GAAPP 2020 Scientific Meeting Summary

Thanks to all who could participate in our 4th scientific meeting on June 8th directly.
For all who did not have the opportunity to participate in the virtually meeting we provide the audio files attached.

Here is a short summary of each speaker’s contribution.

We had four very great speakers who talked about highly topical issues.

  • Prof. Ioana Agache, Past-President EAACI
  • Prof. Tobias Welte, Past-President ERS
  • Patrice Becker M.D., Section Chief, Ashtam and Airways Biology, NIAID/DAIT/AAABB
  • Prof. Andrew Menzies-Gow, Severe Asthma specialist and NHS England’s National Clinic Director for Respiratory Services

Prof. Agache: “EAACI Guidelines: House Dust Mite-driven Allergic Asthma”

https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.13749

o 85% kids with asthma have allergies
o HDM allergy in 20-40% adults with asthma
o Model 1 vs Model 2 approach
o Update to AIT guidelines:

  • HDM tablets – Moderate recommendation Adults
  • HDM Drops – Low recommendation Adults & kids
  • HDM SCIT – Low recommendation Adults & kids

Prevention in kids with AE or strong atopic history—yes—may improve lung functionin small airways

Prof. Agache: “Recommendations on the Use of Biologicals in Severe Asthma”

https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.14235

o Biologic treatment (benralizumab, dupilumab and omalizumab) will be decided upon phenotype and endotype (depending on biomarkers and
comorbidities)
o Shared Decision Making plays a key role in SA treatment choice
>Phenotype + Biomarker + Desired Outcome Shared Decision Making between patients and & HCP
> Initiate 3 months trial & evaluate response
o Please check the Biomarker slide and Comorbidity slide!

Prof. Welte: “Respiratory Diseases and COVID-19”
He reported about an interesting link to Italy Fashion Week & spread from China and the super-spread from the Austrian ski area Ischgl to most Iceland cases.
Spread of disease due to Day 5 before symptoms & PCR testing in first 5 days negative Progression of COVID – Day 14 is key – recovery or progression to ARDS
Fatigue most notable symptom for weeks post COVID
Angiogenesis dependents on affected cells. COVID-19 is an endothelial disease; flu
affects epithelial
Comorbidities: Cardiovascular & Metabolic most common for complication
– Asthma 9% &
– COPD 5%
– Hypertension 56%
– Diabetes 32%
Treatment: Heparin for all patients – all other treatments are experimental
EOS depletion? Welte had patients on biologics with COVID
High eNO High ICS/LABA
No secondary infections seen yet

Prof. Becker: NIH/NIAID
o Her institute is conducting two studies about:

  • Ped allergy & asthma COVID study: within 2000 families; post hospitalization
    study, 1 year post COVID
  • Changes in the immune system: Immune signatures of those who have
    complications vs those who do not

o ACT Treatment Trial—Remdesivir vs Remdesivir +////Mederna vaccine Phase I
o Vaccine likely to be available in 2021 or later; Treatment likely in late 2021-2022
o Patient Engagement in R&D—PFDD, Patient Advocates, Ad Boards, trial design
o Unified airway approach to stop COVID in nasal passage before entering lung

Prof. Menzies-Gow: The Future of Severe Asthma – Advancing the Science
o 48% of asthma patients have never seen a specialist
o >50% of asthma related healthcare costs are caused by 10% of asthma population
o Epithelium seems to be key sensor for external environment; forms
protective barrier; produces cytokines
o Cytokines trigger downstream inflammation process
o TSLP, IL33, IL25 interrupt earlier in cascade
o Some patients claim complete remission of asthma
o OCS Stewardship; 17% OCS rx by PUD (must do better given long-term side
effects of OCS!)

Download the Summary: