The 27th European Respiratory Society Congress was held on 9–13th September 2017 in Milan, Italy. This is the world's largest meeting in the field of respiratory disease, and presented the latest scientific advances in respiratory care as part of an educational programme designed to address the needs of researchers, clinicians, general practitioners, and allied health professionals.
Among the congress highlights, GlaxoSmithKline announced positive results from the Salford Lung Study in asthma, which showed that that initiation of once-daily fluticasone furoate/vilanterol (Relvar Ellipta®) was superior to usual care in achieving a consistent improvement in patient’s asthma control over the 12-month study duration. Other key presentations from GSK’s 45 abstracts included the first efficacy and safety data from METREX and METREO, two phase III studies of mepolizumab, an investigational add-on treatment for patients with eosinophilic chronic obstructive pulmonary disease (COPD). In the overall population, the effects of mepolizumab were modest, but when the population was stratified for blood type, researchers identified a particularly responsive population. In addition, new data was presented from the FULFIL study, which is comparing the effects of the once-daily investigational closed triple combination therapy fluticasone furoate/umeclidinium/vilanterol with twice-daily budesonide/formoterol (Symbicort® Turbohaler®) in patients with advanced COPD. The study has demonstrated clinically meaningful and statistically significant benefits in lung function, health-related quality of life and the annual rate of moderate/severe exacerbations.1
Among 10 abstracts presented by Teva Pharmaceutical Industries Ltd, eight presentations showcased reslizumab (CINQAERO®), a humanized interleukin-5 antagonist monoclonal antibody for the treatment of severe eosinophilic asthma. These included post-hoc pooled analyses from two 52-week trials evaluating the effect of reslizumab on reducing clinical asthma exacerbations as well as improving lung function, asthma control and quality of life. In addition, two presentations focused on inhaler technology, including real-word data indicating that budesonide/formoterol fumarate dehydrate (DuoResp Spiromax®) inhaler is non-inferior to Symbicort® Turbohaler® in terms of the control of asthma and COPD.2
Highlights of AstraZeneca’s presentations included results from the PATHWAY phase IIb study, which shows that tezepelumab, a novel anti-thymic stromal lymphopoietin monoclonal antibody, significantly reduced the rate exacerbations in patients with severe, uncontrolled asthma. Tezepelumab may be a promising option for patients with uncontrolled asthma despite treatment with long-acting β-agonists and medium-to-high doses of inhaled glucocorticoids. Data was also presented from INCONTROL 1, a first-of-its-kind post-hoc analysis of a large pooled data set of phase III COPD studies. This analysis identified patient characteristics that may interact with the treatment response to budesonide/formoterol versus formoterol alone, and also examined the relationship between blood eosinophil levels, risk of exacerbation and treatment selection in COPD. A new post-hoc analysis of the SIROCCO and CALIMA phase III trials reinforced previous efficacy data for benralizumab, an anti-eosinophil monoclonal antibody, and identified factors that predict an enhanced response to benralizumab for severe, uncontrolled asthma. AstraZeneca also presented data highlighting advances in our understanding of disease modification, personalised medicine and drug delivery technology.3
Mundipharma announced new data from four studies demonstrating efficient drug delivery characteristics with flutiform® K-Haler®, a novel, breath-triggered inhaler, currently in development. Results from the AffIRM study, the largest ever real-world flutiform study, showed that the proportion of patients with well-controlled asthma more than doubled 12 months after switching to flutiform pMDI (pressurised metered dose inhaler) compared with baseline.4
Roche announced new data on pirfenidone (Esbriet® ) for idiopathic pulmonary fibrosis (IPF). Data from a new 6-month study showed that the combination of pirfenidone and nintedanib has a similar safety profile to that expected for each treatment alone. A second, retrospective, post-hoc analysis suggests that treatment with pirfenidone may be associated with a reduction of multiple progression events as well as reduction of deaths after one or more progression events. In a third study, involving real-world data from over 1,000 European patients, no new safety signals were observed.5 Also on the subject of IPF, FibroGen, announced positive results from their phase 2b randomized, double-blind, placebo-controlled study on pamrevlumab, a proprietary, first-in-class antibody targeting connective tissue growth factor.6
Also at the meeting, Circassia Pharmaceuticals announced the European launch of the NIOX VERO® nasal application for the screening of primary ciliary dyskinesia (PCD), a genetic condition that can lead to permanent lung damage for which early diagnosis and treatment is essential.7 In addition, CSA Medical hosted a mini-symposium highlighting three-month data in its feasibility study utilizing the RejuvenAir® Metered Cryospray™ System, which is under development for the treatment of chronic bronchitis.8
The ERS has teamed up with the New England Journal of Medicine and Lancet Respiratory Medicine, where this year’s most important studies have been published.
References1. GSK, GSK presents respiratory data from pipeline to clinical practice at ERS, www.gsk.com/en-gb/media/press-releases/gsk-presents-respiratory-data-from-pipeline-to-clinical-practice-at-ers/ (accessed 21 September 2017).