Lung

This monoclonal antibody that blacks the inflammatory response to both neutrophils and eosinophils appears to improve health-related quality of life and reduce moderate to severe exacerbations in people with COPD. However, it may not be available yet and is probably going to be very expensive when it is available.

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Rationale
The efficacy and safety of astegolimab, an anti-ST2 monoclonal antibody, was evaluated in participants with chronic obstructive pulmonary disease (COPD) and frequent exacerbations in the pivotal ALIENTO and ARNASA trials.

Objectives
To report the prespecified pooled analysis of ALIENTO and ARNASA.

Methods
ALIENTO and ARNASA were randomized, double-blind, placebo-controlled trials with similar designs and included participants with COPD, a history of frequent exacerbations, and current/former smoking status, irrespective of blood eosinophil count and chronic bronchitis. Participants were randomized 1:1:1 to astegolimab 476 mg every 2 weeks (Q2W), astegolimab every 4 weeks (Q4W), or placebo for 52 weeks, plus optimized maintenance therapy. The primary endpoint was annualized rate of moderate/severe exacerbations. Secondary endpoints included annualized rate of severe exacerbations. A hierarchical statistical plan was followed with hypothesis testing of secondary efficacy endpoints gated on the primary efficacy endpoint success.

Measurements and Main Results
A total of 2682 participants were included in the pooled intent-to-treat population. Astegolimab significantly reduced the annualized rate of moderate/severe exacerbations by 15% in the Q2W arm (adjusted rate ratio, 0.85 [95% CI, 0.76-0.96]; P = .0077) and by 12% in the Q4W arm (rate ratio, 0.88 [95% CI, 0.78-0.99]; P = .0265). A nominally significant reduction in the annualized rate of severe COPD exacerbations (rate ratio, 0.68 [95% CI, 0.52-0.87]; P = .0028) was observed for astegolimab Q2W vs placebo. Astegolimab was well tolerated.

Conclusions
Astegolimab every 2 weeks reduced the annualized rate of moderate/severe exacerbations in a clinically heterogeneous population of participants with COPD and frequent exacerbations.

Clinical trial registration
ClinicalTrials.gov: NCT05037929; NCT05595642

Author/s:

Jadwiga A Wedzicha, Alvar Agustí, Christopher E. Brightling, Peter Calverley, James D. Chalmers, Neil J. Greening, MeiLan K. Han, Divya Mohan, Julie Ng, Papi, Alberto, Nicolas Roche, Rebecca Saenz, Katerina Samara, Ruth Tal-Singer, Claus F. Vogelmeier, Xiaoying Yang, Bartolome R. Celli

What RSV Is and Why Immunization Matters

Megan George — Tue, 04 Nov 2025 15:48:19 +0000

Date Added:

November 4, 2025

Journal/Publication:

JAMA Pediatrics Patient Page

Publication Date:

September 29, 2025

URL:

What RSV Is and Why Immunization Matters

Type:

Patient Education Materials

Format:

Poster

DOI (1):

10.1001/jamapediatrics.2025.3096

Keywords

pediatrics

RSV

respiratory synytial virus vaccines

immunizations

vaccines

PMID (1):

41021255

MeSH

infant

child

Respiratory Syncytial Virus Infections

Respiratory Syncytial Virus Vaccines* / therapeutic use

Respiratory Syncytial Virus Vaccines* / administration & dosage

Respiration Disorders

Information for parents about RSV. James W. Mold, MD, MPH

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This JAMA Pediatrics Patient Page describes respiratory syncytial virus (RSV) in children and how to prevent its spread.

Author/s:

Alistair Mukondiwa, Callie L. Brown, Lindsay A. Thompson

What Do I Need to Know About the Pneumococcal Pneumonia Vaccine?

Megan George — Tue, 21 Oct 2025 13:35:47 +0000

Date Added:

October 21, 2025

Journal/Publication:

JAMA Internal Medicine Patient Page

Publication Date:

October 20, 2025

URL:

What Do I Need to Know About the Pneumococcal Pneumonia Vaccine?

