ERS International Congress, Madrid 2019

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Beyond T2 mechanisms in asthma: who are the other players?

Hot topic
Chairs: K. Chung (London, United Kingdom), M. Al-Ahmad (Kuwait, Kuwait), N. Jarjour (Madison, United States of America)
Aims: to identify the unmet need for a valid definition of non-T2 severe asthma; to discuss current definitions and their limitations (including those in the relevant ATS/ERS and GINA guidelines); to emphasise the role of corticosteroids in supressing T2 activity and the need for stepdown trials to define non-T2 disease; to ascertain the role of sex hormones in the pathogenesis of asthma onset, progression and/or exacerbations; to discuss the potential for targeting sex hormones and identifying new pathways that can be exploited for therapeutic interventions; to discuss the role of airway dysbiosis in severe asthma and the potential for targeting the microbiome with antibiotics, probiotics or phage therapies; to review novel clinical trial designs employing complex interventions to treat non-T2 severe asthma, focusing on comparisons with standard of care and methods to integrate these trials into existing monoclonal therapy pathways; to discuss the role of adaptive clinical trials and multi-arm multi-stage trial designs in the context of severe asthma; to highlight parallels with other disciplines such as oncology and rheumatology.

Defining non-T2 asthma: moving beyond the absence of T2 activity S. Siddiqui (Leicester, United Kingdom)
The role of sex hormones in severe asthma A. Bossios (Stockholm, Sweden)
Targeting microbes and dysbiosis in severe asthma J. Simpson (New Lambton, Australia)
Lots of promising targets and biomarkers, but how can we deliver the next generation of severe asthma trials? L. Brown (London, United Kingdom)