% higher risk of Alzheimer disease-related mortality (HR, 1.09; 95% CI, 1.03-1.15; P = .003). Therefore, participants with pro-inflammatory diets had significantly elevated risks of Alzheimer disease-related mortality, with the fully adjusted model indicating a 44% increased risk (HR, 1.44; 95% CI, 1.14-1.81; P = .002).

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4. Systemic Immune Response Index Identified as Independent Risk Factor for COPD

The systemic immune response index (SIRI) is an independent risk factor for chronic obstructive pulmonary disease (COPD), according to findings from a Scientific Reports study summarized in a March article. While the link between inflammation and COPD is being increasingly recognized, the investigators noted that the correlation between the disease and SIRI, a novel marker of inflammation, remains unknown. To explore this relationship, they conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey.

The fully adjusted multivariable logistic regression analysis showed that SIRI was associated with a high risk of COPD (OR, 1.350; 95% CI, 1.220-1.493). Subgroup analyses indicated that the effect of SIRI on COPD was more pronounced in smokers, especially those who still smoke (OR, 1.58; 95% CI, 1.34-1.86) and in men who smoke (OR, 1.62; 95% CI, 1.4-1.83).

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3. Bronchiectasis Hospitalizations Deadlier, Costlier Than Those for COPD, Asthma

This article from last month summarizes findings from an ERJ Open Research study that found hospitalizations for bronchiectasis exacerbations are associated with worse outcomes than those for exacerbations of COPD or asthma. Although bronchiectasis is increasingly recognized as a distinct clinical entity, the investigators emphasized that gaps remain in understanding how its hospitalization patterns and outcomes compare with those of more common airway diseases. To address this, they evaluated hospitalizations for bronchiectasis, COPD, and asthma exacerbations from 2017 to 2021 using data from the National Inpatient Sample.

The median (IQR) hospital length of stay was highest among patients with bronchiectasis (5 [3-9] days) and lowest among those with asthma (3 [2-5] days). Costs were also highest for the bronchiectasis cohort, with a median (IQR) of $50,393 ($28,432-$96,242) per hospitalization. Similarly, crude mortality was highest among patients with bronchiectasis (5.8%), followed by COPD (5.0%; P < .0001) and asthma (1.5%; P < .0001). After adjusting for comorbidities, patients hospitalized for bronchiectasis exacerbations were 1.2 times more likely to die than those with COPD and 3.0 times more likely to die than those with asthma exacerbations (P < .0001 for both).

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2. Real-World Evidence Confirms the Benefits of JAK Inhibitors in Patients With Rheumatoid Arthritis

The real-world treatment benefit of Janus kinase (JAK) inhibitors among US patients with rheumatoid arthritis (RA) was demonstrated across various observational studies, according to findings from a Drug, Healthcare, and Patient Safety systematic review summarized in a January article. The investigators noted that several randomized controlled trials (RCTs) have demonstrated clinical improvement with JAK inhibitors, suggesting that novel JAK inhibitor treatment has superior clinical efficacy compared with other biologics for patients with RA.

However, patients enrolled in RCTs often differ from those seen in routine clinical settings, meaning that the treatment efficacy outcomes demonstrated in the trials may not represent real-world effectiveness outcomes. To complement the efficacy data from RCTs, the researchers conducted a systematic review to synthesize the real-world effectiveness outcomes of JAK inhibitors from real-world observational studies among patients with RA in US health care settings.

Across 11 studies that reported JAK inhibitor adherence among patients with RA, the rate ranged between 0.53 and 0.83 for the proportion of days covered. Additionally, JAK inhibitor persistence was reported in 14 studies, which found that the median time for treatment without discontinuation was between 121 and 516 days, with a JAK inhibitor discontinuation rate between 11% and 72.4%. Lastly, 12 studies measured patient-reported outcomes (PROs) among patients with RA using JAK inhibitors. The most widely reported PRO was pain, with all 12 studies including it in their findings; the mean change in pain ranged from –9.3 to 8.9 across studies.

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1. Brensocatib Becomes First FDA-Approved Therapy for Bronchiectasis

This year’s top article highlighted the FDA’s approval of brensocatib (Brinspuri; Insmed) for the treatment of non–cystic fibrosis bronchiectasis, making it both the first therapy approved for this patient population and the first dipeptidyl-peptidase-1 inhibitor approved to treat a neutrophil-mediated disease. It was supported by data from the phase 3 ASPEN trial (NCT04594369), which randomly assigned adults (1:1:1) and adolescents (2:2:1) with bronchiectasis to once-daily brensocatib at either 10 mg or 25 mg or to placebo. The trial showed that brensocatib reduced the annualized rate of exacerbations compared with placebo, with the 25-mg dose also associated with a smaller decline in lung function.

Annualized pulmonary exacerbation rates were 1.02 with 10 mg, 1.04 with 25 mg, and 1.29 with placebo, yielding rate ratios (RRs) of 0.79 (95% CI, 0.68-0.92; adjusted P = .004) for 10 mg and 0.81 (95% CI, 0.69-0.94; adjusted P = .005) for 25 mg vs placebo. At week 52, 48.5% of patients treated with brensocatib remained exacerbation-free vs 40.3% treated with placebo. The RRs for remaining exacerbation-free were 1.20 (95% CI, 1.06-1.37; adjusted P = .02) for 10 mg and 1.18 (95% CI, 1.04-1.34; adjusted P = .04) for 25 mg.

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