Trends in European respiratory medicine in 2019
As medical communicators, we regularly attend international medical meetings. On behalf of our clients, we host live and virtual symposia, organise booth activities and monitor trends in research and therapeutic options which we compile in client-specific congress reports.
The European Respiratory Society (ERS) was one of the highlights of our year in respiratory medicine. Among the many therapy-based findings presented there, the following study results and hypotheses struck us as particularly interesting:
Chronic Obstructive Pulmonary Disease COPD
- Data collected from natural experiments and through indirect multinational observational studies has now firmly established that air pollution is a highly contributing factor to the development of COPD. [1, 2]
- A meta-analysis of seven different studies generated the hypothesis that it may be safer to inhale combination therapies in multi-or single-dose inhalers rather than a multihaler, as the latter appears to increase the risk of pneumonia. [3, 4]
- Recent studies have highlighted the importance of personalising LAMA/LABA treatment (long-acting muscarinic antagonists/ long acting beta agonists bronchodilators; current cornerstones of COPD treatment). Identifying different phenotypes will enable tailored treatment, using the most favourable LAMA/LABA combination for each individual.[5-7]
- The NIVO study from 10 UK hospitals reported that in patients ventilated for COPD exacerbation, there was an increased burden of cardiovascular disease associated with increased mortality. [8]
Idiopathic Pulmonary Fibrosis (IPF) and other Interstitial Lung Diseases (ILDs)
- Data from the German INSIGHTS-IPF registry showed an improved survival of patients receiving anti-fibrotic therapy vs those who did not receive therapy. [9]
- Antifibrotics have also been shown to reduce the progression of progressive fibrosing ILD, and to slow the decline of lung function in patients with a range of fibrosing lung diseases.[10-13]
- In patients with systemic sclerosis (SSc)-ILD, antifibrotics were beneficial in reducing ILD progression irrespective of lung fibrosis level at baseline, when measured at 52 weeks.[14]
Pulmonary Vascular Disease (PVD)
- In a first controlled trial examining the role of immunotherapy in treatment of serious forms of pulmonary arterial hypertension (PAH), it was shown that adjunctive B-cell depletion therapy was a safe and potentially effective treatment for systemic sclerosis-associated PAH.[15]
These studies provide a glimpse into the ever-evolving landscape of respiratory medicine. Whilst many mainstays of treatment remain the same, refinements in their use have been shown to be invaluable. Each study presented at ERS represents another step forward, and highlights key directions for future research.
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Reference
- Doiron, D. et al. 2019. Eur Resp J.; 55(2). DOI: 10.1183/13993003.02140-2018
- Yan, P. et al: Int J Chron Obstruct Pulmon Dis. 2019; 14: 1517–1526. doi: 10.2147/COPD.S190600
- Han M et al. ERS 2019;48:234 (oral presentation).
- Lai C et al. Int J COPD 2019;14:1539-1548.
- Rogliani P et al. ERS 2019;PA3378.
- Salvi S et al. ERS 2019;PA2476.
- Trinkmann F et al. ERS 2019;PA3379.
- Lane N et al. ERS 2019;PA2655.
- Juergen B et al. ERS 2019;51:250 (oral presentation).
- Flaherty K et al. ERS 2019; 253:RCT1881 (oral presentation).
- Flaherty K et al. N Engl J Med 2019; doi: 10.1056/NEJMoa1908681.
- Maher T et al. ERS 2019;253:RCT1880 (oral presentation).
- Maher TM et al. Lancet Respir Med 2019; doi: 10.1016/S2213-2600(19)30341-8.
- Maher T et al. ERS 2019;392:OA3599 (oral presentation)
- Zamanian R et al. ERS 2019;253:RCT1884 (oral presentation).
