Asthma Watch Time: 55 mins

touchEXPERT OPINIONS Severe type 2 asthma: Using biologics to move beyond symptom reduction

Watch leading experts discuss how to identify, assess and manage patients with severe type 2 asthma and consider the optimal use of biologic therapies to improve patient outcomes

This activity is intended for asthma specialists, respiratory care nurses, primary care physicians and other health care professionals involved in the treatment of patients with severe asthma.

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Dr Enrico Heffler
Humanitas University of Milan, Milan, Italy
Type 2 severe asthma: what is the mechanism of disease?

Dr Enrico Heffler, Assistant Professor in Respiratory Medicine at Humanitas University of Milan, Italy, discusses the type 2 inflammatory pathways that characterise type 2 severe asthma and the key roles played by type 2 cytokines in the inflammatory response. He also considers comorbidities mediated by the same cytokine signalling pathway associated with this disease subtype.

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  • What is type 2 asthma?
  • Which pathways are involved in the type 2 inflammatory response that characterizes this disease subtype?
  • What are the roles of the type 2 cytokines IL-4, IL-5 and IL-13 in the development of asthma?
  • What are the co-morbidities commonly associated with type-2 asthma?

Enrico Heffler is Assistant Professor in Respiratory Medicine at Humanitas University of Milan, Italy and consultant at the Personalized Medicine, Asthma & Allergy Unit of the same institution.

Dr Heffler is an Allergist and Clinical Immunologist with a research interest mainly in the field of asthma and other inflammatory airway diseases; in particular, his research is currently on severe asthma and its inflammatory mechanisms. He is author of more than 90 articles published in peer-reviewed journals.

Dr Heffler is currently an elected member of the European Academy of Allergy and Clinical Immunology (EAACI) Asthma Section Board.

Disclosures: Advisory boards participation and speaker for AstraZeneca, Circassia, GlaxoSmithKline, Nestlè Purina, Novartis, Sanofi-Genzyme, Teva.

 
Prof. Santiago Quirce
Hospital La Paz, Madrid, Spain
Type 2 severe asthma: why is additional control needed?

Prof. Santiago Quirce, Head of the Department of Allergy at University Hospital La Paz, Madrid, Spain, highlights the high unmet need in patients with severe type 2 asthma and provides his expert insights about the potential for a personalised approach to asthma and use of guideline recommendations for targeted therapies.

2/5 Next Interview
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  • What are the limitations of established treatments for managing patients with severe type 2 asthma?
  • What side effects are associated with the long-term use of OCS?
  • What are the potential advantages of molecular targeted therapies in severe type 2 asthma?
  • What are guideline recommendations for the management of severe type 2 asthma?

Santiago Quirce has been Head of the Department of Allergy at University Hospital La Paz, Madrid, Spain since 2007. He graduated in Medicine from the University of Santander, Spain, in 1983, and he obtained his PhD at the University of Cantabria in 1991. After completing specialty training in Allergology at Ramón y Cajal Hospital in Madrid, he spent one year as Research Fellow at Vancouver General Hospital, Respiratory Division, University of British Columbia (Canada). Then he joined Fundación Jiménez Díaz at Madrid, where he spent 9 years as a consultant allergist and clinical researcher.

Prof. Quirce has a broad research interest including asthma, rhinitis, and occupational allergy.

Prof. Quirce has edited and authored numerous publications and peer-reviewed papers, including 10 books. He has been a board member of the Asthma Committee of the World Allergy Organization (WAO), chair of the of the Asthma Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) and chair of the Interest Group on Occupational Allergy of the European Academy of Allergy and Clinical Immunology (EAACI).

Disclosures: Consultant to ALK, AstraZeneca, GlaxoSmithKline, Mundipharma, Novartis, Sanofi, Teva, and has received lecture fees from AstraZeneca, Chiesi, GlaxoSmithKline, Leti, Mundipharma, Sanofi and Novartis.

 
Prof. Marc Humbert
Université Paris-Saclay, Le Kremlin-Bicêtre, France
Biologics for type 2 severe asthma: understanding the mechanism of action

Prof. Marc Humbert, Professor of Respiratory Medicine at the Université Paris-Saclay in Le Kremlin-Bicêtre, France, describes the key signalling pathways targeted by biologic therapies in severe type 2 asthma and outlines the mechanism of action of available biologic agents as well as providing his expert insights about how their use may impact future approaches in clinical practice.

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  • What are the key targets for the biologic therapies used to treat severe type 2 asthma?
  • What is the mechanism of action of the biologic agents targeting the IL-5 pathway?
  • What is the mechanism of action of dupilumab, targeting the IL-4/IL-13 pathway?
  • What is the mechanism of action of omalizumab, targeting IgE?
  • Why are these agents important for clinical practice?

Marc Humbert, MD, PhD, is Vice-President of the European Respiratory Society and is Professor of Respiratory Medicine at the Université Paris-Saclay in Le Kremlin-Bicêtre, France. He is the Director of the Department of Respiratory and Intensive Care Medicine at the French Pulmonary Hypertension Reference Centre, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, France.

Prof. Humbert was the Chief Editor of the European Respiratory Journal from 2013 to 2017. He is currently Section Editor in charge of Pulmonary Vascular Medicine.

Prof. Humbert is a Fellow of the European Respiratory Society (FERS Foundation Fellow) and has received several distinctions including the 2006 Cournand Lecture Award, the 2009 Descartes-Huygens Award from the Royal Netherlands Academy of Arts and Sciences, the 2016 Rare Disease Award of the Fondation de France, and the 2018 ERS Award for Lifetime Achievement in Pulmonary Arterial Hypertension.
Since 2017, Prof. Humbert has been the vice-coordinator of the European Reference Network for rare and low prevalence respiratory diseases (ERN-LUNG). Clarivate Analytics listed Marc Humbert as one of the world’s highly cited researchers in the field of Clinical Medicine.

Disclosures: Personal fees from Acceleron, Actelion, Merck and United Therapeutics. Personal fees and grants from Bayer and GlaxoSmithKline.

 
Prof. Klaus Rabe
Clinic Grosshansdorf, Grosshansdorf, Germany
Biologics for type 2 severe asthma: what is the evidence?

Prof. Klaus Rabe, Professor of Pulmonary Medicine at the University of Kiel and Director of the Department of Pneumology at Clinic Grosshansdorf, Germany, reviews the key clinical studies relating to the use of biologics for the treatment of patients with type 2 severe asthma, including considerations for patient selection and treating those with comorbidities.

4/5 Next Interview
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  • What are the key clinical studies assessing biologics for the treatment of patients with type 2 severe asthma?
  • What are the efficacy and safety results from the clinical trials of biologic agents for patients with type 2 severe asthma?
  • How can an understanding of patient characteristics help select which biologic to use in your patient with type 2 severe asthma?
  • What is the evidence for the use of biologics in the treatment of patients with type 2 severe asthma who have comorbidities such as chronic rhinosinusitis with nasal polyps (CRSwNP)?

Klaus Rabe is Professor of Pulmonary Medicine at the University of Kiel and Director of the Department of Pneumology at Clinic Grosshansdorf. In addition, Prof. Rabe is Director of the Airway Research Center North (ARCN) and Member of the German Center for Lung Research (DZL).

He has been active in various fields of respiratory medicine worldwide; predominantly asthma, chronic obstructive pulmonary disease (COPD), lung cancer and interstitial lung disease. Prof. Rabe’s scientific interests are related to large clinical trials in COPD and asthma, the mechanisms of airway inflammation, and the endoscopic staging of lung cancer.

Prof. Rabe has served on various editorial boards as well as GINA (Global Initiative for Asthma) and GOLD (The Global Initiative for Chronic Obstructive Lung Disease). He was the first European Associate Editor of the American Journal of Respiratory and Critical Care Medicine and was Chief Editor of the European Respiratory Journal from 2003 to 2008. He is a member of the German and Dutch Chest Societies, the British Pharmacological Society, the American Thoracic Society, and was President of the European Respiratory Society from 2011to 2012.

 
Prof. Ian Pavord
The Oxford University Hospitals, Oxford, UK
Managing patients with type 2 severe asthma: biologics in the clinic

Prof. Ian Pavord, Professor of Respiratory Medicine at the University of Oxford and Honorary Consultant Physician at the Oxford University Hospitals, UK, shares his expert insights about managing patients with severe asthma including patient assessment, when to consider biologic therapy and how to monitor treatment, as well as discussing a case vignette to illustrate how patient care may be optimised in the clinic.

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  • How do you assess patients with severe asthma?
  • For which patients with severe asthma would you consider type 2 targeted therapy?
  • How do you decide which biologic to use first?
  • How do you manage and monitor type 2 severe asthma treatment?
  • In your experience, how is patient care best optimised in clinical practice?

Ian Pavord, MA DM FRCP FERS FMedSci is Professor of Respiratory Medicine at the University of Oxford and Honorary Consultant Physician at the Oxford University Hospitals. He was a Consultant Physician from 1995 and Honorary Professor of Medicine from 2005-2013 at the Institute for Lung Health, Glenfield Hospital, University Hospitals of Leicester NHS Trust. He was elected an NIHR Senior Investigator in 2011 and 2014, an inaugural Fellow of the European Respiratory Society in 2014 and a Fellow of the Academy of Medical Science in 2015.

His research interests include the clinical aspects of inflammatory airway diseases. He has identified clinically important phenotypes and biomarkers of inflammatory airway disease and has played a lead role in the clinical development of promising new treatments for severe airway disease.

Prof. Pavord was co-editor of Thorax from 2010-2015, Chief Medical Officer of Asthma UK from 2008-2014, Associate Editor of the American Journal of Respiratory and Critical Care Medicine from 2005-2010 and has been Associate Editor of the European Respiratory Journal since 2016. He is the author of over 430 publications. He received the 2016 European Respiratory Society (ERS) Gold Medal for his research and gave the Cournand Lecture at the 2004 ERS meeting. He chaired the 2017 Lancet Commission on asthma.

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Overview & Learning Objectives
Overview

Watch leading experts discuss how to identify, assess and manage patients with severe type 2 asthma and consider the optimal use of biologic therapies to improve patient outcomes

This activity is intended for asthma specialists, respiratory care nurses, primary care physicians and other health care professionals involved in the treatment of patients with severe asthma.

Learning Objectives

After watching this touchEXPERT OPINIONS, you should be able to:

  • Identify patients with severe type 2 asthma promptly, including those with co-morbidities
  • Describe the inflammatory pathways that drive type 2 asthma and are targeted by biologic therapies
  • Summarize the data supporting the use of biologics in patients with type 2 severe asthma, including those with co-morbidities
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