Pulmonology Month in Review: July 2024

Throughout the month of July 2024, the field of pulmonology has seen a significant number of studies highlighting the needs of patients with a variety of conditions. As new research continues to emerge, treatment of conditions such as asthma, chronic obstructive pulmonary disease (COPD), and more has been explored.

In July particularly, new research regarding dupilumab’s impact on exacerbations of asthma in children, the effects of air pollution during the prenatal period, and more was covered by the HCPLive editorial team. Here, we noted some of the most significant coverage for our Month in Review:

FDA Grants Cytisinicline Breakthrough Therapy Designation for Vaping Dependence

In 1 story covered in July, Achieve Life Sciences, Inc., announced a decision by the US Food and Drug Administration (FDA) to approve the company’s Breakthrough Therapy Designation for the plant-based cytisinicline treatment, designed to help nicotine e-cigarettes smokers quit.

The FDA’s decision followed preliminary clinical findings drawn from the phase 2 ORCA-V1 trial findings. The medication itself was designed to be a partial agonist at α4β2 nicotinic acetylcholine receptors, mediating nicotine dependence for individuals who vape.

“Since there are no FDA-approved medications specifically indicated for nicotine vaping cessation, cytisinicline has the potential to be a first-in-class treatment to address the unique challenges of the over 13 million people in the United States who vape nicotine and are struggling to overcome their addiction,” Cindy Jacobs, MD, PhD, president and chief medical officer of Achieve, noted in a statement.

Dupilumab Reduces Exacerbations Among Children with Severe Asthma Up to 2 Years

Another study covered in July found that dupilumab for children aged 6–11 years with uncontrolled moderate-to-severe type 2 asthma had significantly diminished exacerbation rates and improvements in lung function for up to 2 years. This study was led by Wanda Phipatanakul, MD, of Boston Children's Hospital’s division of immunology.

Phipatanakul et al. conducted this research to evaluate the drug’s efficacy and safety as an add-on therapy administered every 2 weeks at 200 mg. The study was the largest dose cohort of both the VOYAGE and EXCURSION studies,

The research team note that prior studies into dupilumab demonstrated that the medication had lowered childrens’ severe exacerbation rates and improved their lung function at 100 and 200 mg doses. However, the drug had not been assessed up to 2 years.

Study Links Air Pollution Exposure During Pregnancy to Reduced Lung Function in Childhood

A significant study covered in July found that higher PM2.5 pollution exposure levels within the prenatal period was linked to reduced lung volume and airflow limitation, suggesting in utero lung development may be most sensitive to exposure to air pollution. This research was led by Jakob Usemann MD, PhD, from the department of respiratory medicine at the University Children's Hospital Zurich.

The investigators conducted their study to address different gaps in knowledge present in existing literature, as patients featured in prior studies had been exposed to higher levels of pollution rather than moderate levels. The study, titled LUIS, was conducted in between 2013 - 2016 and assessed schoolchildren aged 6-17 years from using a cross-sectional population-based trial design.

Study Links Maternal Asthma to Blinding Eye Disease in Premature Infants

New research featured in July suggested that maternal asthma could result in increased likelihood of a blinding eye disease among premature infants. This research was featured at the 42nd American Society of Retina Specialists (ASRS) Annual Scientific Meeting, and involved 2000 infant participants who were screened for retinopathy of prematurity.

“Premature infants of mothers with asthma are more likely to have more advanced [retinopathy of prematurity] and are more likely to require treatment,” investigators stated. “These observations remained significant when controlling for the known risk factors of ROP including gestational age and birth weight.”

PI*SS Genotype Linked to Decreased Risk of AATD-Related Lung Disease

Another study provided an overview for physicians of the differences in risk of alpha-1 antitrypsin deficiency (AATD)-related lung disease among individuals with the PI*SS, PI*ZZ, and PI*SZ genotypes. The investigators looked at data from the European Alpha-1 Antitrypsin Deficiency Research Collaboration (EARCO) international registry, finding that there was lower risk of lung disease development among those with the PI*SS genotype compared to those with the PI*ZZ genotype, though no major differences were seen with the PI*SZ genotype.

“The results of our study suggest that subjects with the PI*SS genotype have a significantly lower risk of lung disease compared with the PI*ZZ genotype, but after careful matching accounting for the most important known confounders we did not find evidence for any significant difference in the risk of lung disease between the PI*SS and PI*SZ genotypes,” the investigators wrote.

Health Consequences of Climate Change with Janelle Bludorn, PA-C, MS

In the latest episode of Lungcast, Janelle Bludorn, MS, PA-C, assistant professor at Duke University School of Medicine’s department of family medicine and community health, spoke to host Albert Rizzo, MD, chief medical officer of the American Lung Association (ALA), about the serious health consequences of environmental shifts and climate change.

Rizzo and Bludhorn reviewed potential tools for screening patients for heat-related illnesses, noting consumer-level resources to be implemented such as the National Weather Service’s HeatRisk tool and the Air Quality Index (AQI). They also highlighted the most common manifestations of heat-related conditions which can present in emergency departments, looking at the ways that climate change can also adversely impact commonly prescribed medicines.