COPD is a leading cause of death in the United States and around the world, necessitating collaboration and innovation from investigators and clinicians to improve disease management and prevention. During CHEST 2024, multiple sessions will explore novel insights, current debates, and best practices for treating patients with the disease.

Controversies in COPD

Presenters will discuss three hot topics that affect the daily care of patients with COPD in the session, Pro-Con Debate: Current Controversies in COPD, Monday, October 7, at 9:15 am ET, in Room 253B of the Boston Convention & Exhibition Center.

The first debate will center on two differing guidelines for accurately defining airflow obstruction in COPD—one from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and one a joint effort from the American Thoracic Society and European Respiratory Society.

Next, attendees will hear opposing views on whether clinicians should routinely measure patients’ peak inspiratory flow before prescribing a dry inhaler. While this approach offers helpful insights, some experts assert that there are alternative, more efficient ways to identify patients’ ideal inhaler delivery method.

The last debate will weigh the optimal initial therapeutic strategy for patients who are categorized as GOLD Group E because of frequent COPD exacerbations or flare-ups. While GOLD recommends prescribing dual bronchodilators, published studies show that triple therapy, with an added inhaled corticosteroid, could be the superior option to reduce patients’ future risks of exacerbations.

“Each of these controversies is intended to be clinically relevant for attendees, and the pro-con approach will hopefully help them consider the best or most appropriate strategies to apply these lessons in their practices,” said Session Chair, Donald A. Mahler, MD, FCCP, Emeritus Professor of Medicine at the Geisel School of Medicine at Dartmouth.

Bronchoscopic management of COPD

Experts will explore multiple technologies that are shifting the paradigm of COPD management during Beyond Bronchodilators: Bronchoscopic Management of COPD, Monday, at 4:30 pm, in Room 205C of the convention center.

“Patients with COPD are showing tremendous interest in new or emerging therapies, and I want providers to be ready for those patient-driven inquiries,” said Session Chair, Jonathan Kurman, MD, MBA, FCCP, Assistant Professor of Medicine at Medical College of Wisconsin. “If we don’t lead the charge, our patients will.”

Session speakers will highlight bronchoscopic lung volume reduction, which has revolutionized COPD management and spurred the investigation of procedural interventions for other aspects of COPD, including bronchoscopic fissure completion using a polymer sealant to limit collateral ventilation between lobes in patients with emphysema.

Presenters will also discuss how bronchial rheoplasty and metered spray cryotherapy can reduce goblet cell hyperplasia and mucous hypersecretion in patients with chronic bronchitis, and when targeted lung denervation using radiofrequency ablation can be utilized to reduce COPD exacerbation frequency.

Current therapies in COPD

The session COPD: Making the Most Out of Current Therapies, Tuesday, October 8, at 9:15 am, in Room 210B, will spotlight some of the currently available therapeutic options for reducing COPD exacerbations and improving patients’ quality of life and survival rates.

Presentations will detail strategies to optimize disease management with home oxygen therapy and respiratory muscle training. Speakers will also cover the most recent evidence related to inhaler therapy and evidence around choosing between azithromycin and roflumilast to reduce hospitalizations for COPD.

“There are some aspects of COPD management that aren’t quite clear in terms of best practices, and not all providers are familiar with the latest COPD guidelines or research,” said Session Chair, Daniel Howell, MBBS, MSc, Clinical Assistant Professor at NYU Grossman School of Medicine. “With this session, I hope we can address some of these areas where there might be controversy or a lack of familiarity.”

In addition to detailed analyses of the evidence behind these treatments, attendees will be exposed to hands-on practice with various devices to develop confidence and familiarity with them moving forward.

Therapeutics for advanced COPD

Speakers representing different subspecialties within pulmonary medicine will provide a comprehensive overview of how to treat patients with particularly complex or advanced COPD during Beyond Inhalers: Therapeutics for Advanced COPD, Wednesday, October 9, at 2:15 pm, in Room 206AB.

“COPD isn’t one uniform disease; it’s quite heterogeneous,” said Session Chair, Philip Choi, MD, Clinical Associate Professor at NYU Grossman School of Medicine. “Beyond the inhalers we use for nearly everyone, we want to spotlight these different therapies that can help manage specific subsets of [patients with COPD] to meet their unique needs.”

Presenters will review noninvasive ventilation for managing patients with COPD and chronic hypercapnic respiratory failure, bronchoscopic and surgical lung volume reduction, lung transplantation, and the developing field of biologics in COPD.