Rabu, 30 Agustus 2017

First Results of Biologics for COPD Eagerly Awaited

First Results of Biologics for COPD Eagerly Awaited


MILAN — Biologics, which have shown promise in severe asthma, are now being studied in chronic obstructive pulmonary disease, and early findings will be among the highlights at the upcoming European Respiratory Society (ERS) International Congress 2017.

“We’re looking forward to hearing the results,” said Guy Brusselle, MD, from the Department of Respiratory Medicine at Ghent University Hospital in Belgium, who is chair of the ERS science council.

New guidelines, including recommendations for COPD exacerbations with acute respiratory failure, will be released at the meeting.

This will be “a much-anticipated session,” Dr Brusselle said. “This is a big step forward for a major health concern. We’re expecting this session to be highly attended and we hope the guidelines will be implemented in clinical practice.”

New Guidelines

Other guidelines will be launched throughout the conference. One set will address novel approaches to the prevention of hospital-acquired pneumonia. Another will make recommendations on the detection and treatment of tuberculosis (TB).

Multidrug-resistant TB will be under the microscope at the congress, especially the development of mycobacterial infections resistant to current TB drugs.

“Novel treatments for drug-resistant TB are very expensive, so it’s becoming extremely important to diagnose TB as soon as possible and to treat it properly from beginning,” explained ERS President Guy Joos, MD, from the Department of Respiratory Medicine at Ghent University Hospital.

Otherwise, the risk for drug-resistant strains of TB increase, putting the infected individual and the population at further risk for infection or death. “We have to mitigate this nightmare,” he explained.

Drug resistance — including issues related to the overuse of antibiotics, particularly in patients with asthma — will be a hot topic at the meeting. “This leads to antimicrobial resistance. We’re looking at this on pan-European and world levels,” Dr Joos pointed out.

Passionate Debate

There will be a debate about how to treat obstructive sleep apnea and a discussion on whether treatment with nasal continuous positive airway pressure throughout the night is beneficial for obese patients with respect to cardiovascular outcomes.

“A recent study shows negative results, so this is sure to be a lively debate at the symposia covering this dilemma,” Dr Brusselle said.

Diesel fuel will be discussed at length. “Outdoor air pollution from diesel exhaust particles is linked to respiratory morbidity and mortality. This is a very hot topic for all of us, especially in light of the recent Volkswagen Dieselgate scandal,” Dr Brusselle explained.

The car manufacturer admitted to evading emissions regulations and specialists will discuss the problem and evaluate the damage to human health.

For the second time, live endoscopies will be performed during a full-day session. Participants will be able to watch procedures performed in real time, ask questions, and interact with the physicians performing the procedures.

Live Endoscopies to Be Performed

There will be a link between the auditorium and the operating theater where invasive pulmonologists will be working. “The procedure will be explained and experts will show their techniques,” Dr Joos told Medscape Medical News.

There will also be a panel of experts to answer questions. “It’s a live experience, so is really something special,” he said. “It was a well-attended and highly successful session when we did it the first time in Amsterdam in 2015,” he said. “I’m hoping to get to that one myself.”

Dr Joos said he is looking forward to hearing more about real-life adherence to bronchiectasis guideline recommendations when the ERS and EMBARC Bronchiectasis Registry results are presented. “This area does not have a lot of research evidence yet, and is a really important hot topic.”

The ERS has teamed up with the New England Journal of Medicine and the Lancet Respiratory Medicine, where the most important studies will be published, to present lunchtime sessions that are not to be missed, Dr Joos pointed out. The session on lung cancer for the pulmonologist will be chaired Jeff Drazen, MD, editor-in-chief of the New England Journal of Medicine.

“We’re also going to hear the increasing evidence that we need to screen for lung cancer with CT scanning in high-risk patients, including heavy smokers,” he noted. “Researchers know that the screening is necessary, but there are questions as to how, which patients, and how to organize and implement this in clinical practice.”

The treatment of lung cancer with tumor immune checkpoint inhibitors will be discussed during several symposia, including a lunchtime session.

Bringing Together Physicians and the Public

Several health campaigns will be launched during the congress, such as the Healthy Lungs for Life campaign, which continues the 2016 theme of Breathe Clean Air and places special attention on smoking cessation and air quality. There will also be a lung function spirometry testing event for the public at the Piazza Castello in Milan, run by the European Lung Foundation, which was founded by the ERS to bring together patients and the public with respiratory professionals to positively influence lung health.

In addition, congress organizers will be collecting signatures on a petition that asks the World Health Organization to recognize September 25 as World Lung Day.

“The day would be devoted to raising awareness about world lung health, the role of pollution, and cigarette smoke. We want to put lungs on the world stage that day, about a week and a half after the conference, and encourage people to hold their own Healthy Lungs for Life events,” Dr Joos explained. “We look forward to seeing this go through.”

Dr Brusselle reports financial relationships with AstraZeneca, Boehringer-Ingelheim, Chiesi, GSK, Novartis, Sanofi, Teva, and Zambon. Dr Joos reports financial relationships with AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Novartis, and Teva.

Follow Medscape Pulmonary Medicine on Twitter @MedscapeLung and Ingrid Hein @ingridhein



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