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ERS Congress Milan 2017: Key highlights

27.09.2017

HRW - ERS International Congress 2017 image

The ERS Congress, which took place this September in Milan, was a huge five day event, where 22,000 delegates from all over the world came together to participate in an impressive scientific and educational programme, to share the latest inspiring, innovative and exciting information in the respiratory space through exhibitions, presentations and posters.

To give an idea on the sheer number of participants and size of the event, one coffee machine at the GSK exhibit stand had produced almost 2000 free shots of coffee in the space of 6 hours. Multiply that by all the major exhibitors giving away free coffee over five days, and that’s a lot of people, and a lot of caffeine!

So what would we say were the key highlights from the ERS congress?

Asthma and COPD:

Unsurprisingly, asthma and COPD had a major focus throughout the Congress, where the main stand out points were:

  • Device use: Did you know that 75% of patients are probably not using their device correctly, and there has been no improvement over the past 20 years? Consequently, many companies have been highlighting how their device can help both reduce the risk of patient error and improve the method of drug delivery to improve outcomes, as well as provide education and training for both patients and HCPs. When we went to view the poster session for this area, we struggled to view the posters due to the huge number of people there, which clearly demonstrated the huge interest in this area.
    • For example, a study carried out by the Groningen Research Institute (Metting et al.) evaluated several sub-studies on the issues around current inhaler instructions, where suggestions for improvement included: improving communication between healthcare providers, increasing physician awareness of the different characteristics of inhalers to choose the best suiting inhaler for each patient, regular training for healthcare professionals, and yearly follow-up for patients.
  • Personalised therapy: We are noticing this trend across many therapy areas, and the idea of personalised therapy, or ‘phenotyping’ patients, is causing a huge amount of excitement in the asthma and COPD space, as this leads to the potential for HCPs having the resources available and the knowledge to really provide the best treatment for each patient.
    • For example, Sanofi Genzyme, together with Regeneron, had a large focus specifically on ‘Type 2 asthma’, and how it encompasses a range of biomarkers and phenotypes driven by Type 2 inflammation. The idea was that we should look beyond eosinophil and IgE levels to get a clearer picture of type 2 inflammation, and that the pathobiology of Type 2 asthma is driven by Type 2 cytokines.
  • R&D investment: There is a huge amount of competition in the asthma and COPD area, leading to the important question of ‘how can we really differentiate our product and company in this respiratory space’? It’s clear from just looking at the exhibitors that there is a huge drive by some companies into R&D and future products for asthma and COPD, which as well as leading to further differentiation, demonstrates company commitment and leadership in this area. Buzzwords from the congress include: biologics, immunotherapy, Type 2 inflammation, phenotyping patients, and looking into underlying causes of asthma and COPD (rather than the treatment itself). Consequently there is a lot of excitement, as well as high expectations, for the future of asthma and COPD patients.
  • GOLD guidelines update: The new GOLD 2017 guidelines, where classification of patients is now based on symptom severity and exacerbation risk, prompted a series of posters and presentations on the correct diagnosis, assessment, treatment and management of COPD patients. It seems that more patients may now fall into Categories A & B than with the previous classification system, and this of course has an impact on the most appropriate treatments for patients, particularly in these two categories.
    • There was a high level of interest in the use of triple therapy in GOLD B COPD patients. Current GOLD management strategy recommends the use of a triple combination only in group D patients; however, TRINITY and TRILOGY studies demonstrated that, in addition to group D patients, extrafine triple therapy reduces moderate/severe exacerbations also in GOLD B patients. The session was so well attended that Caroline and I couldn’t physically get in the room, and we had to watch the presentation on a small TV screen instead!

Less common respiratory diseases:

So how else can companies demonstrate leadership, innovation and commitment to respiratory diseases? Well, by expanding their portfolio into less well known conditions, such as IPF, PAH and SSc-ILD:

  • Idiopathic Pulmonary Fibrosis (IPF): Both Roche and Boehringer Ingelheim had impressive and interesting stands on IPF, which highlights not just their investment into products to slow the progression of IPF, but also around the importance of understanding the patient journey – from increasing awareness of symptoms of IPF to promote earlier diagnosis, to understanding the IPF patient and specific management required.
  • Pulmonary Arterial Hypertension (PAH): Similar to IPF, many presentations and posters focused on the patient journey, including enhancing diagnosis in PAH (and SSc-ILD), evaluating the importance of risk assessment, understanding outcomes that are most important to the patient, and looking into technology such as mobile apps to improve patient management.

Making an impact through digital offerings:

Anyone who has heard of, or even owned, a Fitbit, can tell you how compelling it is to monitor your own diagnostics over time and share this information with others – even your GP. For example, Caroline’s handy app told us that we walked just over 10km on Monday, which highlights pretty well the impressive size of the congress! There is a lot of excitement in this field: from a HCP perspective of being able to adequately monitor their patient and provide the most appropriate treatment, to a company perspective of being able to provide an add-on benefit to their products. This future digital offering was highlighted throughout the congress in a variety of ways:

  • Education and training of correct inhaler use through a VR headset
  • Inhaler usage data captured on patient’s smartphones
  • Use of augmented reality to bring a future concept to life
  • “App” for patients to improve monitoring and control. For example, Herrero Martin et al. assessed a self-monitoring patient diary mobile app, evaluating factors such as asthma control, early acute exacerbation treatment and app adherence. Preliminary results showed relatively good adherence, a decrease in primary care visit and inpatients, and an improvement in asthma control.

Menarini even tried bringing the COPD patient to life through in a 3D room, which was certainly memorable, although we have to say that the demonstration by Boehringer Ingelheim of Respimat inhaler technology through a VR headset was a breath-taking experience, and really demonstrated the power of using new technology to engage and educate physicians and patients.

HRW attendance at key healthcare conferences and events

Through regularly attending conferences, such as the ERS Congress, we are proud to say that we are always up to date with the latest developments, innovations, and ‘hot topics’ in the healthcare arena. If you have any questions, or would like to know more about our expertise in any therapy area of interest, please get in touch – we’d love to hear from you!

By Elizabeth Openshaw

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