Letter from the Editor

Dear Readers,

The ERS of 2023 was held live in Milan, Italy, with a lot of physical attendees. And many other interested colleagues followed many sessions online. Numerous speakers presented the most recent updates in important areas of pulmonary diseases. Some of these studies and findings are highlighted below.

Over 90% of patients with eosinophilic asthma who are effectively managed on benralizumab, an interleukin-5 receptor monoclonal antibody, can successfully be tapered from high-dose (HD) inhaled corticosteroids/ formoterol (ICS/F) within 32 weeks. Maintenance of the achieved lowered ICS dose was possible until week 48 in nearly 96% of participants.

Tezepelumab is a human monoclonal antibody that prevents thymic stromal lymphopoietin (TSLP) from interacting with its heterodimeric receptor. TSLP is involved in the inflammatory cascades of all asthma phenotypes and therefore offers the option of broadly influencing asthma pathophysiology. An analysis of the NAVIGATOR and DESTINATION long-term extension trials revealed that both biomarkers and clinical outcomes slowly decreased over 40 weeks. Further studies are now underway to explore a possible disease-modifying effect of tezepelumab.

A digital inhaler program resulted in significantly improved asthma control with clinical relevance. Adherence improved only in the short term but was not sustained after a year. However, asthma control remained improved in the long term.

Gabapentinoids, i.e. gabapentin and pregabalin, are anticonvulsants that are also indicated for neuropathic pain. Chronic obstructive pulmonary disease (COPD) patients treated with gabapentinoids faced a nearly 50% higher risk of severe exacerbations. Also, respiratory failure was markedly elevated while on this medication.

The observational FAntasTIGUE study explored possible causes of fatigue in patients with chronic obstructive pulmonary disease (COPD). Among the most significant influential factors were higher pain levels and poor sleep quality.

In an observational study, a diverse range of respiratory issues was discovered in the aftermath of a COVID-19 infection that persisted beyond the acute infection. The prevalence appeared to be higher among women.

An association between increased markers of myeloid inflammation and complement activation was identified in patients with long COVID symptoms. Patients exhibiting cognitive impairment or gastrointestinal (GI) symptoms had distinct inflammatory profiles.

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

Stay healthy and kind regards,

Prof. em. Richard Dekhuijzen