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ERS 2020 Articles

Declaration of sponsorship Novartis Pharma AG
Read time: 30 mins
Last updated:11th Nov 2020
Published:30th Sep 2020

Explore this section for the latest updates in asthma diagnosis, treatment and management from ERS International Congress 2020 Virtual.

The hot topic articles have been developed by EPG Health for Medthority. This content has been developed independently of the sponsor Novartis Pharma AG, who have had no editorial input into the content.

Rethinking asthma

Discover the latest updates in asthma diagnosis, treatment and management from ERS International Congress 2020 Virtual. From the contribution asthma phenotypes and endotypes could make in daily clinical practice to the latest research on the role of pharmacotherapy in the management of disease.

Despite significant advances in asthma diagnosis, treatment and management, the burden of asthma remains high1. A hot topic at European Respiratory Society (ERS) 2020 this year was the need to rethink asthma, sharing the latest updates on diagnosis, treatment and management.

The following sessions are some of the highlights you may have missed, examining the role of existing therapies and addressing the concerns around the use of oral and inhaled corticosteroids. New treatments across the spectrum of asthma as well as the role that asthma phenotypes and endotypes may play in daily clinical practice were also featured.

Maximising the benefits of inhaled therapies in asthma

In this session, Professor Christine Jenkins alongside Professors Kenneth Chapman and Richard Van Zyl-Smit, addressed the current challenges in maximising the benefits of inhaled asthma therapies such as treatment mismatch (patients remaining uncontrolled despite use of long-acting β2-agonist/inhaled corticosteroid [ICS/LABA]), low adherence and the misuse of inhaler devices.

The panel also shared new evidence and key clinical data related to new inhaled therapies – indacaterol/glycopyrronium/mometasone furoate (IND/GLY/MF) and IND/MF via Breezhaler®.

Professor Kenneth Chapman explored uncontrolled asthma in the 21st century, sharing insights into the importance of asthma control, the relationship between exacerbations and control as well as adherence and persistence - two fundamental issues for improving control.

Two presentations by Professors Richard Van Zyl-Smit and Christine Jenkins focussed on maximising the potential of inhaled therapies. These presentations shared the results of the Novartis ‘PLATINUM’ programme which included the QUARTZ, PALLADIUM, IRIDIUM and ARGON studies. These studies characterised the efficacy and safety profile of IND/MF and IND/GLY/MF in patients with uncontrolled asthma.

Focusing on lung function, Professor Van Zyl-Smit demonstrated how once daily IND/MF showed sustained lung function benefits over twice-daily MF or twice-daily high-dose salmeterol/fluticasone propionate (SAL/FLU) and how once-daily IND/GLY/MF had sustained lung function benefits over IND/MF, twice-daily SAL/FLU and a free combination of SAL/FLU + tiotropium (TIO).

Professor Jenkins then described the secondary outcomes of the studies, including asthma control and asthma exacerbations.

She revealed that once-daily high-dose IND/GLY/MF significantly improved asthma control compared with both SAL/FLU and a free combination of SAL/FLU + TIO. Further, once-daily high-dose IND/GLY/MF significantly reduced the rate of all exacerbations compared with twice-daily SAL/FLU and moderate exacerbations compared with free combination SAL/FLU + TIO. Both IND/GLY/MF and IND/MF were well tolerated, with comparable safety across treatment arms.

Ending with a panel discussion, the faculty discussed key topics such as the extent to which complexity is driving poor adherence, the most important components that account for the efficacy of the new IND/GLY/MF combination regimen and the practicalities of stepping up and stepping down from these three drug regimens.

Rethinking asthma

This fascinating session, chaired by Professors Daiana Stolz and Thomas Geiser, aimed to give insights into management strategies and new treatments across the spectrum of asthma as well as present the evolution in our understanding of asthma phenotypes and endotypes and their relevance in daily clinical practice.

