Embargoed for release until 5:00 p.m. ET on Monday 2 March 2026
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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine . The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.
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1. ACP advises all adults 75 or older get a protein subunit RSV vaccine
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-05485
URL goes live when the embargo lifts
The American College of Physicians (ACP) issued updated vaccine practice points for physicians that advise adults aged 75 or older should receive a protein subunit Respiratory Syncytial Virus (RSV) vaccine and those aged 60-74 at increased risk for severe RSV may consider receiving the protein subunit RSV vaccine. “Respiratory Syncytial Virus Vaccines in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points from the American College of Physicians” is published in Annals of Internal Medicine .
Annually in the US, an estimated 170,000 adults aged 50 or older will be hospitalized and 14,000 deaths will occur due to RSV. Most adults infected by RSV have mild upper respiratory tract infections, but it can also cause life threatening lower respiratory tract infections. Among adults, severe RSV infection is more likely in those aged 75 or older, living in a long-term care facility or with a comorbid condition such as chronic kidney, liver, or lung disease, cardiovascular disease, hematologic conditions (such as sickle cell disease), diabetes, obesity, or a combination of these conditions. Unlike other respiratory virus vaccines that are administered annually, such as influenza, an RSV vaccine is administered only once, and the need for repeat vaccination is being studied.
The ACP Population Health and Medical Science Committee (PHMSC) developed the RSV practice points based on a rapid review by the ACP Center for Evidence Reviews. They addressed the efficacy, comparative effectiveness, and harms of RSV vaccines in adults aged 18 or older who were not pregnant or immunocompromised.
The PHMSC considered evidence on benefits (all-cause mortality, reduced RSV-related hospitalization or severe illness) and harms (such as Guillain-Barré syndrome) and concluded that the benefits of the protein subunit vaccines outweigh the harms in adults aged 75 years or older. The benefits, such as prevention of hospitalization, are lower in adults aged 60-74 years compared to those 75 years or older but with the same harms.
Related Evidence Review:
Efficacy, Comparative Effectiveness, and Harm of Respiratory Syncytial Virus (RSV) Vaccines in Adults Who Are Not Pregnant or Immunocompromised: A Rapid Review for the American College of Physicians
Abstract: https://www.acpjournals.org/doi/10.7326/ ANNALS-25-05536
Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To speak with someone at ACP, please contact Angela Collom at acollom@acponline.org.
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2. Breast MRI may offer added benefit for women with very dense breasts and high cancer risk
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00792
Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-26-00214
A collaborative modeling study found that adding biennial breast magnetic resonance imaging (MRI) to routine mammogram screening could avert more breast cancer deaths among women with extremely dense breasts and higher-than-average cancer risk. If MRI costs and false-positive biopsy recommendations are reduced, supplemental MRI directed to high-risk women with dense breasts could show promise. The study is published in Annals of Internal Medicine.
In response to new federally mandated breast density notification regulations, researchers funded by the National Cancer Institute aimed to determine when supplemental breast MRI is most beneficial for women receiving standard breast cancer screening. They used Breast Cancer Surveillance Consortium (BCSC) data with three Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer simulation models to compare clinical and economic population-level outcomes of digital breast tomosynthesis (a 3D mammogram) alone versus a 3D mammogram combined with MRI for women ages 40 and over at average to 4 times higher breast cancer risk levels. The results showed that mammography prevented the majority of breast cancer deaths, while adding MRI provided modest additional benefit and also led to more false-positive biopsy recommendations. When MRI was added for women with extremely dense breasts and at least double the average breast cancer risk, the balance of benefits and harms where comparable to mammography screening. The researchers conclude that supplemental MRI could be a reasonable option for higher-risk women with dense breasts, especially if MRI costs and unnecessary biopsies can be reduced.
Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Anna N.A. Tosteson, ScD please email Derik Hertel at derik.hertel@dartmouth.edu.
3. Metformin and ursodeoxycholic acid both fail to improve long COVID recovery in new clinical trial
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04883
A randomized clinical trial found that a two-week course of metformin or ursodeoxycholic acid (UDCA) did not meaningfully improve recovery from long COVID symptoms, despite earlier evidence suggesting metformin could lower long-term risk when taken during acute infection. The findings underscore the continued lack of proven treatments to alleviate symptoms of long COVID. The study is published in Annals of Internal Medicine .
Researchers from Asan Medical Center and Hallym University Kangnam Sacred Heart Hospital in Seoul tested whether short-term treatment with metformin, a common diabetes drug shown to reduce the incidence of long COVID by 41%, or UDCA, a liver medication with potential antiviral and immunomodulatory effects, could ease long COVID symptoms months after infection. Researchers randomly assigned 396 adults with persistent symptoms to receive metformin, UDCA, or placebo for two weeks in a double-blind trial conducted at two hospitals in South Korea between July 2024 to January 2025, with follow-up completed in April 2025. After eight weeks, recovery rates and symptom improvements were similar across all three groups, indicating neither drug helped patients recover faster or more completely than placebo. The authors conclude that while long COVID remains a major public health challenge, these widely used medications do not appear to offer a solution when given after symptoms have already developed. The findings highlight the need for further studies to support the development of targeted therapies addressing immune dysregulation in long COVID pathophysiology.
Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Sung-Han Kim, MD, PhD please email kimsunghanmd@hotmail.com or shkimmd@amc.seoul.kr.
Also new this issue:
The Case Against Six-Month Limits on Buprenorphine Telehealth Prescribing
Daniel Eisenkraft Klein, PhD, MSc; Madeleine Bullen, BS; David T. Zhu, BSc; and Aaron S. Kesselheim, MD, JD, MPH
Ideas and Opinions
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-04975
Annals of Internal Medicine
News article
People
Respiratory Syncytial Virus Vaccines in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points From the American College of Physicians
3-Mar-2026