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jamainternmed.2025.5277

Keywords

'Vaccination

Infectious diseases

Patient Information

Pneumococcal Vaccines

PMID (1):

41114997

MeSH

23-valent pneumococcal capsular polysaccharide vaccine

pneumonia

13-valent pneumococcal vaccine

spleen

COVID-19

Streptococcus pneumoniae

Influenza

Pneumococcal Vaccines

Pneumococcal Infections

Hypersensitivity

Herpes Zoster

Information for patients about pneumococcal immunizations. James W. Mold, MD, MPH

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What Is the Pneumococcal Pneumonia Vaccine?
The pneumococcal vaccine protects against infections from a type of bacteria called pneumococcus. Pneumococcus is a common cause of pneumonia (a lung infection), as well as other serious infections. The vaccine prepares your immune system to recognize and fight pneumococcal bacteria. The vaccine is usually given through an injection into the arm. Some versions can also be inhaled. The vaccines do not contain living or dead bacteria. The pneumococcal vaccine does not protect you from other lung infections like the flu (influenza), COVID-19, RSV (respiratory syncytial virus), or other kinds of bacteria that cause pneumonia. It is still important to get your flu shot every year and other vaccines your doctor recommends, even if you already got the pneumococcal vaccine.

What Are Benefits of Pneumococcal Pneumonia Vaccines?
The vaccine substantially lowers your risk of hospitalization or dying from serious pneumococcal infection. Vaccination can reduce the risk of pneumonia-related deaths by almost half.

Why Is There a New Pneumococcal Pneumonia Vaccine, and How Does It Differ From Prior Versions?
There are several types of pneumococcal bacteria that can cause pneumonia. Being vaccinated against one type of pneumococcus may not protect you from other types that could make you sick. Previous pneumococcal pneumonia vaccines like PPSV23 or PCV13 do not protect against all types of the pneumococcal bacteria that cause pneumonia. Newer vaccines were made in 2021 (PCV15 and PCV20) and 2024 (PCV21). These help to prevent infections from types of bacteria not covered by older versions.

What Are the Potential Side Effects?
Side effects are frequent but generally mild. The most common side effect is pain or redness at the site of injection. Less common side effects include fever, feeling tired, muscle ache, and headache. These are less severe than for other vaccines like flu and shingles. These effects can be treated with over-the-counter medications and generally go away within 24 to 48 hours. Life-threatening allergic reactions are extremely rare but possible. Seek immediate medical attention if you experience severe symptoms like difficulty breathing or progressive weakness after vaccination. The pneumonia vaccine cannot cause pneumonia or other bacterial illness.

Who Should Get a New Pneumococcal Pneumonia Vaccine?
All adults 50 years and older who have not been vaccinated should receive one of the new vaccines: PCV21, PCV20, or a sequence of PCV15 followed by PPSV23. People younger than 50 years with certain health problems should also get the new vaccine. These health problems include diabetes; chronic conditions affecting the heart, lungs, liver, or kidneys; current tobacco use or heavy alcohol consumption; a weak immune system from certain health problems or medications; absence or prior removal of the spleen; and a history of spinal fluid leak or a cochlear (inner ear) implant.

Most adults who got either PPSV23 and/or PCV13 should still get a booster with one of the newer vaccines. The different pneumococcal vaccines protect against different types of bacteria. Some types of bacteria are more common in people depending on their age, health, and where they live. Talk to your doctor about which vaccine is best for you.

Author/s:

Jerard Z. Kneifati-Hayek, Michael A. Incze

Small Cell Lung Cancer: A Review

Alex Haga — Thu, 03 Apr 2025 17:35:00 +0000

Date Added:

April 3, 2025

Journal/Publication:

JAMA

Publication Date:

March 31, 2025

URL:

Small Cell Lung Cancer: A Review

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2025.0560

Keywords

small cell lung cancer

small cell

lung cancer

Lung

PMID (1):

40163214

MeSH

Small Cell Lung Carcinoma

lung neoplasms

Immunotherapy

Lung

An evidence-based review of small cell lung cancer. James W. Mold, MD, MPH

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Importance: Small cell lung cancer (SCLC) is a high-grade neuroendocrine carcinoma with an incidence of 4.7 cases per 100 000 individuals in 2021 in the US and a 5-year overall survival of 12% to 30%.