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Digital health in airway disease

Find out the latest updates on digital health in airway disease including the potential role of digital technology to enhance the diagnosis, treatment and management of asthma from ERS International Congress 2020 Virtual.

Around the world, digital technology is becoming an ever-growing presence in daily life. The surge of these new technologies is also giving rise to new opportunities in the diagnosis and management of conditions such as asthma, chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD).

The following sessions are some of the highlights you may have missed at European Respiratory Society (ERS) 2020, discussing topics such as enhancing asthma classification and precision medicine as well as a look at existing technology and what the future may bring for digital health.

AI: are the doctors still needed?

From playing chess to driving cars, artificial intelligence (AI) is beginning to change the world around us. In this session on the use of AI in respiratory medicine, Dr Marko Topalovic posed the question - with the development of AI, are doctors still needed?

To answer this, Dr Topalovic described what makes AI intelligent and how AI can use data from asthma, COPD or ILD patients to learn their characteristics. The ability to learn from large quantities of data has already given AI a large range of capabilities including aiding diagnoses, robot-assisted surgeries and medication management.

Dr Topalovic also shared the capabilities of AI in the three main fields that are pioneering AI research in respiratory medicine - thoracic imaging, histopathology and cytology, and physiological measurements.

But what lies in store for AI in the future? Do doctors still have a place in medicine? Ending the session on a positive note, Dr Topalovic also explained the various ways in which AI is a great tool to enhance the work carried out by doctors.

Digital health: a brave new world?

This symposium covered a wide range of updates on digital health from the utility of sensors, trackers and monitors to the promising role of artificial intelligence in future digital trials.

Dominique Hamerlijnck gave an overview of recent advances in using e-Health to help patients and the importance of trust in algorithms and the doctor-patient relationship.

To ensure that caregivers are fully taking advantage of technology and digital services, Professor Lars Kayser shared a new multi-dimensional model for eHealth literacy and the need to develop digital resources that are accessible.

Dr Omar Usmani identified the drivers of digital health in asthma and the different technologies utilised in asthma health, including asthma apps and ‘multi-featured digital health systems’. He also highlighted the current and future challenges for digital health in asthma.

Looking at how AI could improve the future of clinical trials, Professor Konstantinos Kostikas shared the drawbacks of complex clinical trials and the potential for AI to transform clinical trial design, from study preparation to execution, and improve clinical trial success rates.

Closing the session, Dr Vitalii Poberezhets provided clinicians with the patient perspective on the utility of sensors, trackers and monitoring.

The new reality: better asthma care supported by digital health solutions

In this Novartis-sponsored industry symposium, Professors David Price, Konstantinos Kostikas and Dr Holger Woehrle explored how digital solutions have the potential to address unmet needs in inhaled asthma therapies, especially in adherence.

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The environmental impact of asthma and COPD therapy

Many inhalers for conditions such as asthma contain propellants that are known to be potent greenhouse gases, but is the global warming potential of these inhalers having a significant impact?

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Latest insights in respiratory management

Find out the latest insights in asthma and COPD management from ERS International Congress 2020 Virtual, sharing updates in prevention, risk mitigation, diagnostics, treatment and management strategies.

Effective respiratory management is essential for improving the quality of life of patients with respiratory disease. At the European Respiratory Society (ERS) 2020, a wide range of engaging sessions provided the latest insights in respiratory management.

The following sessions are highlights you may have missed on this topic including asthma management in adolescent and young adult patients, the need to consider a gender perspective in severe asthma patients and the impact of fear, anxiety and wellbeing in chronic lung diseases.

Successfully managing adolescent and young adult patients with asthma

In this expert view, Professor Graham Roberts described the challenges faced by adolescents and young adults with asthma and their at-risk status as patients.

These challenges included an increased rate of mortality as well as being overlooked in terms of service provision and training for healthcare professionals. Psychological factors also play a role with social anxiety, depression and stress impacting adolescents and young adults with asthma.

