Pulmonology opened Q1 2026 with long-overdue clinical infrastructure and closed it with one of the most consequential chronic obstructive pulmonary disease (COPD) trial readouts in years. January brought CHEST's first guideline dedicated to biologic selection and sequencing in severe asthma — a practical framework for a therapeutic landscape that has grown faster than the evidence guiding its use — alongside FDA clearance of LEADOPTIK's LIA system, a biopsy tool that embeds real-time depth imaging into the needle itself and may meaningfully compress the diagnostic timeline in lung cancer. February's signal came from the pipeline: verekitug's phase 2 VALIANT data positioned the TSLP receptor antagonist as a credible addition to the severe asthma biologic class, and real-world findings for AREXVY extended the case for RSV vaccination in older adults by linking it to reductions in major adverse cardiovascular events during RSV-related hospitalizations.