Observations: Cigarette smoking is the primary risk factor for development of SCLC, as 95% of patients diagnosed with SCLC have a history of tobacco use. Patients with SCLC may present with respiratory symptoms such as cough (40%), shortness of breath (34%), hemoptysis (10%), or metastases with corresponding local symptoms (30%) such as pleuritis or bone pain; approximately 60% of patients with SCLC may be asymptomatic at diagnosis. Chest imaging may demonstrate central hilar (85%) or mediastinal lymphadenopathy (75%). At diagnosis, approximately 15% of patients have brain metastases, which may present as headache or focal weakness. Diagnosis is confirmed by biopsy of a primary lung mass, thoracic lymph node, or metastatic lesion. Small cell lung cancer is classified into limited stage (LS-SCLC; 30%) vs extensive stage (ES-SCLC; 70%) based on whether the disease can be treated within a radiation field that is typically confined to 1 hemithorax but may include contralateral mediastinal and supraclavicular nodes. For patients with LS-SCLC, surgery or concurrent chemotherapy with platinum-etoposide and radiotherapy is potentially curative in 30% of patients. More recently, median survival for LS-SCLC has reached up to 55.9 months with the addition of durvalumab, an immunotherapy. First-line treatment for ES-SCLC is combined treatment with platinum-etoposide chemotherapy and immunotherapy with the programmed cell death 1 ligand 1 (PD-L1) inhibitors durvalumab or atezolizumab followed by maintenance immunotherapy until disease progression or toxicity. Although initial rates of tumor shrinkage are 60% to 70% with platinum-etoposide and immunotherapy treatment, the median overall survival of patients treated for ES-SCLC is approximately 12 to 13 months, with 60% of patients relapsing within 3 months. Second-line therapy for patients with ES-SCLC includes the DNA-alkylating agent lurbinectedin (35% overall response rate; median progression-free survival, 3.7 months) and a bispecific T-cell engager against delta-like ligand 3, tarlatamab (40% overall response rate; median progression-free survival, 4.9 months).

Conclusions and relevance: Small cell lung cancer is a smoking-related malignancy that presents at an advanced stage in 70% of patients. Three-year overall survival is approximately 56.5% for LS-SCLC and 17.6% for ES-SCLC. First-line treatment for LS-SCLC is radiation targeting the tumor given concurrently with chemotherapy and followed by consolidation immunotherapy. For ES-SCLC, first-line treatment is chemotherapy and immunotherapy followed by maintenance immunotherapy.

Author/s:

So Yeon Kim, Henry S Park, Anne C Chiang

A review on oral manifestations of COVID-19 disease

Aubrey Delammermore — Sun, 06 Nov 2022 05:00:00 +0000

Date Added:

November 6, 2022

Journal/Publication:

Journal of Family Medicine and Primary Care

Publisher:

Wolters Kluwer

Publication Date:

October 1, 2022

Issue:

Volume:

Pages:

5879-5886

URL:

A review on oral manifestations of COVID-19 disease

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.4103/jfmpc.jfmpc_205_22

Keywords

MeSH

A comprehensive review of orofacial manifestations that have been associated with COVID-19 infection. James W. Mold, MD, MPH

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COVID-19, a multi-system-affecting disease presents with an extensive clinical spectrum, ranging from no symptoms at all to fatal lung involvement. Several orofacial manifestations have also been reported, among which dysgeusia is one of the earliest reported symptoms. Several other manifestations of extensive variety have also been reported by various authors worldwide since the outbreak of the disease. This comprehensive review dispenses a synopsis of the orofacial manifestations of COVID-19 along with a working classification, the knowledge of which is of utmost importance to medical and dental professionals for early detection and prevention of transmission of the disease.

Author/s:

Kumar, H., Nishat, R., Desai, A.

