The  second day of AAAAI 2012 was again full of clinically-relevant sessions and papers, and one of the hot topics being discussed was the effectiveness of immunotherapy in asthma. This has proven to be one of the more contentious areas of debate among our KOLs. 

Previous research showed that one major unmet need in asthma is the lack of effective treatment for severe uncontrolled asthma, and all KOLs in Europe and the US expressed their frustration about this situation. 

The oral and poster sessions of the American Academy of Allergy, Asthma, and Immunology (AAAAI) 2012 Annual Conference kicked off on Saturday, and there have already been numerous presentations of new evidence that are likely to impact clinical practice. However, among the multitude of papers, we have chosen to focus on a poster that will likely intensify the ongoing debate about whether the combination of inhaled corticosteroid therapy and long-acting beta-2 agonist (ICS/LABA) should be used as initial maintenance therapy.

Welcome to Part 2 of Sociable Pharma’s preview of the American Academy of Allergy, Asthma, and Immunology 2012 Annual Meeting. In our first preview blog, we highlighted some of the ‘must-see’ papers being presented that may have an impact on clinical practice and the competitive landscape in asthma.

In this part of the preview, we will continue our analysis, focusing on the three remaining themes: optimizing the combined therapy of inhaled corticosteroids and long-acting beta-2 agonists; the effectiveness of immunotherapy; and developments in asthma and COPD pipelines.

Welcome to Sociable Pharma’s preview of the American Academy of Allergy, Asthma, and Immunology 2012 Annual Meeting, a conference that will be full of insightful presentations to address the challenges facing doctors in the treatment of asthma.

With the input of our KOLs, Sociable Pharma has identified six key clinical practice themes that will feature prominently at the upcoming event and which we will cover in this preview blog.

For each theme, we have identified some ‘must see’ papers that we believe will likely have a major impact on clinical practice.

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), cigarette smoking is the primary cause of COPD, and smoking cessation is the single most efficacious and cost-effective intervention to reduce the risk of developing COPD and stop its progression. However, quitting smoking can be a challenging task and very often, it requires pharmacological intervention.

Sociable Pharma’s recent research showed that choosing an appropriate initial maintenance treatment for patients with asthma continues to be a significant challenge for doctors. Although guidelines recommend the use of inhaled corticosteroid (ICS) therapy, there is ongoing debate about whether leukotriene receptor antagonists (LTRAs) - primarily montelukast and zafirlukast - should be the first-choice option, and recent evidence suggests that this debate is only likely to intensify.

A recent study appears to suggest that scientists have found a way to restore steroid sensitivity in patients with COPD, opening the door to potential treatments that may end the ongoing controversy about the use of inhaled corticosteroids (ICS) in this disease.

The controversy of ICS therapy in COPD stems from the fact that there was little scientific evidence of their benefit prior to their adoption in the disease, with their use primarily being based on their effectiveness in asthma.

For many years there has been the assumption that better compliance leads to improved outcomes in the treatment of asthma, and this maxim has driven much of the R&D activity in the area. However, this assumption has been profoundly challenged by a recent study.

A large cross-sectional study from the US focused on children hospitalized due to an asthma attack showed that no matter how well a hospital complies with a post-hospitalization home care plan, it has no effects on subsequent emergency department (ED) visits or hospital re-admissions by patients.

Sociable Pharma recently attended the European Respiratory Society 2011 Annual Meeting and, among the many themes and topics discussed, one emerged that had previously been overlooked by many. This new topic was the impact that better treatment of small airway disease may have on clinical practices in asthma and COPD. 

The increasing importance of this issue was reflected by the number of presentations on the topic during the conference. In fact, there were three 2-hour symposia alone solely dedicated to discussing small airways in both diseases. 

There were a number of clinical themes in asthma and COPD that developed during the third day of the ERS 2011 Annual Meeting. These included some exciting areas such as exhaled biomarkers in clinical practice and novel immunotherapy for asthma. However, there were also more ‘traditional’ areas of discussion such as evolving treatment strategies with tiotropium in asthma, understanding the burden of chronic respiratory diseases, managing COPD co-morbidities in primary care, and insights into the perennial problem of COPD exacerbations.