These issues were further explained in the ‘fear and anxiety, psychological wellbeing and prevention of psychological distress in chronic lung diseases’ session below.

So how can we better support adolescents? The need to have an adolescent-specific approach to asthma management was emphasised by Professor Roberts and included various options such as direct appropriate education, simple treatment regimens and methods for enabling adolescents and young adults to better self-manage their asthma.

Professor Roberts also shared the possibility of working in collaboration with colleagues to develop an adolescent and young adult clinic and the benefits of seeing adolescents on their own.

Find out the latest insights in asthma and COPD management from ERS International Congress 2020 Virtual, sharing updates in prevention, risk mitigation, diagnostics, treatment and management strategies.

A ‘gender phenotype’ does really exist in severe asthma

The difference in clinical and functional features in severe asthma between is poorly understood. In an intriguing ePoster, Sonia Rizzello describes her study into the clinical, functional and biological features of patients with severe asthma according to their gender.

Examining a variety of factors including quality of life, asthma control and lung function, Rizzello et al. revealed a significantly higher lung hyperinflation in female patients with severe asthma. Studies such as this further reinforce the need for a gender perspective in investigating severe asthma patients.

Fear and anxiety, psychological wellbeing and prevention of psychological distress in chronic lung diseases

Chaired by Professors Marion Delcroix and Thierry Troosters, this comprehensive session identified fear anxiety as important risk factors and explored various approaches to minimise these risks.

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Early life origins of respiratory illness

Explore research into the complex mechanisms and pathways involved in the relationship between early-life events and chronic respiratory diseases that is opening up new opportunities for the treatment and management of respiratory illness.

Chronic obstructive respiratory disorders, such as asthma and chronic obstructive pulmonary disease (COPD), begin in early life. Various factors have an impact on respiratory health, including genetic predisposition and environmental exposures. Some of these factors may be modifiable, such as smoke exposure and diet, while others are more difficult to influence, such as early exposure to viruses or allergens.

An understanding of these critical early stages and mechanisms can help determine early disease biomarkers and risk profiles that are predictive of chronic respiratory conditions.

The following sessions from European Respiratory Society (ERS) International Congress 2020 Virtual explore this relevant topic, from physical activity in childhood to the relationship between reduced size during foetal life and early time to onset of asthma symptoms.

Physical activity and childhood asthma

A rise in asthma prevalence over recent decades has coincided with a global increase in obesity and a decrease in physical activity levels1. Does this mean there is a link between asthma and physical activity?

In this session, Dr Marianna Eijkemans described the well-established link between obesity and asthma in adults and children. She also explored the multifactorial pathophysiology of asthma and the role of inflammation and environmental factors such as diet, vitamin D intake and physical activity.

However, the potential link between physical activity and asthma remains unclear. Sharing the various potential causes, Dr Eijkemans explored the possibility of physical limitations due to asthmatic symptoms, fear of asthma attack and the potential for physical activity to influence the inflammatory state.

Ending with a clinical year in review, Dr Eijkemans also shared several notable articles that investigated the link between physical activity levels and asthma in children.

This session revealed the importance of considering environmental factors when treating childhood asthma, such as diet and physical activity. However, the potential association between physical activity and asthma is still very much the subject of debate.

Reduced antenatal and birth size and time to onset of asthma

In this ePoster session, Professor Stephen Turner described his study into the potential relation between reduced size during foetal life and early time to onset of asthma symptoms. By comparing routinely acquired foetal, neonatal and maternal data collected between 1987 and 2015 with asthma-related hospital admission and prescribing data, Professor Turner revealed that small for gestational age (SGA) is a strong predictor of early onset asthma.

Respiratory diseases in children and adults

This thought-provoking session covered the early life origins of asthma and COPD with Professors Sejal Saglani and Alvar Agusti, as well as risk factors for cystic fibrosis (CF) and lower respiratory tract infections with Professor Stephen Stick and Dr Jessica Rademacher.

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