Trends in Pulmonary & Respiratory Medicine: Insights from Dr. Roy St. John

With over three decades of experience and a distinguished career, Dr. St. John brings invaluable expertise to our research initiatives. We recently met with him to discuss the latest trends in pulmonary and respiratory medicine, including biologics, triple inhalers, and respiratory vaccines.

Dr. Roy St. John has served as a Clinical Associate Professor of Medicine for The Ohio State University College of Medicine, and has also served as Associate Medical Director of eICU for OhioHealth. He continues to serve as an Ohio Health eICU staff physician and as Chief Medical Officer at The Breathing Association in addition to his work with Remington-Davis.

Here are four trends he’s following closely.

The Growth of Biologics in Pulmonary Research

Biologics have revolutionized the treatment landscape for various pulmonary conditions, offering targeted therapies that can significantly improve patient outcomes. Dr. St. John emphasized the importance of biologics in treating specific patient types, particularly those with severe asthma and chronic obstructive pulmonary disease (COPD).

"Over the years, I've seen the respiratory space evolve, with a notable uptick in the last several year focusing on biologics," he said. "These therapies are designed to target specific pathways in the immune system, offering personalized treatment options for patients who may not respond to traditional therapies."

Recent studies have highlighted the efficacy of biologics in reducing exacerbations and improving lung function in patients with severe asthma and COPD. These advancements not only enhance the quality of life for patients but also pave the way for more personalized treatment approaches.

Triple Inhalers for COPD and Severe Asthma

The development of triple inhalers has been a significant advancement in the management of COPD and severe asthma. These inhalers (such as BREZTRI and Trelegy Ellipta) combine three medications—typically an inhaled corticosteroid(ICS), an anticholinergic(LAMA), and a long-acting beta-adrenergic agonist (LABA)—into a single device to simplify treatment for patients.

"Triple inhalers have been a game-changer for patients with COPD and severe asthma," notes Dr. St. John. "We have seen promising results from studies involving these inhalers, including a reduction in the risk of cardiovascular complications."

Triple inhalers such as Trelegy Ellipta and Breztri Aerosphere have demonstrated substantial benefits in clinical trials, including improved lung function, reduced exacerbations, and enhanced overall symptom control. These advancements underscore the importance of combination therapies in managing complex respiratory conditions.

Remington-Davis is currently enrolling patients for several studies exploring whether triple inhalers reduce the risk of cardiovascular complications, including a study of COPD patients with a history of cardiac risk factors and another of COPD patients with a history of exacerbation.  

Vaccines for RSV and Human Metapneumovirus

Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) pose significant health risks, particularly for young children and older adults. Dr. St. John highlights the ongoing efforts to develop effective vaccines for these viruses.

"RSV is the third leading cause of respiratory problems, especially in children and patients over 60," explains Dr. St. John. hMPV is the fourth leading respiratory viral infection. "The push for vaccines against RSV and hMPV is crucial in preventing severe respiratory illnesses in vulnerable populations."

Recent advancements in vaccine technology have led to the development of promising treatments, including FDA approval of Arexvy, the first RSV vaccine approved in the United States, last year. Two other RSV vaccines have also been approved (Abrysvo, mRESVIA). While there are no approved vaccines for hMPV, several investigational vaccines are in development. These vaccines aim to reduce the incidence of respiratory infections, hospitalizations, and mortality rates associated with these viruses.

The ongoing research efforts hold great potential for improving public health outcomes.

The Role of Diabetic Medications in Weight Loss

Diabetic medications such as semaglutides (including Ozempic, Rybelsus and Wegovy) have gained attention for their potential in promoting weight loss in non-diabetic individuals. Dr. St. John, who has previous experience with clinical trials for the treatment of diabetes and weight loss drugs including tirzepatide, discussed the exciting prospect of these treatments for weight management.

"Semaglutide and similar GLP-1 receptor agonists have shown remarkable results in clinical trials for weight loss," Dr. St. John said. "These medications offer a new avenue for managing obesity, which may improve sleep apnea.

Studies have demonstrated that semaglutide can lead to substantial weight loss and improve metabolic health, making it a valuable tool in the fight against obesity. The implications of these findings extend beyond diabetes management, offering hope for individuals struggling with weight-related health issues.

Improving Quality of Life Through Clinical Trials

Participating in clinical trials offers numerous benefits for study participants and the broader medical community. Dr. St. John underscored the importance of clinical research in advancing treatment options and improving patient outcomes.

"Clinical trials provide access to cutting-edge therapies that may not be available to the general public," explains Dr. St. John. "By participating in these studies, patients contribute to medical advancements that can benefit countless others."

At Remington-Davis, we are committed to conducting high-quality clinical trials that prioritize patient safety and well-being. Our patient-centric approach, combined with the expertise of physicians like Dr. St. John, ensures that our research efforts continue to drive innovation in pulmonary medicine.

The field of pulmonary medicine is witnessing remarkable advancements, with the growth of biologics and triple inhalers.  The development of vaccines and innovative weight loss treatments are other exciting areas on the horizon.. With Dr. Roy St. John joining our team, Remington-Davis is well-positioned to lead the way in cutting-edge research. We look forward to exploring new frontiers in respiratory health and improving the lives of patients through our clinical trials.