Screening for Lung Cancer US Preventive Services Task Force Recommendation Statement

Devin Evans — Wed, 24 Mar 2021 05:00:00 +0000

Date Added:

March 24, 2021

Journal/Publication:

Journal of the American Medical Association

Publication Date:

March 9, 2021

Issue:

Volume:

325

Pages:

962-970

URL:

Screening for Lung Cancer US Preventive Services Task Force Recommendation Statement

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2021.1117

Keywords

tobacco

smoking

Cancer Screeing

PMID (1):

33687470

MeSH

smoke

Tobacco Smoke Pollution

early detection of cancer

Updated USPSTF recommendation regarding screening for lung cancer. James W. Mold, MD, MPH

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Importance: Lung cancer is the second most common cancer and the leading cause of cancer death in the US. In 2020, an estimated 228 820 persons were diagnosed with lung cancer, and 135 720 persons died of the disease. The most important risk factor for lung cancer is smoking. Increasing age is also a risk factor for lung cancer. Lung cancer has a generally poor prognosis, with an overall 5-year survival rate of 20.5%. However, early-stage lung cancer has a better prognosis and is more amenable to treatment.

Objective: To update its 2013 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a systematic review on the accuracy of screening for lung cancer with low-dose computed tomography (LDCT) and on the benefits and harms of screening for lung cancer and commissioned a collaborative modeling study to provide information about the optimum age at which to begin and end screening, the optimal screening interval, and the relative benefits and harms of different screening strategies compared with modified versions of multivariate risk prediction models.

Population: This recommendation statement applies to adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.

Evidence assessment: The USPSTF concludes with moderate certainty that annual screening for lung cancer with LDCT has a moderate net benefit in persons at high risk of lung cancer based on age, total cumulative exposure to tobacco smoke, and years since quitting smoking.

Recommendation: The USPSTF recommends annual screening for lung cancer with LDCT in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation) This recommendation replaces the 2013 USPSTF statement that recommended annual screening for lung cancer with LDCT in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.

Author/s:

US Preventive Services Task Force

Bronchoscopic Lung Volume Reduction: A New Hope for Patients With Severe Emphysema and Air Trapping

Brian Desmarais — Mon, 31 Aug 2020 21:38:45 +0000

Date Added:

August 31, 2020

Journal/Publication:

Mayo Clinic proceedings

Publication Date:

August 20, 2020

URL:

Bronchoscopic Lung Volume Reduction: A New Hope for Patients With Severe Emphysema and Air Trapping

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

doi: 10.1016/j.mayocp.2020.03.027

MeSH

Residual Volume

Pneumonectomy

Cost-Benefit Analysis

cause of death

Pulmonary Emphysema

pulmonary disease, chronic obstructive

Lung Volume Measurements

Lung

Dyspnea

Emphysema

referral and consultation

This relatively new procedure is probably worth knowing about. I’m not sure where, other than Mayo, it is being done. James W. Mold, MD, MPH

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Chronic obstructive pulmonary disease (COPD) is common and has significant morbidity and mortality as the fourth leading cause of death in the United States. In many patients, particularly those with emphysema, COPD is characterized by markedly increased residual volume contributing to exertional dyspnea. Current therapies have limited efficacy. Surgical resection of diseased areas of the lung to reduce residual volume was effective in identified subgroups but also had significant mortality in and suboptimal cost effectiveness. Lung-volume reduction, using bronchoscopic techniques, has shown substantial benefits in a broader patient population with less morbidity and mortality. This review is meant to spread the awareness about bronchoscopic lung-volume reduction and to promote its consideration and early referral for patients with advanced COPD and emphysema frequently encountered by both primary care physicians and specialists. A search was conducted on PubMed (MEDLINE), EMbase, and Cochrane library for original studies, using the following keywords: "lung-volume reduction." "endobronchial valves," "intrabronchial valves," "bronchoscopic lung-volume reduction," and "endoscopic lung-volume reduction." We included reports from systematic reviews, narrative reviews, clinical trials, and observational studies. Two reviewers evaluated potential references. A total of 27 references were included in our review. Included studies report experience in the diagnosis and bronchoscopic treatment for emphysema; case reports and non-English or non-Spanish studies were excluded.

Author/s:

Abia-Trujillo, David, Johnson, Margaret M, Patel, Neal M, Hazelett, Britney, Eric S Edell, Kern, Ryan