Pulmonary Fibrosis and COPD to Headline Thoracic Meeting

Jim Kling

May 11, 2015

DENVER — Details on treatments for idiopathic pulmonary fibrosis and improvements in the subtyping and treatment of chronic obstructive pulmonary disease (COPD) will be among the highlights at the American Thoracic Society (ATS) 2015 International Conference.

Trials of two new drugs for idiopathic pulmonary fibrosis — pirfenidone and nintedanib — were presented at last year's meeting. This year, analyses and extensions of those trials should illuminate the risk–benefit profiles of the drugs in various settings, as well as in the off-label use in interstitial lung diseases other than pulmonary fibrosis.

"These are studies that will broaden the area. It's really exciting. I will definitely crossover and look at that data, even though that's not my particular area of expertise," Gary Ferguson, MD, director of the Pulmonary Research Institute of Southeast Michigan in Livonia, told Medscape Medical News.

Dr Ferguson will present his own research on COPD at the meeting.

Overall, the organizers expect about 14,000 attendees, and the meeting will feature almost 5500 research abstracts and case reports.

This year will mark the 110th anniversary of the conference, and that milestone will be acknowledged during a plenary session that "will celebrate the past, present, and future of important achievements in pulmonary critical care medicine," said Irina Petrache, MD, from the Indiana University School of Medicine in Indianapolis, who is international conference chair of the meeting.

The primary focus of the meeting will be pulmonary medicine, critical care, and sleep, but other topics will also be addressed, such as allergy, immunology, and asthma; behavioral science; cardiology; environmental and occupational health; and infectious disease.

Therapies for COPD are likely to get a lot of attention at this year's meeting. Research will be presented on improvements in traditional therapies and on the newer biologics and targeted therapies.

In addition, subsets of COPD will be addressed. "We realize now there are more specific things going on, pathologically and biologically," said Dr Ferguson. "There are certain cytokines and chemokines that lead to inflammation and fibrosis, and we're able to selectively target them."

The COPD drug landscape is promising but complex. Dr Ferguson said he isn't expecting any big breakthrough clinical trials. However, although there will be nothing "earth-shattering," he explained, "there will be multiple companies with multiple interventions, all bringing something to the table."

Personalized Treatments

In a specific subset of patients, the presentation of comorbid COPD and asthma is unlike the presentation of either condition alone. Researchers are trying to better group patients and work out the type of inflammation involved. "The hope is that by targeting specific areas, we will get better responses in specific patients and not give medications to patients that won't provide much benefit," Dr Ferguson said.

"COPD is overdue for better phenotyping and personalized identification of subgroups of patients," said Dr Petrache.

In the past year, we've had some amazing breakthroughs, and I suspect you'll see even more here.

Lung cancer could also generate buzz at the meeting. In some cases, "if you have the right gene and the right target," the novel biologics "just melt these diseases away," said Dr Ferguson. "In the past year, we've had some amazing breakthroughs, and I suspect you'll see even more here."

It all adds up to much progress in the personalized treatment of lung and airway disease.

Genomic and proteomic studies began to tease out some of the differences between patients in the 2000s, and clinical applications are picking up steam. "I'm most excited about the advancement of those clinical trials," said Dr Petrache. "The studies take 5 to 10 years to conduct, so we're starting to see the fruit of that. I'm excited about learning the results and seeing them applied to various pulmonary diseases."

Dr Ferguson reports receiving research support from AstraZeneca, Boehringer Ingelheim, Forest, GlaxoSmithKline, and Pearl; being on advisory committees for AstraZeneca, CSL Behring, Boehringer Ingelheim, Novartis, and Pearl; and being a speaker for Boehringer Ingelheim, Forest, and GlaxoSmithKline. Dr Petrache has disclosed no relevant financial relationships.


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