Letter from the Editor

 

Dear Reader,

As expected, the ATS 2021 was held online, due to the COVID-19 pandemic. Again, numerous speakers were able to present the most recent updates in important areas of pulmonary diseases. Some of these studies and findings are highlighted below.

As a high viral load of SARS-CoV-2 was linked to worse outcomes of COVID-19, monoclonal antibodies with the ability to counteract the virus have come into focus for possible treatment. The casirivimab and imdevimab combination comprises 2 potent neutralising monoclonal antibodies that bind non-competing epitopes on the SARS-CoV-2 spike protein. In patients with mild-to-moderate COVID-19, this combination showed a risk reduction for death of over 70%, and also a 4-day reduction of disease duration.

Even with air pollution levels decreasing during the lockdowns, the COVID-19 pandemic has highlighted adverse health impacts of air pollution. Air pollutants increase the fatality of viral infections. In a Chinese study during the SARS epidemic, the fatality rate increased with the increment of the air pollution index. This was now also demonstrated in the COVID-19 pandemic.

Healthcare workers (HCW) are more likely to get infected (7.3%) compared with non-HCW (0.4%). Duration of symptom prevalence was additionally followed, and even though most subjects were not hospitalised, some of their symptoms were longer lasting. Fatigue and chest tightness persisted in almost 20% of positive cases of HCW.

The GINA guidelines no longer recommend short-acting β2-agonists (SABA) as needed as sole treatment. Interesting data for step 2 have now been presented. As-needed ICS-formoterol reduces the risk of exacerbations compared with as-needed SABA. In real-world studies, it also reduced severe exacerbations and had a similar effect on symptom scores compared with regularly scheduled ICS, with a lower ICS dose.

The IL-4/13 blocker dupilumab has been shown to be effective in adolescents and adults with moderate-to-severe asthma. The VOYAGE trial showed that dupilumab reduced exacerbations in schoolchildren with uncontrolled moderate-to-severe asthma by >50% compared with placebo. The safety profile was similar to that seen in adolescents and adults.

An observational study assessed the influence of earlier versus later therapy with the tyrosine kinase inhibitor nintedanib in patients diagnosed with idiopathic pulmonary fibrosis. Early therapy was associated with less hospitalisations and a reduction of all-cause medical costs.

This report outlines the most significant advancements discussed at the ATS conference. So, we hope that you will enjoy reading this Conference Report!

Stay healthy and kind regards,

Prof. Richard Dekhuijzen

Biography:

Prof. P.N. Richard Dekhuijzen is Professor of Pulmonology at the Radboud University Medical Center in Nijmegen, the Netherlands. His specific area of clinical and research interest includes asthma, COPD, and inhalation technology. He studied medicine at VU Amsterdam and completed his training in pulmonology at the Onze Lieve Vrouwe Gasthuis in Amsterdam and in the Academic Hospital Nijmegen. In 1989, he finished his PhD thesis on training of the respiratory muscles in COPD, followed by a PhD thesis on steroid induced myopathy of the diaphragm in 1994 at the Catholic University Leuven (Belgium). He is author/co-author of over 330 peer-reviewed papers and many textbook chapters on respiratory medicine. From 2008-2010, he was Head of the Cardiology Department at Radboudumc. Until 2016, he chaired the Department of Pulmonary Diseases, the Heart-Lung Centre Nijmegen, and the Medical Staff at Radboudumc. He is the scientific chair of the Aerosol Drug Management Improvement Team (ADMIT) and chair of the Dutch Inhalation Technology Working Group. Currently, he is chair of the Medical Ethical Committee of the Radboudumc.

Conflict of Interest Statement:

In the last 3 years, Richard Dekhuijzen and/or his department received research grants, unrestricted educational grants, and/or fees for lectures and advisory board meetings from AstraZeneca, Boehringer-Ingelheim, Chiesi, GSK, Mundipharma, Novartis, Sandoz, Teva, and Zambon.

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Posted on 5 July 2021