NeumoChiesi 2019 reinforces its commitment to respiratory diseases

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Date: 22/10/2019

Barcelona, October 22, 2019. NeumoChiesi, is consolidated as a reference appointment in the field of pulmonology. This year, the scientific event, organized by Omniprex with the scientific endorsement of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) and sponsored by Chiesi, has celebrated its ninth edition in Zaragoza with the assistance of more than 300 specialists. “Today, pulmonology has as challenges: to lead the knowledge, treatment, and management of respiratory and thoracic diseases; thoughts to change and the vision of the future; and add value to the vocation”, explains Dr. Julio Ancochea, from the University Hospital of La Princesa de Madrid and member of the Scientific Committee.

 

In NeumoChiesi 2019 the focus has been placed on three pathologies: asthma, COPD and bronchiectasis. In addition to the pathophysiological basis of these diseases, novelties in diagnosis and latest advances and therapeutic challenges, professionals have addressed current issues such as, for example, artificial intelligence.

As in previous editions, NeumoChiesi 2019 has had the participation of an important panel of national and international experts gathered by a Scientific Committee formed by Dr. Àlvar Agustí, Dr. Àlvar Agustí, from  Instituto Respiratorio del Hospital Clinic de Barcelona; el Dr. Julio Ancochea, from Hospital Universitario de La Princesa de Madrid; el Dr. Marc Miravitlles, from Hospital Universitario Vall d’Hebron de Barcelona; Dr. Luis Perez de Llano, from Hospital Universitario Lucus Augusti de Lugo; and  Dr. Vicente Plaza, from Hospital de la Santa Creu i Sant Pau de Barcelona.

 

Asthma Treatment: An Exciting and Hopeful Moment

Incorporating new drugs is helping the healthcare professional to better understand pathologies such as asthma, which can guarantee a great clinical improvement to these patients. “We are in an exciting and hopeful moment in which, each time, we have a greater number of treatments aimed at the different therapeutic targets and clinical profiles (phenotypes), with new molecules under investigation with very promising results. The future of asthma is personalized medicine, we are moving from "coffee for all" to "a la carte coffee"”, said Dr. Ancochea.

Faced with data on the lack of asthma control currently in existence and the high percentage of therapeutic non-compliance among patients, professionals point out that the future of treatment in mild asthma should be aimed at using therapies with more flexible dosages aimed at improving the underlying inflammation and the future risk that this entails of exacerbations and deterioration of the pulmonary function, at the same time that the reality of the treatment of a disease such as chronic asthma is adapted, but of variable course in time.

 

COPD: Moving towards personalized medicine

COPD is a complex and heterogeneous disease that requires a multidimensional assessment and individualized treatment. Precisely, as regards treatment, progress is being made towards more personalized medicine that takes into account the associated comorbidities. "In their latest versions, both the GOLD document and the GesEPOC guide, propose a categorization of patients, according to ABCD scheme or clinical phenotypes respectively, aimed at achieving greater personalization of the treatment," explained Dr. Julio Ancochea.

The important pharmacological development in this area in recent years has given rise to new combinations of drugs that allow a better adaptation to the clinical characteristics of the patient, having demonstrated its efficacy in randomized clinical trials. In this regard, the professionals gathered at NeumoChiesi 2019 have stressed that, “currently, we have two combinations of LABA / LAMA / CI in a single device (triple fixed therapy) that have proven their effectiveness in patients with moderate-severe COPD not properly controlled in terms of reducing moderate-severe exacerbations, decreasing hospitalizations, improving lung function and quality of life, with an acceptable safety profile.”

 

Bronquiectasias

What is the relevance of bronchiectasis today? This question has been reflected during NeumoChiesi 2019. Today, bronchiectasis is the third cause of obstructive airways disease, after COPD and Asthma. "The number of patients with bronchiectasis is increasing, according to the aging of the population, its relationship with chronic diseases and accessibility to the diagnostic gold standard that is HRCT," said Dr. Ancochea.

This reality is a challenge for the pulmonologist, who must understand that bronchiectasis is a complex and heterogeneous disease. "We could talk about ‘bronchiectatic syndrome’ in which there are different clinical connotations," experts said. This complexity or heterogeneity explains, in part, the lack of clinical evidence. “Sometimes, treatment is more guided by experience (clinical practice or trajectory in diseases such as cystic fibrosis) than by evidence. And it is not due to a lack of effort in conducting clinical trials. Perhaps due to this complexity or heterogeneity, or to an error in choosing the main outcomes of the trials, there is little evidence. It occurs in such an important aspect as the use of inhaled antibiotic therapy in chronic bronchial infection by Pseudomonas aeruginosa in reducing exacerbations.” Therefore, Clinical Guides such as the SEPAR Regulations are helpful.

However, experts point out that the interest in this pathology makes it possible to affirm that we are going through a “good time” in regard to treatments and that the treatments are directed towards personalized medicine in which we try to phenotype (clinical features) and endotyping (biopathological features) to patients